Increased levels of lipid peroxides as predictive of symptomatic vasospasm and poor outcome after aneurysmal subarachnoid hemorrhage

Kamezaki, Takao; Yanaka, Kiyoyuki; Nagase, Sohji; Fujita, Keishi; Kato, Noriyuki; Nose, Tadao

doi:10.3171/jns.2002.97.6.1302

Cited by 45 publications

(32 citation statements)

References 21 publications

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“…Its exact pathophysiologic mechanisms are not fully established and multi-factorial processes that contain oxygen free radicals, endothelin, vascular endothelial growth factor, arachidonic acid derivatives, lipid peroxidation, inactivation of nitrous oxide (NO), activation of protein kinase C system released from blood clots in the subarachnoid spaces and cisterns, are known to be related to cerebral vasospasm 3,10,12,14,15,19,21,22,24,31,[35][36][37] . There are numerous clinical studies that early surgical removal of blood clots and massive irrigation may reduce the risk of cerebral vasospasm 13,18,23) .…”

Section: Discussionmentioning

confidence: 99%

The Utility and Benefits of External Lumbar CSF Drainage after Endovascular Coiling on Aneurysmal ubarachnoid Hemorrhage

Kwon

Kim

et al. 2008

J Korean Neurosurg Soc

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Section: Discussionmentioning

confidence: 99%

The Utility and Benefits of External Lumbar CSF Drainage after Endovascular Coiling on Aneurysmal ubarachnoid Hemorrhage

Kwon

Kim

et al. 2008

J Korean Neurosurg Soc

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“…The association of oxidative stress with SAH and cerebral vasospasm has been widely studied [12][13][14][15][16][17][18] . Brain tissue is more prone to oxidative damage in relation to other organs due to its high concentration and consumption of oxygen 19 .…”

Section: Discussionmentioning

confidence: 99%

Effect of N-acetylcysteine on vasospasm in subarachnoid hemorrhage

Filho

Soares

et al. 2010

Arq. Neuro-Psiquiatr.

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Vasospasm remains an extremely serious complication that affects patients presenting with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms. The current therapeutic armamentarium is still insufficient in many cases, and the search for new therapies is necessary. In this study, we evaluated the effect of N-acetylcysteine (NAC) on cerebral arterial vasospasm using an experimental model. Twenty-four wistar rats were divided into 4 groups: and [4] SAH+Placebo. The experimental model employed double subarachnoid injections of autologous blood. The proposed dose of NAC was 250 mg/kg intraperitoneally per day. We analyzed the inner area of the basilar artery to assess the action of NAC. The experimental model proved to be very adequate, with a mortality rate of 4%. The inner area of the basilar artery in the SAH group showed significant difference to the control group (p=0.009). The use of NAC significantly reduced vasospasm as compared to the untreated group (p=0.048) and established no significant difference to the control group (p=0.098). There was no significant improvement with the administration of placebo (p=0.97). The model of the dual hemorrhage proved to be very useful for vasospasm simulation, with overall low mortality. The administration of NAC significantly reduced vasospasm resulting from SAH, and may represent a new therapeutic alternative. Key words: subarachnoid hemorrhage, vasospasm, N-acetylcysteine.Efeito da N-acetilcisteína sobre o vasoespasmo na hemorragia subaracnóidea RESUMO O vasoespasmo arterial encefálico continua sendo uma complicação extremamente grave que acomete pacientes com hemorragia subaracnóidea (HSA) por ruptura de aneurismas. O arsenal terapêutico atual ainda, em muitos casos, é insuficiente e a busca de novas alternativas terapêuticas torna-se necessária. Neste estudo, avaliamos a ação da N-acetilcisteína (NAC) sobre o vasoespasmo arterial encefálico em um modelo experimental. Foram utilizados 24 ratos wistar divididos em 4 grupos:HSA+Placebo. O modelo experimental utilizado foi o da dupla injeção subaracnóidea de sangue autólogo. A dose proposta da NAC foi de 250 mg/kg/dia por via intraperitoneal. Foi analisada a área interna da artéria basilar para avaliação da ação da NAC. O modelo experimental mostrou-se excelente com mortalidade de 4%. A mensuração da área interna da artéria basilar do grupo HSA demonstrou diminuição significativa em relação ao grupo controle (p=0,009). A administração da NAC reduziu significativamente

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“…OxyHb-induced free radical products and lipid peroxidation are mostly accepted as the first step to start vasospasm (9,11). Many authors have also shown the role of free radicals and lipid peroxidation in the pathogenesis of vasospasm in experimental and clinical studies (1, 11,18,25). The important role of free radical products was studied in our previous experimental study; free radical production and lipid peroxidation was started at the cisterna magna in cats by hemoglobin-free erythrocyte membrane mixed with NADPH and ADP and ferrous sulphate (2).…”

Section: Tekiner a Et Al: Proanthocyanidin In Experimental Cerebral mentioning

confidence: 99%

“…The possible mechanisms are as follows: increased endothelin activity, ADP-induced vasomotor changes, inhibition of NO pathway, increased free radical products and lipid peroxidation stimulating the PKC pathway in vascular smooth muscle, and adhesion molecule pathways (16,23). OxyHb-induced free radical products and lipid peroxidation are mostly accepted as the first step to start vasospasm (9,11). Many authors have also shown the role of free radicals and lipid peroxidation in the pathogenesis of vasospasm in experimental and clinical studies (1, 11,18,25).…”

Section: Tekiner a Et Al: Proanthocyanidin In Experimental Cerebral mentioning

confidence: 99%

“…Clinical and experimental studies imply that oxygen free radical generation increase after subarachnoid hemorrhage (SAH) and that these radicals and consequently lipid peroxidation may be causally related to the expression of cerebral vasospasm (2, 11,16). It has been shown that lipid peroxidation inhibition and oxygen free radical scavengers relieve vasospasm in experimental vasospasm models (6,7).…”

Section: Introductionmentioning

confidence: 99%

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The therapeutic value of proanthocyanidin İn experimental cerebral vasospasm following subarachnoid hemorrhage

Tekiner

Yılmaz²,

Polat³

et al. 2014

Turkish Neurosurgery

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AIm: We aimed to examine the basilar artery in an experimental subarachnoid hemorrhage (SAH) model both from the ultrastructural and radiological aspects and tried to evaluate the benefit of proanthocyanidin (PC), an antioxidant matter, in reducing vasospasm. mATERIAl and mEThods: A total of 21 male New Zealand rabbits were divided into three groups after performing angiography. Group I: Control group, Group II: Subarachnoid hemorrhage group, Group III: Subarachnoid hemorrhage and Proanthocyanidin group (100 mg/kg/ day). Rabbits were sacrificed on the 5th day after angiography. A segment of the basilar artery, 4 mm in length, was prepared for ultrastructural examination.REsulTs: There was no ultrastructural or radiological abnormality in the basilar artery in Group 1. In the basilar artery digital subtraction angiography (DSA) of Group 2, a statistically significant decrease in basilar artery calibration was found (p<0.05). There was no damage in the endothelium, subendothelium, tunica media and adventitia of the basilar artery ultrastructurally but a statistically significant narrowing in lumen diameter was seen. There was also no difference in basilar artery calibration in the DSA of Group 3 (p>0.05). No damage was seen in the basilar artery ultrastructurally. BulGulAR: Grup I'de baziller arterde ultrastrüktürel ve radyolojik anormallik yoktu. Grup II'nin baziller arter kalibrasyonunda istatistiksel anlamlı azalma saptandı (p<0,05). Baziller arterin endotelyum, subendotelyum, tunika media ve tunika adventisiyasında ultrastrüktürel olarak zedelenme yoktu, fakat lümen çapında istatistiksel anlamlı daralma görüldü. Aynı zamanda grup 3'ün anjiyografisinde baziller arter kalibrasyonunda istatistiksel anlamlı daralma yoktu (p>0,05). Baziller arterde ultrastrüktürel zedelenme görülmedi.soNuÇ: Güçlü antioksidan ve muhtemel vazomotor etkili proantosiyanidin, subaraknoid kanamaya bağlı vazospazmı anlamlı düzeyde azaltabilir.

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Increased levels of lipid peroxides as predictive of symptomatic vasospasm and poor outcome after aneurysmal subarachnoid hemorrhage

Cited by 45 publications

References 21 publications

The Utility and Benefits of External Lumbar CSF Drainage after Endovascular Coiling on Aneurysmal ubarachnoid Hemorrhage

The Utility and Benefits of External Lumbar CSF Drainage after Endovascular Coiling on Aneurysmal ubarachnoid Hemorrhage

Effect of N-acetylcysteine on vasospasm in subarachnoid hemorrhage

The therapeutic value of proanthocyanidin İn experimental cerebral vasospasm following subarachnoid hemorrhage

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