Background: Subarachnoid hemorrhage (SAH) is a devastating disease with high morbidity and mortality. Neuroprotective effects of the noble gas argon have been shown in animal models of ischemia. The aim of this study was to investigate the effects of argon in the immediate early phase of SAH in a rat model.
Methods: A total of 19 male Wistar rats were randomly assigned to three treatment groups. SAH was induced using a endovascular filament perforation model. Cerebral blood flow, mean arterial blood pressure (MAP), and body temperature were measured continuously. Group A received 2 h of ventilation by 50% argon/50% O (n = 7) immediately following SAH. Group B underwent a sham operation and was also ventilated by 50% argon/50% O (n = 6). Group C underwent SAH and 50% O/50% N ventilation (n = 6). Preoperative and postoperative neurological and behavioral testing were performed. Histology and immunohistochemistry were used to evaluate the extent of brain injury and vasospasm.
Results: The cerebral blood flow dropped in both treatment groups after SAH induction (SAH, 63.0 ± 11.6% of baseline; SAH + argon, 80.2 ± 8.2% of baseline). During SAH, MAP increased (135.2 ± 10.5%) compared with baseline values (85.8 ± 26.0 mm Hg) and normalized thereafter. MAP in both groups showed no significant differences (p = 0.3123). Immunohistochemical staining for neuronal nuclear antigen demonstrated a decrease of hippocampal immunoreactivity after SAH in the cornu ammonis region (CA) 1-3 compared with baseline hippocampal immunoreactivity (p = 0.0127). Animals in the argon-ventilated group showed less neuronal loss compared with untreated SAH animals (p < 0.0001). Ionized calcium-binding adaptor molecule 1 staining showed a decreased accumulation after SAH + argon (CA1, 2.57 ± 2.35%; CA2, 1.89 ± 1.89%; CA3, 2.19 ± 1.99%; DG, 2.6 ± 2.24%) compared with untreated SAH animals (CA1, 5.48 ± 2.39%; CA2, 4.85 ± 4.06%; CA3, 4.22 ± 3.01%; dentate gyrus (DG), 3.82 ± 3.23%; p = 0.0007). The neuroscore assessment revealed no treatment benefit after SAH compared with baseline (p = 0.385).
Conclusion: In the present study, neuroprotective effects of argon occurred early after SAH. Because neurological deterioration was similar in the preadministration and absence of argon, it remains uncertain if neuroprotective effects translate in improved outcome over time.
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http://dx.doi.org/10.1007/s12028-024-02090-3 | DOI Listing |
Oxf Med Case Reports
December 2024
Coronary Care Unit, Al Nasiriyah Heart Hospital, Thi Qar 64001, Iraq.
We present a case detailing the diagnostic challenges of a 23-year-old male presenting with a sudden severe headache, nausea, vomiting, and chest heaviness. Initial evaluation showed elevated blood pressure and respiratory rate. An emergency electrocardiogram (ECG) indicated ST-segment elevation myocardial infarction (STEMI), leading to immediate referral for percutaneous coronary intervention, which revealed normal coronary arteries.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK.
Objective: Hyponatremia after aneurysmal subarachnoid hemorrhage (aSAH) is common, however the incidence, and association with vasospasm, morbidity, and mortality, has yet to be defined. We aimed to identify incidence of hyponatremia after aSAH, and quantify its association with measurable outcomes.
Methods: A PRISMA-compliant systematic review and meta-analysis was conducted (PROSPERO ID CRD42022363472).
J Clin Neurosci
December 2024
Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) carries a high economic cost and clinical morbidity in the United States. Beyond prolonged admissions and poor post-injury functional status, there is an additional cost of chronic shunt-dependent hydrocephalus for many aSAH patients. Adjuvant lumbar drain (LD) placement has been hypothesized to promote clearance of subarachnoid blood from the cisternal space, with an ultimate effect of decreasing shunt placement rates.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Paediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India; Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Pune, India.
Sci Rep
December 2024
Department of Neurology, Mayo Clinic, Jacksonville, MN, USA.
We developed a simple quantifiable scoring system that predicts aneurysmal subarachnoid hemorrhage (aSAH) mortality, delayed cerebral ischemia (DCI), and modified Rankin scale (mRS) outcomes using readily available SAH admission data with SAH volume (SAHV) measured on computed tomography (CT). We retrospectively analyzed a cohort of 277 patients with aSAH admitted at our Comprehensive Stroke Center at Mayo Clinic in Jacksonville, Florida, between January 5, 2012, and February 24, 2022. We developed a mathematical radiographic model SAHV that measures basal cisternal SAH blood volume using a derivation of the ABC/2 ellipsoid formula (A = width/thickness, B = length, C = vertical extension) on noncontrast CT, which we previously demonstrated is comparable to pixel-based manual segmentation on noncontrast CT.
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