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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
The systemic implications of aneurysmal subarachnoid hemorrhage.
Robert D Stevens1, Paul A Nyquist
1Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. rstevens@jhmi.edu
Journal of the Neurological Sciences
|June 5, 2007
Summary
Aneurysmal subarachnoid hemorrhage (SAH) causes widespread organ dysfunction, impacting survival and recovery. Addressing these systemic issues in clinical trials may improve outcomes for SAH patients.
Area of Science:
- Neurology
- Critical Care Medicine
- Neuroscience
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) critically disrupts brain function.
- SAH triggers systemic dysfunctions affecting cardiovascular, respiratory, endocrine, hematological, and immune systems.
- Extracerebral organ dysfunction correlates with the neurological insult's severity, suggesting neurogenic pathways.
Purpose of the Study:
- To investigate the link between SAH and systemic organ dysfunction.
- To explore the mechanisms driving neurogenic, neuroendocrine, and neuroimmunomodulatory effects in SAH.
- To highlight the association of systemic organ involvement with mortality and neurological impairment.
Main Methods:
- Review of pathophysiological mechanisms in SAH.
- Analysis of systemic organ dysfunction following SAH.
- Correlation of organ dysfunction with neurological injury severity and clinical outcomes.
Main Results:
- SAH acts as a "watershed," causing extensive brain and systemic derangements.
- Systemic organ dysfunction is linked to increased mortality and neurological deficits.
- Secondary brain injury from hypoxemia, circulatory failure, fever, or hyperglycemia contributes to poor outcomes.
Conclusions:
- Systemic organ dysfunction is a significant predictor of outcomes in SAH patients.
- Neurogenic, neuroendocrine, and neuroimmunomodulatory mechanisms are implicated.
- Clinical trials testing interventions to manage systemic perturbations are crucial for improving SAH patient survival and recovery.
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