Minimally Invasive Procedures for Evacuation of Intracerebral Hemorrhage Reduces Perihematomal Glutamate Content, Blood–Brain Barrier Permeability and Brain Edema in Rabbits

Wu, Guofeng; Li, Chang; Wang, Likun; Mao, Yuanhong; Zhao, Hong

doi:10.1007/s12028-010-9473-8

Cited by 37 publications

(31 citation statements)

References 26 publications

(31 reference statements)

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“…There is evidence from porcine (Wagner et al, 1999) and rabbit (Wu et al, 2011a) ICH models of decreased tissue injury, BBB opening, and edema and hematoma volumes through minimally invasive clot aspiration and thrombolysis. A recent clinical randomized controlled trial showed benefits of stereotactic evacuation over conventional craniotomy in terms of functional outcomes and postoperative complications (Zhou et al, 2011), and a further randomized clinical trial (the Minimally Invasive Surgery plus Tissue Plasminogen Activator for Intracerebral Hemorrhage Evacuation, MISTIE trial) is currently ongoing.…”

Section: Clot Removalmentioning

confidence: 99%

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Kirkman

Allan

Parry‐Jones

2011

J Cereb Blood Flow Metab

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Intracerebral hemorrhage (ICH) has the highest mortality of all stroke subtypes, yet treatments are mainly limited to supportive management, and surgery remains controversial. Despite significant advances in our understanding of ICH pathophysiology, we still lack preclinical models that accurately replicate the underlying mechanisms of injury. Current experimental ICH models (including autologous blood and collagenase injection) simulate different aspects of ICH-mediated injury but lack some features of the clinical condition. Newly developed models, notably hypertension-and oral anticoagulant therapy-associated ICH models, offer added benefits but further study is needed to fully validate them. Here, we describe and discuss current approaches to experimental ICH, with suggestions for changes in how this condition is studied in the laboratory. Although advances in imaging over the past few decades have allowed greater insight into clinical ICH, there remains an important role for experimental models in furthering our understanding of the basic pathophysiologic processes underlying ICH, provided limitations of animal models are borne in mind. Owing to differences in existing models and the failed translation of benefits in experimental ICH to clinical practice, putative neuroprotectants should be trialed in multiple models using both histological and functional outcomes until a more accurate model of ICH is developed.

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Section: Clot Removalmentioning

confidence: 99%

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Kirkman

Allan

Parry‐Jones

2011

J Cereb Blood Flow Metab

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“…In recent years, the minimally invasive surgery has been emerging as an alternative for craniotomy due to its improved survival rate and reduced complication rate [32]. Several clinical and experimental studies have demonstrated minimally invasive techniques to be effective for the treatment of ICH [29,30,32]. However, although MIS can alleviate the hematoma to a large extent by reducing its physical size and the release of neurotoxic substances, it cannot remove the erythrocytes and cytotoxic substances that extravasate into the brain adjacent to the hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…The methods used in this study were same to those in our previously published studies [29,30]. Briefly, the rabbits were anesthetized by injecting 20% urethane (2ml/kg) into the marginal ear vein.…”

Section: Ich Model Preparationmentioning

confidence: 99%

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Minimally Invasive Surgery for Intracerebral Hematoma Evacuation followed by Rosiglitazone Infusion Therapy Increased Perihematomal Occludin, Zonula Occludens-1 Expression and Decreased the Blood Brain Barrier Permeability in Rabbits

Ren¹,

Wu²,

Huang³

et al. 2018

Neuropsychiatry

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Objective: To observe the effects of minimally invasive surgery (MIS) for hematoma of intracerebral hemorrhage (ICH) evacuation followed by rosiglitazone (RSG) infusion therapy on perihematomal tight junction associated proteins occludin and zonula occludens-1 (ZO-1) expression as well as blood brain barrier (BBB) permeability in rabbits.Methods: A total of 50 male rabbits (2.5-3.5 kg) were randomly assigned to a sham group (Sham group, 10 rabbits), an ICH model group (HM group, 10 rabbits), a RSG medication group (RSG group, 10 rabbits), a minimally invasive surgery group (MIS group, 10 rabbits) and a MIS combined with RSG group (MIS+RSG group, 10 rabbits). ICH was induced in all of the rabbits except for those in the Sham group. An MIS was performed to evacuate the hematoma at 6 hours after the successful preparation of the ICH model in the MIS group and the MIS+RSG group. The RSG (0.5mg, dissolved in 0.1 ml of 0.9% sodium chloride solution) was infused into the hematoma area in the RSG group and the MIS+RSG group. All rabbits were sacrificed on day 7 after the relative processes were performed successfully, and the perihematomal brain tissue was removed to determine the occludin and ZO-1 expression and BBB permeability by Evens Blue (EB). Results:The occludin and ZO-1 expression were all significantly decreased and the BBB permeability was increased in the HM group compared with the Sham group. The RSG used alone or performing the MIS alone to evacuate the ICH resulted in a marked increase in the occludin and ZO-1 expression and decrease in BBB permeability. The MIS+RSG group displayed a great increase in the occludin and ZO-1 expression and a more significant decrease in BBB permeability. Conclusions:The MIS combined with RSG medication could significantly increase the perihematomal occludin and ZO-1 expression and decrease in BBB permeability which plays an important therapeutic role in secondary brain damage following ICH. KeywordsIntracerebral hemorrhage, Minimally invasive surgery, Rosiglitazone, Tight junction, Occludin, Zonula occludens-1, Blood-brain barrier Rosiglitazone (RSG), an agonist of peroxisome proliferator-activated receptor-gamma (PPARγ), has shown neuroprotective effects in patients with ischemic stroke and Alzheimer's disease. It has reported that RSG could significantly reduce brain tissue loss, ameliorated white matter injury, and improved sensorimotor and cognitive functions and increased the numbers of newly generated mature oligodendrocytes after middle cerebral artery occlusion [24]. RSG reversed depressive behaviors in mice, as indicated by the forced swimming test and open field test. RSG was also found to inhibit the inflammatory response, decrease corticosterone levels, promote astrocyte proliferation and neuronal axon plasticity in the prefrontal cortex of mice, and exerts an antidepressive effect in unpredictable chronic mildstress-induced depressive mice by maintaining essential neuron autophagy and inhibiting excessive astrocytic apoptosis [25]. Several studies have ...

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“…However, the increase in BBBP was sustained for up to 14 days [36]. One animal study found that the measurements of the BBBP were similar between 1 week and 1-day post-ICH [40].…”

Section: Application In Hemorrhagic Strokementioning

confidence: 99%

Permeability imaging in cerebrovascular diseases: applications and progress in research

Chen

Liu

et al. 2016

Neurovasc Imaging

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Cerebrovascular disease is currently the second most common cause of death after ischemic heart disease. In this article, we mainly focus on the application of permeability imaging in cases of ischemic and hemorrhagic stroke, and cerebral small vessel disease. In this review, we discuss the application of permeability imaging in ischemic stroke from two aspects: 1) for the prediction of hemorrhagic transformation after infarction, and 2) for the evaluation of newborn secondary and tertiary collateral circulations. Quantitative measurements of blood-brain barrier (BBB) disruption by the Dynamic Contrast Enhance MR (DCE-MR) can reveal the severity of intracranial hemorrhage (ICH)-induced brain damage, and that the technique has the potential to be used for testing the efficacy of interventions aimed at reducing tissue damage around the hematoma. Currently, DCE-MR is mostly applied for the assessment of tumors in patients. There is less research focused on the evaluation of mild BBB defects in normal or abnormal aging brains, dementia, or cerebral small vessel disease. More work needs to be done to select the appropriate contrast agents and decide their doses, as well as to identify methods for parameter collection and data analysis.

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Minimally Invasive Procedures for Evacuation of Intracerebral Hemorrhage Reduces Perihematomal Glutamate Content, Blood–Brain Barrier Permeability and Brain Edema in Rabbits

Abstract: Minimally invasive surgery for removal of an intracerebral hematoma could significantly reduce the glutamate content, BBB permeability and the brain water content in perihematomal brain tissues.

Cited by 37 publications

References 26 publications

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Minimally Invasive Surgery for Intracerebral Hematoma Evacuation followed by Rosiglitazone Infusion Therapy Increased Perihematomal Occludin, Zonula Occludens-1 Expression and Decreased the Blood Brain Barrier Permeability in Rabbits

Permeability imaging in cerebrovascular diseases: applications and progress in research

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