Microthrombosis at the Ultra-early Stages after Experimental Subarachnoid Hemorrhage Results in Early Brain Injury.

Masaki Kumagai, Yusuke Egashira, Nozomi Sasaki, Shinsuke Nakamura, Yoshiki Kuse, Hirohumi Matsubara, Yukiko Enomoto, Tsuyoshi Izumo, Hideaki Hara, Masamitsu Shimazawa
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Abstract

Introduction: Early Brain Injury (EBI) significantly contributes to poor neurological outcomes and death following subarachnoid hemorrhage (SAH). The mechanisms underlying EBI post-SAH remain unclear. This study explores the relationship between serial cerebral blood flow (CBF) changes and neurological symptoms, as well as the mechanisms driving CBF changes in the ultra-early stages after experimental SAH in mice.

Methods: SAH was induced by endovascular perforation in male ddY mice. Mice were sacrificed at 6, 12, 24, and 48 h after behavioral tests using the modified neurological score and grid walking test, and CBF was measured via Laser Speckle Flow Imaging (LSFI). Neurofunctional evaluation, CBF analysis, and Western blotting were used to assess SAH-induced damage.

Results: Neurological symptoms were significantly worse at 12 h post-SAH compared to sham (9.5 ± 1.7 vs. 25.6 ± 0.63, respectively; p < 0.0001). CBF was significantly reduced at 12 h post- SAH compared to sham (35.34 ± 8.611 vs. 91.06 ± 12.45, respectively; p < 0.0001). Western blotting revealed significantly elevated thrombin and matrix metalloproteinase 9 levels 12 h post-SAH (p < 0.05).

Conclusion: Our results suggest that microthrombus formation peaked at 12 h post-SAH, potentially causing EBI and worsening neurological symptoms. Microthrombus formation in the ultraearly stages may represent a novel therapeutic target for managing EBI.

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实验性蛛网膜下腔出血后超早期微血栓形成导致早期脑损伤。
早期脑损伤(EBI)对蛛网膜下腔出血(SAH)后的神经预后不良和死亡有重要影响。sah后EBI的机制尚不清楚。本研究探讨小鼠实验性SAH后超早期脑血流(CBF)变化与神经系统症状的关系,以及CBF变化的驱动机制。方法:用血管内穿孔法诱导雄性小鼠SAH。分别于行为测试后6、12、24和48 h处死小鼠,采用改良神经评分和网格行走测试,并通过激光散斑流成像(LSFI)测量CBF。神经功能评估、脑血流分析和Western blotting用于评估sah诱导的损伤。结果:与假手术组相比,sah后12小时神经系统症状明显加重(分别为9.5±1.7比25.6±0.63);P < 0.0001)。与假手术相比,SAH后12 h CBF显著减少(分别为35.34±8.611∶91.06±12.45);P < 0.0001)。Western blotting显示,sah后12 h凝血酶和基质金属蛋白酶9水平显著升高(p < 0.05)。结论:我们的研究结果表明,微血栓形成在sah后12小时达到高峰,可能导致EBI和神经系统症状恶化。超早期微血栓形成可能是治疗EBI的一个新的治疗靶点。
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