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Updated: Jun 19, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Microthrombi and hypercoagulability's contribution to delayed cerebral ischemia after aneurysmal subarachnoid
William Walker Wroe1, Hussein A Zeineddine1, Spiros Blackburn1
1The Vivian L Smith Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Abstract:
Despite increasing knowledge over the last several decades of the factors contributing to delayed cerebral ischemia (DCI), it remains a significant cause of morbidity after aneurysmal subarachnoid hemorrhage (aSAH). The hypercoagulable state induced by aneurysm rupture is critical to most proposed mechanisms of DCI either through its direct contribution to microthrombi formation, or through the indirect effects of the products of coagulation on vasospasm, and inflammation. In this review we summarize clinical evidence of hypercoagulability after aSAH as well as both the clinical and pre-clinical evidence of its role in DCI, highlighting the role that microthrombi and NETosis are thought to play.
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