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Updated: Dec 23, 2025
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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
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Spreading Depolarizations and Subarachnoid Hemorrhage.
Kazutaka Sugimoto1,2, David Y Chung3,4,5
1Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6403, Charlestown, MA, 02129, USA.
Summary
Cortical spreading depolarizations (SD) impact outcomes in subarachnoid hemorrhage (SAH). Therapies targeting SDs, like cilostazol, show promise for improving brain blood flow and patient recovery.
Area of Science:
- Neuroscience
- Neurology
- Neurosurgery
Background:
- Cortical spreading depolarizations (SD) are linked to poor outcomes and brain injury in aneurysmal subarachnoid hemorrhage (SAH).
- Preclinical research suggests SDs causally influence tissue damage after SAH.
- Emerging therapies aim to target SDs, viewing them as both a treatment target and a potential biomarker.
Purpose of the Study:
- To review current therapeutic strategies targeting cortical spreading depolarizations (SD) in aneurysmal subarachnoid hemorrhage (SAH).
- To evaluate the efficacy of cilostazol and ketamine in managing SDs and improving outcomes in SAH patients.
- To discuss the role of SDs as a biomarker for brain injury in SAH.
Main Methods:
- Review of single-center randomized trials assessing cilostazol in SAH patients.
- Discussion of preclinical and clinical studies on NMDA receptor antagonists like ketamine for SD blockade.
- Analysis of the relationship between SDs, cerebral blood flow, and clinical outcomes in SAH.
Main Results:
- Cilostazol treatment in SAH patients improved functional outcomes and SD-related metrics, potentially via enhanced cerebral blood flow.
- NMDA receptor antagonists like ketamine are being explored as a method to block SDs.
- SDs are increasingly recognized as a potential biomarker for brain injury severity in SAH.
Conclusions:
- Therapeutic interventions targeting cortical spreading depolarizations (SD) show promise in improving outcomes for patients with subarachnoid hemorrhage (SAH).
- Cilostazol demonstrated benefits in functional recovery and SD metrics, suggesting a role in managing cerebral blood flow.
- Further clinical and preclinical research is essential to validate these findings and understand the SD-SAH relationship.
Keywords:
Cerebral aneurysmCortical spreading depressionsDelayed cerebral ischemiaDelayed ischemic neurological deficits and strokeVasospasmMore Related Videos
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