Reflex Spasm Research Articles

Ethyl alcohol. Influence on the dynamics of blood supply of skin and other soft tissues during their sudden cooling

It is shown that in norm (i.e. in sober people in the absence of ethyl alcohol in blood) sudden local cooling of skin and soft tissues of different parts of the body from +37 to +18 °С and below (but not below 0 °С) causes in the cooled tissues 2-phase change in the value of blood vessels tone, their blood filling, intensity of blood supply and feeling of painfulness. Thus from the first seconds of cooling the tone of blood vessels of muscular type begins to increase, their blood filling begins to decrease, skin color lightens and soon in the cooled area of the body there is a feeling of acute soreness. After a few tens of seconds of cooling, the spasm of blood vessels reaches maximum values, their filling with blood decreases to a minimum, the skin turns white, and the soreness reaches maximum values. These changes persist at their peak for a few minutes, after which they begin to disappear, despite the persisting hypothermia. But then, after 10-15 minutes of cooling, hyperemia inevitably develops in the hypothermia zone, as a result of which the soreness disappears and the skin reddens. It is established that in the norm, sudden cooling of tissues causes irritation of temperature receptors located in them. The resulting excitation of temperature receptors causes reflex spasm of blood vessels, which has an adaptive value, as it is evolutionarily developed for temperature homeostasis of warm-blooded organism. It has been found out that acute painfulness accompanying cold spasm of blood vessels arises due to mechanical squeezing of pain receptors located under the muscular layer in the wall of blood vessels. On the other hand, the presence of ethyl alcohol in the blood (the presence of alcohol intoxication) fundamentally changes the dynamics of blood supply of tissues at their sudden cooling: during cooling, blood vessels expand and overflow with blood without the initial phase of spasm and the appearance of a sense of pain. At the same time, hyperemia persists not only throughout the cooling period, but also after it. In other words, alcohol intoxication is manifested by the immediate development of hyperemia and redness of the skin in the cooled area of the body without the initial spasm of blood vessels, the appearance of a feeling of soreness and pallor of the skin in the area of cooling.

The use of sodium thiosulfate in the treatment of hemorrhoids

Hemorrhoidal disease is one ofthe most common pathologies ofthe anorectal region, its specific weight in the structure of diseases ofthe colon is about 40%. Hemorrhoids are a socially significant disease, most often found in the able-bodied population. The reason for the development of hemorrhoids, on the one hand, is a violation of blood circulation in the cavernous corpuscles, due to which they increase and nodes form, and on the other hand, dystrophic changes in the ligamentous apparatus of hemorrhoids, in connection with which they gradually shift down and begin to fall out of the anal canal. One of the factors provoking the development of hemorrhoidal disease may be the presence of dissinergia of the pelvic floor muscles, which, in accordance with the Roman criteria IV, is part of the functional constipation syndrome. Not only dissinergia, but also high basal pressure in the anal canal (increased tone of the internal anal sphincter) can lead to stool retention. High rates of basal anal pressure can occur as a result of damage to the mucous membrane of the anal canal during straining, which leads to reflex spasm of the anal sphincter (anal continuity reflex). Thus, a vicious circle can form and thereby exacerbate constipation and the course of hemorrhoidal disease. Also, the relationship between dysenergic defecation and hemorrhoidal disease can be justified by the fact that physiotherapy aimed at correcting the work of the pelvic floor muscles contributes to better control over the manifestations of hemorrhoidal disease in complex therapy. The return of symptoms or, in other words, the recurrence of the disease in patients after surgery for hemorrhoids more often occurs with concomitant constipation. In accordance with clinical recommendations for the treatment of hemorrhoids, the use of an adequate amount of fluid and the intake of dietary fiber (fiber preparations) is indicated to normalize the activity of the gastrointestinal tract and eliminate constipation as part of complex therapy. If it is impossible to take dietary fiber, laxatives come to the fore of constipation therapy. This article presents clinical examples of the efficacy and safety of using sodium picosulfate.

Severe near Reflex Spasm in a Healthy Teenager. A Case Report

Spasm of the near reflex usually includes accommodative spasm, esophoria/tropia, and different degrees of miosis. Patients usually refer to distance blurred and fluctuating vision, ocular discomfort, and headaches. The diagnosis is established with refraction with and without cycloplegia; most of the cases have a functional etiology. However, some cases require neurological conditions to be ruled out; cycloplegics have an important diagnostic and therapeutic role. To describe a case of bilateral severe accommodative spasm in a healthy 14-year-old teenager. A 14-year-old boy with progressive diminished visual acuity attended for YSP consultation. The diagnosis of bilateral spasm of the near reflex was made, based on a gap refraction of 9.75 D between retinoscopy with and without cycloplegia and esophoria with normal keratometry and axial length. The spasm was eliminated with 2 drops of cycloplegic in each eye separated by 15 days; no clear etiology was found other than the start of school. Clinicians should be aware of pseudomyopia, especially in children with acute changes in visual acuity, who are usually exposed to myopigenic environmental factors that induce overstimulation of the parasympathetic third cranial nerve's innervation.

Accommodative spasm and its different treatment approaches: A systematic review.

This article is about the accommodation spasm. The primary rule for near vision is ciliary muscle constriction, synchronised convergence of both eyes, and pupil constriction. Any weaknesses in these components could result in an accommodative spasm. Variable retinoscopic reflex, unstable refractive error, and lead of accommodation in near retinoscopy are common causes of spasm. We conducted a thorough literature search in the PubMed and Google Scholar databases for published journals prior to June 2022, with no data limitations. This review contains twenty-eight case reports, six cohort studies, four book references, four review articles, and two comparative studies after applying the inclusion and exclusion criteria. The majority of studies looked at accommodative spasm, near reflex spasm, and pseudomyopia. The most common causes of accommodative spasm are excessive close work, emotional distress, head injury, and strabismus. Despite side effects or an insufficient regimen, cycloplegic drops are effective in diagnosing accommodation spasm. The modified optical fogging technique is also effective and may be an option for treating accommodative spasm symptoms. Bifocals for near work, manifest refraction, base-in prisms, and vision therapy are some of the other management options. As a result, it requires a comprehensive clinical treatment strategy. This review aims to investigate the various aetiology and treatments responsible for accommodative spasm and proposes widely implementing the modified optical fogging method and vision therapy in clinics as comprehensive management to reduce the future upward trend of accommodative spasm.

Изменения функционального состава тромбоцитов у пациентов с политравмой

Акутальность. Политравма остается главной причиной глобальной заболеваемости и смертности и является причиной более 10 % смертей. Цель: изучить данные литературы об изменениях показателей сосудисто-тромбоцитарного гемостаза у пациентов с политравмой, исследовать динамику морфофункционального состояния тромбоцитов, проанализировать изменения показателей внутрисосудистой активации тромбоцитов у пациента с политравмой. Результаты. Для нормального свертывания крови нужны как минимум 4 компонента — кровеносные сосуды, тромбоциты, способность крови к свертыванию и фибринолиз. Определение таких компонентов, как показатели внутрисосудистой активации тромбоцитов, может стать важным шагом оценки нарушений тромбоцитарного звена гемостаза у пациентов с политравмой. Сосудисто-тромбоцитарный гемостаз начинается рефлекторным первичным спазмом артериол, после чего возникает вторичный спазм артериол, дальше образуется первичная тромбоцитарная пробка (адгезия и агрегация) и, соответственно, консолидация тромба, в результате чего формируется окончательный тромбоцитарный тромб. Еще до контакта тромбоцитов с обнаженным коллагеном происходит первичная активация тромбоцитов. Сначала меняется форма интактных тромбоцитов с дискоидной формы к активированым клеткам — дискоэхиноцитам, сфероцитам и/или сфероэхиноцитам. Нами установлено, что на 3-и сутки после травмы при нормальном количестве тромбоцитов в венозной крови уменьшается количество интактных тромбоцитов — дискоцитов, растет количество активных форм тромбоцитов — дискоэхиноцитов и сфероэхиноцитов, соответственно, растет общая сумма активных форм тромбоцитов. Нормальный уровень тромбоцитов у пациентов с политравмой может замаскировать выраженность коагулопатии, а проведение исследований показателей внутрисосудистой активации тромбоцитов может стать диагностическим компонентом сосудисто-тромбоцитарного звена гемостаза у пациентов с политравмой. Выводы. У пациентов с коагулопатией вследствие политравмы на 3 сутки наблюдаются изменения показателей внутрисосудистой активации тромбоцитов и агрегации тромбоцитов, индуцированной адреналином и АДФ.

Ethical Issues at the Interface of Physiotherapy Care and Research Practice in Pediatric Oncology-Descriptive Study

Pediatric oncology has a major role in research. This paper discuss about the ethical consequences ofphysiotherapy care and research in Pediatric Oncology. Empirical ethics is a broad division,grasping,difference in indicatingethics and empirical research. A major Australian tertiary teaching hospital revealsthat 65 % of patient presents with specific indication for physiotherapy, in that only12.8% are receivingphysiotherapy. Indications includes in physiotherapy care are pain, lymph- oedema, incontinence, respiratoryand musculoskeletal Problems also it includes hard to move. Physiotherapy has extensive role inpalliativeoncology, it also has large preventative ,educative and supportive roles to play and provides independentand complementary therapies for physical debility and pain. Pain from reflex spasm and contracture aredealt with Physiotherapists. Founded that no reference based on standard of life and quality-adjusted lifeyears in terms of preventing dependance and avoid hospitalisation. Treatment of pediatric oncology oftenhas physically, socially and psychologically demands. Always there must be some ethical reason for allthe decision on treatment and care for a patient with cancer. It is a fact that ethics needs not only all thestakeholders to do the right things but also it needs the one who do it in the right way. Research practice hasled us to great advances in pediatric oncology and the proportion is greater in children than adults. Obtainingthe informed consent and assent was the most important ethical challenges faced during the research.

КОМПРЕСІЙНА АСФІКСІЯ


 
 
 Compression asphyxia is a type of mechanical asphyxia when breathing stops with external pressure on the body, which leads to the absence of respiratory movements and disrupts venous return from the head. With a strong compression of the chest, a reflex spasm of the glottis occurs, which contributes to an increase in intrathoracic pressure, reverse venous blood flow and an obstruction of venous flow to the heart occur. A sharp increase in intracranial pressure and venous congestive congestion / hemorrhage deepen central respiratory failure. Mild degree: mental agitation; puffy face, slight cyanosis; individual conjunctival petechiae; tachypnea. Medium degree: light or heavy stunning, lost orientation; the face is puffy, cyanotic; swelling of the cervical veins, acrocyanosis; multiple petechiae that spread across the face, neck, conjunctiva of the eyes, inspiratory dyspnea, visual impairment. Severe degree: stupor or coma, sharp cyanosis of the whole body, exophthalmos; swelling of the face, neck and shoulder girdle, arms, multiple petechiae of the face, neck, arms, legs, conjunctiva of the eyes, swelling of the cervical veins, cyanosis and edema of the upper half of the body; superficial breathing, frequent, in the absence of treatment passes to agonal and apnea. Intensive care includes analgesia, oxygenation or mechanical ventilation, anticonvulsant, dehydration and decongestant therapy, prevention of acute kidney damage, DIC, septic complications, and treatment of posthypoxic encephalopathy.
 
 

A Rare Cause of Diplopia: Functional Near Reflex Spasm

Introduction: Many serious neurological and ophthalmological diseases are reported in patients presenting to the emergency service with the complaint of diplopia. Near reflex spasm is a rare cause of diplopia, which may mimic abducens nerve palsy.Case Report: A 27-year-old female presented to the emergency service with the complaint of diplopia and blurred vision. There was no drug usage or exposure to toxic substances. In the physical examination, convergent strabismus was observed and the pupils were miotic. Ciliary spasm was detected in the ophthalmologic examination. The results of the examinations for organic etiologies were negative. The patient recovered after the application of cycloplegic drops and the arrangement of treatment after psychiatric examinations.Conclusion: Considering near reflex spasm in patients presenting with diplopia could save the emergency services, where time is important, from unnecessary further examinations. It should not be forgotten to pay attention to miosis because it is the most important clue evocative of this rare disease

Myogenic Trigger Zone of Trapezius Muscle Increases the Tone of the Middle Cerebral Artery

A myogenic trigger zone (MTZ) has been shown to affect the tone of the surface arteries of the head and lower limbs. However, it remains largely unknown whether the tone of the intracranial arteries is regulated by MTZ. The aim of the present study was to investigate the effect of MTZ in trapezius muscle on the tone of the middle cerebral artery. Using ultrasound measurements of the peak velocity of blood flow and the Lindegaard index (LI), we found that the presence of an active MTZ in a trapezius muscle was per se associated with an increased LI values and that pressure stimulation of the MTZ further increases LI. When MTZ was eliminated by means of manual therapy, the indices of blood flow and LI returned to normal values. We conclude that the reflex spasm of the middle cerebral artery can occur in the presence of an active MTZ-TM and that this phenomenon contributes to the pathogenesis and the clinical symptoms associated with the cervicogenic and tension headaches.

Clinical significance of heart rhythm variability in patients with gastroesophageal reflux disease

Cardiac manifestations of gastroesophageal reflux disease (GERD) including retrosternal pain and cardiac rhythm disorders were often mentioned in early publications. However, classification of GERD adopted at the 2005 Montreal congress does not include such conditions. Non-coronarogenic pain in the thoracic cage is recognized to be a typical esophageal syndrome while the reflex spasm of coronary arteries and cardiac rhythm disorders associated with GERD should be regarded as manifestations of comorbidity of GERD and cardiovascular diseases. Arrhythmias occur in 30% of patients with GERD, but relevant therapeutic and preventive modalities are poorly developed. Nor are there reliable predictors of arrhythmias. An important role in their pathogenesis in patients with GERD is played bydisbalance of sympathetic and parasympathetic components of vegetative nervous system (VNS). One of the approaches to studying this issue is the analysis of heart rhythm variability (HRV). We consider basic principles of clinical interpretation of the results of HRV research that allow to evaluate the state of VNS and interaction of its components. Analysis of recent publications gives evidence that many HRV parameters depend not only on the balance between components of VNS as was believed by earlier authors (for the lack of their reciprocal relationship) but also on the activity of these components. Other modulating factors include the heart rate, respiratory pattern, intrathoracic pressure, and diastolic atrial extension. We report the results of HRV assessment in patients with GERD that illustrate heart rhythm rigidity and predominant disorders of activity of the parasympathetic component of VNS especially well apparent in patients with erosive reflux esophagitis. However, other authors demonstrate oppositely directed changes and the involvement of the sympathetic component. A possible cause of this discrepancy is factors other than VNS influencing HRV. It is concluded that analysis of HRV can be used to develop a method for the prevention of GERD-associated arrhythmia. The diagnostic value of such method is limited and requires new algorithms for data interpretation taking account of their multifactorial origin.

Sociodemographic features, depression and anxiety in women with life-long vaginismus

Objective: Vaginismus is a female sexual dysfunction with reflex spasm of the muscles around vagina making penile penetration impossible. Many factors such as psychological, social and cultural may cause vaginismus were proposed, but debates are still ongoing. In this study, factors that may be related with vaginismus were studied and compared with controls. Methods: The participants were women with vaginismus without any organic pathology in gynecological examination and healthy controls. Twenty-five women with vaginismus and 25 controls who have no difficulty with vaginal penetration were evaluated by self-reported scales for depression, anxiety and sexual function. Sociodemographic variables were collected for each participants. Results: Women with vaginismus did not differ from controls in sociodemographic characteristics. The women with vaginismus had significantly higher levels of depression and anxiety. Total score of Glombok-Rust Sexual Satisfaction Scale, subscores of vaginismus, satisfaction, avoidance, anorgasmia were significantly higher and level of sexual knowledge was also limited in women with vaginismus. Discussion: Multiple sociodemographic and clinical factors are found associated with vaginismus. Some of the findings are supported by the literature but some are not. This may remind us there are still unclear concerning related factors in vaginismus. So, there is need for further studies in which hypotheses of different etiopathogeneses of vaginismus will be held.

Spasm of the near reflex. Treatment with botulinum toxin

Clinical caseA 38-year-old female with diplopia and esotropia, with limitation of ocular abduction in both eyes, with full abduction after doll's head rotation also being observed. She was diagnosed with spasm of the near reflex. Treatment with injections of botulinum toxin in both medial rectus has temporally resolved the convergence spasm. DiscussionNear reflex spasm is characterized as miosis, pseudomyopia, and convergent strabismus that lead to diplopia, blurred vision, headache, and variable, progressive, and intermittent esotropia. As the spasm worsens there will be limited ocular versions and ductions simulating a sixth nerve palsy. Botulinum toxin may be effective in some cases.

Rare Case of Choking Death by Dispersible Tablet: A Case Report

Choking is a form of asphyxia caused by an obstruction within the air passage. Aspiration of a foreign body is common in children and cause upper airway obstruction leading to significant morbidity and mortality. In most of the cases, death is due to mechanical obstruction of airway, in some cases, death may be due to reflex spasm of respiratory tract or by neurogenic cardiac arrest. Deaths due to choking are relatively rare occurrence.

Espasmo del reflejo de cerca. Tratamiento con toxina botulínica

Clinical caseA 38-year old female with diplopia and esotropia, with limitation of ocular abduction in both eyes, with full abduction after doll's head rotation also being observed. She was diagnosed with spasm of the near reflex. Treatment with injections of botulinum toxin in both medial rectus has temporally resolved the convergence spasm. DiscussionNear reflex spasm is characterized as miosis, pseudomyopia, and convergent strabismus that lead to diplopia, blurred vision, headache, and variable, progressive, and intermittent esotropia. As the spasm worsens there will be limited ocular versions and ductions simulating a sixth nerve palsy. Botulinum toxin may be effective in some cases.

Comparative Effect of Ultrasound Therapy and Laser Therapy for Relief of Pain, Swelling and Trismus Following Third Molar Surgeries

Abstrac: Inabil ity to open the mouth even within i ts normal l imits is cal led a trismus. This is so due to a reflex spasm of the masticatory muscles leading to a completely or incompletely l imited mouth opening in a patient. I t is diagnosed from clinical examination of the maximal in terincisal d istance (MID) of less than 40-45mm caused by contracture not by obstructive jo int impingement. Objectives of the study was to evaluate the comparative ef fect iveness of u l trasound therapy & laser therapy in addit ion to mouth opening exercises in patients with pain, swell ing and trismus fol lowing third molar surgeries. 30 subjects aged 18-35 yeras were made part of the study based on inclusion and exclusion criteria and then divided into two groups named group A and group B. Group A received ultrasound therapy for frequency of 1MHz, pulsed 20% and dose 1 .0W/sq.cm for 7minutes for first three days af ter surgery. Group B received laser therapy as output power 15mW, pulsed 80% and dose 4 .3J/sq.cm for 6minutes for also first three days af ter surgery. Material used in study were Sl iding Caliper, Graduated tape, Wooden splints. PainIt wil l be evaluated by using VAS scale. Swell ingI t wil l be measured by measuring in between horizontal and vertical direct ions.HorizontalI t will be measured as horizontal d istance from t ip of tragus to ipsi la teral commissure of mouth.Vert icalI t wil l be measured from lateral external canthus of eye to ipsila teral gonion.TrismusI t wil l be measured of interincisal d istance. Addit ionally mouth opening exercises both active and passive were given to all the patients in both the groups. Pre and post treatment readings were taken of pain, swell ing and trismus. Results showed that there was a signif icant dif ference between pain, swell ing and trismus within the groups. But there was not a signif icant di fference between both the groups. The study concluded that though stat istical ly both groups showed the signif icant improvement in al l parameters. But when we compare both groups with each other then there is no stat ist ical di fference between them. So null hypothesis was accepted.

Reflex anuria: an old concept with new evidence

Reflex anuria (RA) was defined by Hull as cessation of urine output from both kidneys due to irritation or trauma to one kidney or its ureter, or severely painful stimuli to other organs. This is not a common concept among urologists or nephrologists even though it has been proposed for more than half a century. The phenomenon has not been thoroughly understood. But intrarenal arteriolar spasm and ureteral spasm have gained wide acceptance as the mechanisms of RA. The present review summarized papers published up to now on RA, in order to depict the general profile of the disease and to further elucidate the pathogenesis of RA. A classification system of RA was proposed as neurovascular reflex, ureterorenal reflex, radiated renovascular reflex, renoureteral reflex, ureteroureteral reflex and radiated ureteral reflex, based on the two assumed mechanisms and the stimulus' origins. All these types except renoureteral reflex had gained supporting evidence from animal experiments and/or clinical case reports. RA is a diagnosis of exclusion, only being considered after ruling out common and tangible etiologies such as ureteral calculi, acute tubular necrosis, renal vascular occlusion, hypovolemia, infection, etc. If the diagnosis has been established, treatment plan should be directed toward the mechanisms more than the causative factors. Abnormalities of the autonomic nerve system and congenital urogenital malformations incline people to RA. In summary, RA is a cessation of urine production caused by stimuli on kidney, ureter or other organs, through a mechanism of reflex spasm of intrarenal arterioles or ureters, leading to acute renal failure. It is a functional rather than parenchymal disease.

Treatment of patients with primary open angle glaucoma with the use of myotherapy

Aim. To evaluate the effectiveness of myotherapy, which is conducted to stabilize the glaucoma optic neuropathy in patients with primary open-angle glaucoma. Methods. Treatment with the use of myotherapy was performed in 50 patients (94 eyes) with open-angle glaucoma of the I-II stage with decompensation of intraocular pressure b-c, at the age of 45 to 67 years. The control group consisted of 50 patients (100 eyes) with similar stages of glaucoma, at the age of 47 to 60 years who were treated with vascular drugs. The complex ophthalmologic examination included visometry, auto-refractometry, biomicroscopy, gonioscopy, direct ophthalmoscopy with medical mydriasis, the Heidelberg retinal tomography of the optic disc, computer static perimetry, 24-hour tonometry, tonography, Doppler ultrasound. Repeated complex examination of all patients was performed 6-12 months after treatment. Results. In the first group stabilization of the visual function and morphological parameters of the optic nerve disc was registered in 19.1% of cases (18 eyes), a positive dynamic was registered in 74.4% of cases (70 eyes). In the second (control) group stabilization was achieved in 16% of cases (16 eyes), a positive dynamic was achieved only in 8% of cases (8 eyes), while a negative dynamic was noted in 76% of cases (76 eyes) compared with 6.4% in the first group. Conclusion. Treatment of the reflex spasm of the ciliary muscle after removal of the muscle blocks of the upper cervical spine leads to stabilization of the visual function, morphological parameters of the optic nerve and visual field expansion due to restoration of the hydrodynamic parameters as well as the cerebral and regional hemodynamics of the eye.

Accessory Transversarium Foramen of Cervical Vertebrae: A Case Study

The anatomical variations of the cervical vertebrae as reported in most classical anatomical textbooks mainly include: cervical ribs, non fusion of the halves of the posterior arch of the atlas, presence of articular facets on the superior margin of the anterior arch of the atlas incase of presence of a third occipital condyle. A male cadaver preserved by means of the routine embalming techniques following the completion of dissection was used for bone maceration. The soft tissues were removed and the cervical vertebrae were studied for variations. The variations recorded in this study include the presence of accessory transverse foramina in the atlas, C5 and C6, The presence of an accessory foramen transversarium in the cervical vertebra is a rare variation. It narrowed the size of the real transverse process and this may result in pressure on the vertebral artery and the sympathetic plexus embedding it. Similarly the narrowing of the transverse foramen may result in formation of atheromatose plaque which may also result to thrombosis emboli or just reflex spasm. The implications of these variations in the anatomy of this region should be noted by neurologist and by those who advocate instrumentation of the cervical vertebrae.Key words: Cervical vertebra, Atlas, Accessory transverse foramina, Foramen transversarium

The Classic: Congenital Dislocation of the Hip

The Classic: Congenital Dislocation of the Hip

Ultrastructural changes in the circumventricular organs after experimental subarachnoid hemorrhage

Objectives: Circumventricular organs (CVOs) are fine, periventricular, neurotransmitter-rich structures that are devoid of a blood–brain barrier and are known for their secretory role controlling fluid and electrolyte balance, thirst and even reproduction. Common pathologies of the brain such as trauma or bleeding affect CVOs, and hence their function. However, at what stage of these disease processes are CVOs affected and the time sequence of their recovery is still not clear. The aim of this study was to detect the morphological changes in CVOs using electron microscopy after experimental subarachnoid hemorrhage (SAH).Methods: Experimental SAH was induced by transclival puncture of the basilar artery. Both scanning and transmission electron microscopic examination of the representive sections from each CVO was undertaken.Results: Electron microscopy has shown that after SAH, the cells that form the CVOs exhibit signs of cellular necrosis with margination of the nucleus as well as cytoplasmic, mitochondrial and axonal edema. The subfornicial organ and organum vasculosum lamina terminalis appear to be more vulnerable to the effects of SAH than the median eminence or area postrema.Discussion: Considering the fact that the experimental SAH model we have used is very similar to the momentary rupture of an aneurysm with secondary reflex spasm to seal the hole, it will not be unrealistic to consider that similar effects may also take place in the clinical setting.