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Is vasospasm related to proliferative arteriopathy?
R M Pluta1, A Zauner, J K Morgan
1Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Journal of Neurosurgery
|November 1, 1992
Summary
Cell proliferation in the arterial wall does not cause vasospasm after subarachnoid hemorrhage (SAH). This study found no link between cell division and the narrowing of cerebral arteries following SAH in primates.
Area of Science:
- Neuroscience
- Vascular Biology
- Pathology
Background:
- Proliferative arteriopathy is a suspected cause of vasospasm after subarachnoid hemorrhage (SAH).
- Previous histological studies on cerebral vasospasm after SAH have yielded conflicting results.
- An in vivo method to assess cell proliferation was needed to clarify the role of arteriopathy in SAH-induced vasospasm.
Purpose of the Study:
- To investigate the association between cell proliferation in the cerebral arterial wall and vasospasm following subarachnoid hemorrhage (SAH) in a primate model.
- To determine if increased cell division contributes to the development or severity of vasospasm after SAH.
Main Methods:
- Subarachnoid hemorrhage (SAH) was induced in 15 cynomolgus monkeys by placing blood clots around the middle cerebral artery (MCA).
- Bromodeoxycytidine, an in vivo marker of cell division, was infused continuously from surgery until sacrifice on days 7, 12, or 27.
- MCA sections were stained for bromodeoxycytidine to quantify cell proliferation, and arteriography assessed vasospasm.
Main Results:
- Vasospasm was observed in 9 monkeys on Day 7 but resolved by Day 12 and 27.
- Blood clots increased cell proliferation in all layers of the MCA wall, particularly the adventitia and endothelium.
- No significant association was found between the extent of cell proliferation and the occurrence or severity of vasospasm on any day.
Conclusions:
- Cerebral vasospasm following subarachnoid hemorrhage (SAH) is not directly associated with increased cell proliferation in the arterial wall.
- The observed proliferative changes in the vessel wall after SAH are limited and unlikely to cause the significant arterial narrowing seen in vasospasm.