Nitric oxide inhalation reduces brain damage, prevents mortality, and improves neurological outcome after subarachnoid hemorrhage by resolving early pial microvasospasms
| Autor: | Nicole Heumos, Nikolaus Plesnila, Sergej Feiler, Serge C. Thal, Nicole A. Terpolilli, John F. Stover, Ari Dienel, Frank Müller, Karsten Schöller, Benjamin Friedrich |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Subarachnoid hemorrhage Ischemia Hippocampus Brain Edema Brain damage Nitric Oxide Nitric oxide Mice 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Administration Inhalation medicine Animals Vasospasm Intracranial cardiovascular diseases Cerebral perfusion pressure Inhalation business.industry Original Articles Subarachnoid Hemorrhage medicine.disease nervous system diseases Mice Inbred C57BL Treatment Outcome 030104 developmental biology Neurology chemistry Brain Injuries Anesthesia Microvessels Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Intravital microscopy |
| Zdroj: | Journal of Cerebral Blood Flow & Metabolism. 36:2096-2107 |
| ISSN: | 1559-7016 0271-678X |
| DOI: | 10.1177/0271678x15605848 |
| Popis: | Subarachnoid hemorrhage is a stroke subtype with particularly bad outcome. Recent findings suggest that constrictions of pial arterioles occurring early after hemorrhage may be responsible for cerebral ischemia and – subsequently – unfavorable outcome after subarachnoid hemorrhage. Since we recently hypothesized that the lack of nitric oxide may cause post-hemorrhagic microvasospasms, our aim was to investigate whether inhaled nitric oxide, a treatment paradigm selectively delivering nitric oxide to ischemic microvessels, is able to dilate post-hemorrhagic microvasospasms; thereby improving outcome after experimental subarachnoid hemorrhage. C57BL/6 mice were subjected to experimental SAH. Three hours after subarachnoid hemorrhage pial artery spasms were quantified by intravital microscopy, then mice received inhaled nitric oxide or vehicle. For induction of large artery spasms mice received an intracisternal injection of autologous blood. Inhaled nitric oxide significantly reduced number and severity of subarachnoid hemorrhage-induced post-hemorrhage microvasospasms while only having limited effect on large artery spasms. This resulted in less brain-edema-formation, less hippocampal neuronal loss, lack of mortality, and significantly improved neurological outcome after subarachnoid hemorrhage. This suggests that spasms of pial arterioles play a major role for the outcome after subarachnoid hemorrhage and that lack of nitric oxide is an important mechanism of post-hemorrhagic microvascular dysfunction. Reversing microvascular dysfunction by inhaled nitric oxide might be a promising treatment strategy for subarachnoid hemorrhage. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|