New endovascular perforation subarachnoid hemorrhage model for investigating the mechanisms of delayed brain injury

J Neurosurg. 2019 Nov 22;134(1):84-94. doi: 10.3171/2019.9.JNS191934.

Abstract

Objective: Delayed brain injury (DBI) is considered one of the most important causes of mortality and morbidity after subarachnoid hemorrhage (SAH). However, no suitable experimental rat endovascular perforation (EVP) SAH model was available for investigating DBI. The authors added early cerebral hypoperfusion to a mild EVP SAH model by unilateral common carotid artery occlusion (UCCAO) 24 hours after induction of SAH to mimic the clinical course of early cerebral hypoperfusion after SAH.

Methods: A total of 109 adult male Sprague-Dawley rats were randomly divided into 2 groups: no SAH and SAH. Next, no-SAH rats were randomly divided on day 1 into 2 groups: sham and UCCAO. SAH rats with a neurological score of 15 or greater were randomly divided into 2 groups: SAH - UCCAO and SAH + UCCAO group.

Results: The mild SAH model had a lower mortality rate of 5.4% within the first 24 hours. No rat died in the SAH + UCCAO group until day 7. DBI as well as early brain injury (EBI), reactive astrogliosis, and cerebral vasospasm significantly worsened in the SAH + UCCAO group.

Conclusions: The present SAH + UCCAO model can simulate EBI with aggravation of reactive astrogliosis, cerebral vasospasm, and DBI but without high mortality.

Keywords: delayed brain injury; early brain injury; endovascular perforation model; reactive astrogliosis; subarachnoid hemorrhage; vascular disorders.