Abstract
BackgroundHydrocephalus is a common and major complication that affects outcome after intraventricular hemorrhage (IVH). While aging impacts the occurrence of hydrocephalus in patients with IVH this and the underlying mechanisms have received little attention. The present investigation, therefore, studied the impact of aging on hydrocephalus after IVH in a rat model.MethodsYoung and aged (3 and 18 months old, respectively) male Fischer 344 rats had an intraventricular injection of 200 μl autologous blood or saline. Ventricular volume was estimated using magnetic resonance imaging (MRI), while ventricular wall damage, heme oxygenase-1 (HO-1) and epiplexus cell activation were quantified by histological staining and Western blot. Additionally, the impact of intraventricular iron injection was examined in young and aged rats.ResultsIntraventricular injection of autologous blood induced hydrocephalus in both young and aged rats but ventricular volumes were larger in aged rats compared to young rats from day 3 to day 14 followed IVH. In addition, ventricular wall damage and periventricular HO-1 upregulation were greater in aged versus young rats on day 1 after IVH. Aged rats also had more choroid plexus epiplexus cells on day 14 after IVH. Additionally, organized hematomas were observed in 23% (3/13) of aged rats but not in young rats after IVH. Organized hematomas in aged rats showed larger T2* lesions on MRI compared to rats with non-organized hematomas. Similar to the effects of IVH, intraventricular injection of iron resulted in more epiplexus cells activation and more severe hydrocephalus in aged compared to young rats.ConclusionsIVH causes more severe hydrocephalus in aged compared to young rats. Enhanced ventricular wall damage, epiplexus cell activation and iron overload may contribute to this aggravated hydrocephalus development in aged animals.
Highlights
Hydrocephalus is a common and major complication that affects outcome after intraventricular hemorrhage (IVH)
We found that spontaneously hypertensive rats exhibited epiplexus cell activation during the hydrocephalus that normally occurs during development in that strain [10]
Ventricle enlargement in young and aged rats after IVH Intraventricular injection of 200 μl autologous arterial blood resulted in bilateral ventricles enlargement of both young and aged animal in serial magnetic resonance imaging (MRI) scanning (Fig. 1a)
Summary
Hydrocephalus is a common and major complication that affects outcome after intraventricular hemorrhage (IVH). While aging impacts the occurrence of hydrocephalus in patients with IVH this and the underlying mechanisms have received little attention. The present investigation, studied the impact of aging on hydrocephalus after IVH in a rat model. Intraventricular hemorrhage (IVH) secondary to intracerebral hemorrhage (ICH) or subarachnoid. Wan et al Fluids Barriers CNS (2020) 17:8 over 12,000 infants develop hydrocephalus after IVH per year [3]. In the Surgical Trial in Intracerebral Hemorrhage (STICH) Trial [1], the mean age was 60.9 years in patients with secondary IVH following ICH. 58% of the patients greater than or equal to 50-year-old developed hydrocephalus after IVH, compared to only 41% of patients less than 50-year-old. The mechanisms by which aging might impact IVH-induced brain injury and hydrocephalus development are still unclear
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