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Bumetanide lowers acute hydrocephalus in a rat model of subarachnoid hemorrhage

  • Original Article - CSF Circulation
  • Published:
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Abstract

Background

Subarachnoid hemorrhage (SAH) can lead to acute hydrocephalus (AH). AH pathophysiology is classically attributed to an obstruction of the arachnoid granulations by blood. Recent findings in rodents suggest that after intraventricular hemorrhage, AH is related to cerebrospinal fluid (CSF) hypersecretion by the choroid plexus (CP), as it can be reduced by intracerebroventricular (ICV) injection of bumetanide.

Objective

Here, we investigated if and how CSF hypersecretion and/or CSF outflow disorders contribute to post-SAH hydrocephalus.

Methods

Ninety-four Wistar rats were used. SAH was induced by the endovascular perforation technique. The presence of AH was confirmed by magnetic resonance imaging (MRI), and rats with AH were randomly assigned to 4 groups: control group, superior sagittal sinus (SSS) thrombosis to block CSF reabsorption, ICV injection of saline, and ICV injection of bumetanide to decrease CSF secretion. Clinical outcome was evaluated with a neuroscore. A second MRI was performed 24 h later to evaluate the ventricular volume.

Results

Fifty percent of rats that survived SAH induction had AH. Their ventricular volume correlated well to the functional outcome after 24 h (r = 0.803). In rats with AH, 24 h later, ventricular volume remained equally increased in the absence of any further procedure. Similarly, ICV injection of saline or SSS thrombosis had no impact on the ventricular volume. However, ICV injection of bumetanide reduced AH by 35.9% (p = 0.002).

Conclusion

In rodents, post-SAH hydrocephalus is may be due to hypersecretion of CSF by the CP, as it is limited by ICV injection of bumetanide. However, we cannot exclude other mechanisms involved in post-SAH acute hydrocephalus.

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Abbreviations

AH:

Acute hydrocephalus

CP:

Choroid plexus

DCI:

Delayed cerebral ischemia

CSF:

Cerebrospinal fluid

EVD:

External ventricular drain

ICV:

Intracerebroventricular

IVH:

Intraventricular hemorrhage

PHH:

Post-hemorrhagic hydrocephalus

SAH:

Subarachnoid hemorrhage

SSS:

Superior sagittal sinus

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Caen, 14000, Caen, France

    Thomas Metayer, Evelyne Emery & Thomas Gaberel

  2. Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain at Caen-Normandie, Cyceron, 14000, Caen, France

    Thomas Metayer, Cyrille Orset, Carine Ali, Jonathane Furon, Nicolas Szabla, Evelyne Emery, Denis Vivien & Thomas Gaberel

  3. Medical School, University of Caen Normandy, 14000, Caen, France

    Evelyne Emery, Denis Vivien & Thomas Gaberel

  4. Department of Clinical Research, Caen-Normandie University Hospital, CHU, 14000, Caen, France

    Denis Vivien

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  1. Thomas Metayer
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  2. Cyrille Orset
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  3. Carine Ali
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Correspondence to Thomas Metayer.

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Metayer, T., Orset, C., Ali, C. et al. Bumetanide lowers acute hydrocephalus in a rat model of subarachnoid hemorrhage. Acta Neurochir 164, 499–505 (2022). https://doi.org/10.1007/s00701-021-05088-4

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  • DOI: https://doi.org/10.1007/s00701-021-05088-4

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