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Studies of intravascular components in cerebral vasospasm following subarachnoid hemorrhage

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Summary

Cerebral vasospasm with subsequent infarction gives important influence to the prognosis of patients with ruptured intracranial aneurysms. Many factors should be considered in the pathogenesis of cerebral infarction. Clinical and experimental studies of intravascular components with particular reference to platelet and coagulation factors were performed. Both studies revealed systemic platelet hyperactivity and a hypercoagulable state; in further experimental studies, crenated red blood cells were recognized in the course of cerebral vasospasm. These systemic changes of intravascular components are thought to accelerate cerebral ischemia through formation of microthrombosis, increased blood viscosity and reduced deformability of the red blood cells.

Zusammenfassung

Zerebrale Gefäßspasmen mit nachfolgendem Infarkt haben großen Einfluß auf die Prognose von Patienten mit Aneurysmarupturen. In der Pathogenese von Hirninfarkten müssen viele Faktoren berücksichtigt werden.

Hier werden klinische und experimentelle Untersuchungen intravaskulärer Faktoren vorgenommen, besonders der Blutplättchen und der Gerinnungsfaktoren. Sie ergaben eine Hyperaktivität des Blutplättchensystems und eine Hyperkoagulabilität. In weiteren Untersuchungen wurden geschrumpfte rote Blutkörperchen im Verlauf von Gefäßspasmen gefunden. Es wird angenommen, daß diese systemischen Veränderungen intravaskulärer Faktoren durch Bildung von Mikrothromben, erhöhte Blutviskosität und verminderte Verformbarkeit der Erythrozyten eine zerebrale Ischaemie beschleunigen.

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References

  1. Allcock, J. M., C. G. Drake: Ruptured intracranial aneurysms — the role of arterial spasm. J. Neurosurg. 22 (1965) 21–29

    PubMed  Google Scholar 

  2. Allen, G. S., G. J. Gross, L. A. French, S. N. Chou: Cerebral arterial spasm-Part 5: In vitro contractile activity of vasoactive agents including human CSF on human basilar and anterior cerebral arteries. J. Neurosurg. 44 (1976) 594–600

    PubMed  Google Scholar 

  3. Astrup, T.: Assay and content of tissue thromboplastin in different organs. Thrombos. Diathes. haemorrh. (Stuttg.) 14 (1965) 401–416

    Google Scholar 

  4. Barnhart, M. I., J. Gilroy, J. S. Meyer: Dextran 40 in cerebrovascular thrombosis. Thrombos. Diathes. haemorrh. (Suppl.) 42 (1970) 321–344

    Google Scholar 

  5. Barnhart, M. I., R. T. Walsh, J. A. Robinson: A three-dimensional view of platelet responses to chemical stimuli. Ann. N.Y. Acad. Sci. 201 (1972) 360–390

    PubMed  Google Scholar 

  6. Braasch, D.: Red cell deformability and capillary blood flow. Physiol. Rev. 51 (1971) 679–701

    Google Scholar 

  7. Brawley, B. W., D. E. Strandness Jr., W. A. Kelly: The biphasic response of cerebral vasospasm in experimental subarachnoid hemorrhage. J. Neurosurg. 28 (1968) 1–8

    PubMed  Google Scholar 

  8. Brecher, B., M. Bessis: Present status of spiculed red cells and their relationship to the discocyte-echinocyte transformation — a critical review. Blood 40 (1972) 333–334

    PubMed  Google Scholar 

  9. Crompton, M. R.: Cerebral infarction following the rupture of cerebral berry aneurysms. Brain 87 (1964) 263–280

    Google Scholar 

  10. Crompton, M. R.: The pathogenesis of cerebral infarction following the rupture of cerebral berry aneurysms. Brain 87 (1964) 491–510

    PubMed  Google Scholar 

  11. Denton, I. C. Jr., J. T. Robertson, M. Dugdale: An assessment of early platelet activity in experimental subarachnoid hemorrhage and middle cerebral artery thrombosis in the cat. Stroke 2 (1971) 268–272

    PubMed  Google Scholar 

  12. Deuticke, B.: Transformation and restoration of biconcave shape of human erythrocytes induced by amphiphilic agent and changes of ionic environment. Biochim. Biophys. Acta 163 (1968) 494–500

    PubMed  Google Scholar 

  13. Ehrly, A. M.: Improvement of the flow properties of blood — a new therapeutical approach in occlusive arterial disease. Angiology 27 (1976) 188–196

    PubMed  Google Scholar 

  14. Ettinger, M. G.: Coagulation abnormalities in subarachnoid hemorrhage. Stroke 1 (1970) 139–142

    PubMed  Google Scholar 

  15. Fein, J. M., W. J. Flor, S. L. Cohan, J. Parkhurst: Sequential changes of vascular ultrastructure in experimental cerebral vasospasm-myonecrosis of subarachnoid arteries. J. Neurosurg. 41 (1974) 49–58

    PubMed  Google Scholar 

  16. Hashi, K., J. S. Meyer, S. Shinmaru, K. M. A. Welch, T. Teraura: Cerebral hemodynamic and metabolic changes after experimental subarachnoid hemorrhage. J. Neurol. Sci. 17 (1972) 1–14

    PubMed  Google Scholar 

  17. Keimowitz, R. M., B. Annis: Disseminated intravascular coagulation associated with massive brain injury. J. Neurosurg. 39 (1973) 178–180

    PubMed  Google Scholar 

  18. Kim, S., K. Sano: The role of platelets and erythrocytes in disturbance of cerebral microcirculation. Neurol. Med. Chir. 17, Part II (1977) 135–144

    Google Scholar 

  19. Kin, H., M. Mizukami, G. Aaraki: The pathological study of so-called vasospasm. Neurol. Med. Chir. 16 (1976) 115–125

    Google Scholar 

  20. Kuwayama, W., N. T. Zervas, R. Belson: A model for experimental cerebral arterial spasm. Stroke 3 (1972) 49–56

    PubMed  Google Scholar 

  21. Matsuda, T.: Hypercoagulability and stroke. Brain and Nerve 30 (1978) 13–25

    PubMed  Google Scholar 

  22. Millikan, C. H.: Cerebral vasospasm and ruptured intracranial aneurysm. Arch. Neurol. 32 (1975) 443 to 449

    Google Scholar 

  23. Mullan, S., K. Hanlon. F. Brown: Management of 139 consecutive supratentorial berry aneurysms. J. Neurosurg. 49 (1978) 794–804

    PubMed  Google Scholar 

  24. Nakao, M., T. Nakao, S. Yamazoe, H. Yoshikawa: Adenosine triphosphate and shape of erythrocytes. J. Biochem. 49 (1961) 487–492

    PubMed  Google Scholar 

  25. Nakao, K., T. Wada, T. Kamiyama, M. Nakao, K. Nagano: A direct relationship between adenosine triphosphate-level and in vivo viability of erythrocytes. Nature 194 (1962) 877–878

    PubMed  Google Scholar 

  26. Peerless, S. J., J. C. Griffiths: Plasma catecholamines following subarachnoid hemorrhage. In: Smith, R. P., J. T. Robertson: Subarachnoid hemorrage and cerebrovascular spasm. C. C. Thomas, Springfield 1975, pp 148–154

    Google Scholar 

  27. Ransohoff, J., A. Goodgold, M. V. Benjamin: Preoperative management of patients with ruptured intracranial aneurysms. J. Neurosurg. 36 (1972) 525–530

    PubMed  Google Scholar 

  28. Schneck, S. A., J. J. Kricheff: Intracranial aneurysm rupture, vasospasm, and infarction. Arch. Neurol. 11 (1964) 668–680

    PubMed  Google Scholar 

  29. Stornelli, S. A., J. O. French: Subarachnoid hemorrhage — factors in prognosis and management. J. Neurosurg. 21 (1964) 769–780

    PubMed  Google Scholar 

  30. Tanabe, Y., K. Sakata, H. Yamada, T. Ito, M. Takada: Cerebral vasospasm and ultrastructural changes in cerebral arterial wall — an experimental study. J. Neursorg. 49 (1978) 229–238

    Google Scholar 

  31. Van der Sande, J. J., J. J. Veltkamp, R. J. Boekhout-Mussert, M. L. Bouwhuis-Hoogerwerf: Head injury and coagulation disorders. J. Neurosurg. 49 (1978) 357–365

    PubMed  Google Scholar 

  32. Watanabe, H., M. Ito, H. Chigasaki, S. Ishii: Antifibrinolytic therapy in rupturedintracranial aneurysm through repeated monitoring of fibrinolytic activity of blood. Neurol. Med. Chir. 16, Part I (1976) 91–96

    Google Scholar 

  33. Watanabe, H., H. Chigasaki, S. Ishii: Studies on the fibrinolytic system in ruptured intracranial aneurysm. Part 1. Monitoring of antifibrinolytic therapy through repeated measurement of SK-Euglobulin Lysis Time and FDP. Neurol. Surg. 5 (1977) 857–863

    Google Scholar 

  34. Watanabe, H., S. Ishii, T. Matsuda: Studies on the fibrinolytic system in ruptured intracranial aneurysm. Part 2. Fibrinogen changes in acute stage of SAH as a risk factor of the ischemic complication following vasospasm. Neurol. Surg. 6 (1978) 563–569

    Google Scholar 

  35. Weir, B., M. Grasce, J. Hansen, Ch. Rothberg: Time course of vasospasm in man. J. Neurosurg. 48 (1978) 173–178

    PubMed  Google Scholar 

  36. Yoshida, S., R. A. R. Fraser: Experimental cerebral vasospasm — comparison of perfusion deficits with angiography. Brain and Nerve 29 (1977) 1167–1173

    PubMed  Google Scholar 

  37. Zucker, M. B., J. Borrelli: Quantity, assay and release of serotonin in human platelets. J. appl. Physiol. 7 (1955) 425–431

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Juntendo University, School of Medicine, 2-1-1, Hongo, Tokyo, Japan

    T. Hasegawa, H. Watanabe & S. Ishii

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  1. T. Hasegawa
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  2. H. Watanabe
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  3. S. Ishii
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Additional information

Dedicated to Professor Dr. K. J. Zülch on the occasion of his 70th birthday.

This paper was presented in part at the Annual Meeting of the American Association of Neurological Surgeons in Los Angeles in April 1979.

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Hasegawa, T., Watanabe, H. & Ishii, S. Studies of intravascular components in cerebral vasospasm following subarachnoid hemorrhage. Neurosurg. Rev. 3, 93–100 (1980). https://doi.org/10.1007/BF01644061

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