Abstract
Although there have been several investigations regarding acute brain injury after subarachnoid hemorrhage (SAH), the pathological conditions of severe SAH are unclear. In this study, we pursued the characteristics of cerebrovascular injury in the hyperacute phase after experimentally induced severe SAH. Twenty-three male Sprague-Dawley rats were subjected to sham or SAH operation using the endovascular perforation method and were evaluated for brain edema, blood-brain barrier (BBB) permeability, and arterial endothelial cell injury at 5 min after SAH (experiment 1). Next, animals were examined for functional and morphological changes of cerebral artery for 30 min after an acetazolamide injection administered 5 min after SAH (experiment 2). In experiment 1, while cerebral blood flow (CBF) was reduced, brain edema was not observed in SAH-operated rats. BBB permeability detected by immunoglobulin G extravasation was observed in the optic tract and was accompanied by the upregulation of phosphorylated extracellular signal-regulated kinase (ERK)-positive astrocytes. In addition, the number of phosphorylated ERK-positive endothelial cell in the distal middle cerebral artery (MCA) was significantly increased by SAH. In experiment 2, CBF in non-lethal SAH rats was reduced, and no response to acetazolamide was detected. Conversely, CBF in lethal SAH increased due to acetazolamide, although the value of CBF was low. Furthermore, there was significant narrowing of the MCA in SAH-operated rats. The findings suggest that the optic tract and the cerebral artery are the most vulnerable areas regarding cerebrovascular injury in a hyperacute phase after severe SAH and that they are associated with fatal outcomes.
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Frontera JA, Ahmed W, Zach V, Jovine M, Tanenbaum L, Sehba F, et al. Acute ischaemia after subarachnoid haemorrhage, relationship with early brain injury and impact on outcome: a prospective quantitative MRI study. J Neurol Neurosurg Psychiatry. 2015;86:71–8.
Bederson JB, Germano IM, Guarino L. Cortical blood flow and cerebral perfusion pressure in a new noncraniotomy model of subarachnoid hemorrhage in the rat. Stroke. 1995;26:1086–91. discussion 1091–2.
Povlsen GK, Johansson SE, Larsen CC, Samraj AK, Edvinsson L. Early events triggering delayed vasoconstrictor receptor upregulation and cerebral ischemia after subarachnoid hemorrhage. BMC Neurosci. 2013;14:34.
Bederson JB, Levy AL, Ding WH, Kahn R, DiPerna CA, Jenkins 3rd AL, et al. Acute vasoconstriction after subarachnoid hemorrhage. Neurosurgery. 1998;42:352–60. discussion 360–2.
Bederson JB, Connolly Jr ES, Batjer HH, Dacey RG, Dion JE, Diringer MN, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40:994–1025.
Huang J, van Gelder JM. The probability of sudden death from rupture of intracranial aneurysms: a meta-analysis. Neurosurgery. 2002;51:1101–5. discussion 1105–7.
Chen S, Li Q, Wu H, Krafft PR, Wang Z, Zhang JH. The harmful effects of subarachnoid hemorrhage on extracerebral organs. Biomed Res Int. 2014;2014:858496.
Zhao W, Ujiie H, Tamano Y, Akimoto K, Hori T, Takakura K. Sudden death in a rat subarachnoid hemorrhage model. Neurol Med Chir (Tokyo). 1999;39:735–41. discussion 741–3.
Sehba FA, Mostafa G, Friedrich Jr V, Bederson JB. Acute microvascular platelet aggregation after subarachnoid hemorrhage. J Neurosurg. 2005;102:1094–100.
Sehba FA, Mostafa G, Knopman J, Friedrich Jr V, Bederson JB. Acute alterations in microvascular basal lamina after subarachnoid hemorrhage. J Neurosurg. 2004;101:633–40.
Sehba FA, Schwartz AY, Chereshnev I, Bederson JB. Acute decrease in cerebral nitric oxide levels after subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2000;20:604–11.
Mehta SL, Manhas N, Raghubir R. Molecular targets in cerebral ischemia for developing novel therapeutics. Brain Res Rev. 2007;54:34–66.
Maddahi A, Edvinsson L. Cerebral ischemia induces microvascular pro-inflammatory cytokine expression via the MEK/ERK pathway. J Neuroinflammation. 2010;7:14.
Suzuki H, Hasegawa Y, Kanamaru K, Zhang JH. Mechanisms of osteopontin-induced stabilization of blood-brain barrier disruption after subarachnoid hemorrhage in rats. Stroke. 2010;41:1783–90.
Suzuki H, Ayer R, Sugawara T, Chen W, Sozen T, Hasegawa Y, et al. Protective effects of recombinant osteopontin on early brain injury after subarachnoid hemorrhage in rats. Crit Care Med. 2010;38:612–8.
Hasegawa Y, Suzuki H, Altay O, Zhang JH. Preservation of tropomyosin-related kinase B (TrkB) signaling by sodium orthovanadate attenuates early brain injury after subarachnoid hemorrhage in rats. Stroke. 2011;42:477–83.
Uekawa K, Hasegawa Y, Ma M, Nakagawa T, Katayama T, Sueta D, et al. Rosuvastatin ameliorates early brain injury after subarachnoid hemorrhage via suppression of superoxide formation and nuclear factor-kappa B activation in rats. J Stroke Cerebrovasc Dis. 2014;23:1429–39.
Dong YF, Kataoka K, Tokutomi Y, Nako H, Nakamura T, Toyama K, et al. Beneficial effects of combination of valsartan and amlodipine on salt-induced brain injury in hypertensive rats. J Pharmacol Exp Ther. 2011;339:358–66.
Sugawara T, Ayer R, Jadhav V, Zhang JH. A new grading system evaluating bleeding scale in filament perforation subarachnoid hemorrhage rat model. J Neurosci Methods. 2008;167:327–34.
Hasegawa Y, Suzuki H, Nakagawa T, Uekawa K, Koibuchi N, Kawano T, Kim-Mitsuyama S. Assessment of the correlations between brain weight and brain edema in experimental subarachnoid hemorrhage. Acta Neurochir Suppl. in press.
Hasegawa Y, Nakagawa T, Uekawa K, Ma M, Lin B, Kusaka H, Katayama T, Sueta D, Toyama K, Koibuchi N, Kim-Mitsuyama S. Therapy with the combination of amlodipine and irbesartan has persistent preventative effects on stroke onset associated with BDNF preservation on cerebral vessels in hypertensive rats. Transl Stroke Res. in press.
Wu CH, Chi JC, Jerng JS, Lin SJ, Jan KM, Wang DL, et al. Transendothelial macromolecular transport in the aorta of spontaneously hypertensive rats. Hypertension. 1990;16:154–61.
Egashira Y, Hua Y, Keep RF, Xi G. Acute white matter injury after experimental subarachnoid hemorrhage: potential role of lipocalin 2. Stroke. 2014;45:2141–3.
Sehba FA, Friedrich Jr V, Makonnen G, Bederson JB. Acute cerebral vascular injury after subarachnoid hemorrhage and its prevention by administration of a nitric oxide donor. J Neurosurg. 2007;106:321–9.
Little JR, Kerr FW, Sundt Jr TM. Microcirculatory obstruction in focal cerebral ischemia. Relationship to neuronal alterations. Mayo Clin Proc. 1975;50:264–70.
Paljärvi L, Rehncrona S, Söderfeldt B, Olsson Y, Kalimo H. Brain lactic acidosis and ischemic cell damage: quantitative ultrastructural changes in capillaries of rat cerebral cortex. Acta Neuropathol. 1983;60:232–40.
Ansar S, Edvinsson L. Subtype activation and interaction of protein kinase C and mitogen-activated protein kinase controlling receptor expression in cerebral arteries and microvessels after subarachnoid hemorrhage. Stroke. 2008;39:185–90.
Ansar S, Eftekhari S, Waldsee R, Nilsson E, Nilsson O, Säveland H, et al. MAPK signaling pathway regulates cerebrovascular receptor expression in human cerebral arteries. BMC Neurosci. 2013;14:12.
Beg SA, Hansen-Schwartz JA, Vikman PJ, Xu CB, Edvinsson LI. ERK1/2 inhibition attenuates cerebral blood flow reduction and abolishes ET(B) and 5-HT(1B) receptor upregulation after subarachnoid hemorrhage in rat. J Cereb Blood Flow Metab. 2006;26:846–56.
Henriksson M, Xu CB, Edvinsson L. Importance of ERK1/2 in upregulation of endothelin type B receptors in cerebral arteries. Br J Pharmacol. 2004;142:1155–61.
Maddahi A, Povlsen GK, Edvinsson L. Regulation of enhanced cerebrovascular expression of proinflammatory mediators in experimental subarachnoid hemorrhage via the mitogen-activated protein kinase kinase/extracellular signal-regulated kinase pathway. J Neuroinflammation. 2012;9:274.
Reinprecht A, Czech T, Asenbaum S, Podreka I, Schmidbauer M. Low cerebrovascular reserve capacity in long-term follow-up after subarachnoid hemorrhage. Surg Neurol. 2005;64:116–20. discussion 121.
Offenhauser N, Windmüller O, Strong AJ, Fuhr S, Dreier JP. The gamut of blood flow responses coupled to spreading depolarization in rat and human brain: from hyperemia to prolonged ischemia. Acta Neurochir Suppl. 2011;110(Pt 1):119–24.
Shigeno T, Fritschka E, Brock M, Schramm J, Shigeno S, Cervoś-Navarro J. Cerebral edema following experimental subarachnoid hemorrhage. Stroke. 1982;13:368–79.
Gibbs JM, Wise RJ, Leenders KL, Jones T. Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion. Lancet. 1984;1:310–4.
Powers WJ, Raichle ME. Positron emission tomography and its application to the study of cerebrovascular disease in man. Stroke. 1985;16:361–76.
Zhang JH. Vascular neural network in subarachnoid hemorrhage. Transl Stroke Res. 2014;5:423–8.
Larsen CC, Hansen-Schwartz J, Nielsen JD, Astrup J. Blood coagulation and fibrinolysis after experimental subarachnoid hemorrhage. Acta Neurochir (Wien). 2010;152:1577–81. discussion 1581.
Schwartz AY, Masago A, Sehba FA, Bederson JB. Experimental models of subarachnoid hemorrhage in the rat: a refinement of the endovascular filament model. J Neurosci Methods. 2000;96:161–7.
Acknowledgments
This study was supported by JSPS KAKENHI Grant Number 24592135. We thank Yuriko Shimamura, Miho Kataoka, Michie Uchikawa, and Keiko Morozumi for their support.
Compliance with Ethics Requirements
All institutional and national guidelines for the care and use of laboratory animals were followed.
Conflict of Interest
The authors declare that they have no competing interests.
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Hasegawa, Y., Suzuki, H., Uekawa, K. et al. Characteristics of Cerebrovascular Injury in the Hyperacute Phase After Induced Severe Subarachnoid Hemorrhage. Transl. Stroke Res. 6, 458–466 (2015). https://doi.org/10.1007/s12975-015-0423-9
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DOI: https://doi.org/10.1007/s12975-015-0423-9