Mast cell blocking improves outcome after experimental intracerebral hemorrhage

Abstract

Intracerebral hemorrhage (ICH) accounts for 15% of all strokes and is associated with high mortality and disability, because of mass effect and brain swelling. This study was based on our previous finding of 50% reduction of ischemic brain edema by mast cell (MC) blocking. In autologous blood injection model we treated one group (n=11) with a MC stabilizer, and the control group (n=11) with saline 5 minutes before induction of ICH. One hour later, MRI was performed. 24 hours later we scored the neurological score and repeated MRI in survivors. Neurological score in the treatment group were statistically significantly better than in the control group (P<0.001). There was a 55% mortality rate in the control group and no deaths in the treatment group (p<0.01) by 24 hours. There was statistically significant difference in growth of brain edema between the groups (P<0.001). We found highly significant correlation between neurological score and hemisphere volumetric growth during 24 hours (R = 0.8, P<0.001, Fig. 1). There was statistically significant difference in hematoma volume at 24 hours (P<0.001), while hematoma volumes were not significantly different at baseline (P = 0.97). MC blocking significantly improved clinical outcome and reduced mortality in experimental ICH. We found 4 times less brain swelling and 1.5 times lesser hematoma volume in the treatment group at 24 hours. MC contain potent vasoactive and proteolytic substances and their functional inhibition should be further studied as a potential pharmacological approache to limit tissue injury and fatal outcomes after ICH.