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  • The Preventive Effect of Sympathectomy on the Prebifurcation Level Middle Cerebral Artery Vasospasm in Subarachnoid Hemorrhage: An Animal Model

    Final Number:

    Mehmet Resid Onen MD; Ulas Cikla MD; Ilhan Yilmaz MD; Mehmet Dumlu Aydin

    Study Design:
    Laboratory Investigation

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Cerebral arteries innervated by several systems contribute to the control of cerebral blood flow. Subarachnoid hemorrhage causes acutely developed vasospasm by various mechanical and neurochemical mechanisms cranial parasympathetic nerve ischemia and related stellate ganglion overdyscharges. Dilatatory sensory fibers of cranial parasympathetic nerves and vasospastic fibers of stellate ganglions have a vasoregulatory effect on the cerebral arteries The aim of this study is to investigate the effect of sympatectomy on vasospasm of the middle cerebral artery.

    Methods: This study was performed on 30 rabbits. Five of them were used as a baseline control group, five for a SHAM group, five for an SAH group and the remainder were used as a study group (n=15). A proportion of the middle cerebral artery wall sectioning surface values (Wall ring) to lumen surface values were accepted as the vasospasm index (VSI). The differences of vasospasm index (VSI) values of the middle cerebral arteries of all groups were analysed using statistical methods.

    Results: Noticed brain swelling, cortical echimosis, arachnoid-pia adhesions and sulcal loss were detected in a gross examination of the brains. In histopathological examinations, endothelial cell loss, internal elastic membrane convolutions, muscular sortening with contractions, intimal edema, endothelial basal mebrane detachments, periarterial clot formation and endothelial apoptosis and severe vasospasm were detected in nonsympathectomised animals compared to the sympathectomised animals. Also the mean VSI values were evaluated as 1.032±0.054 in the control; 0.996±0.198 in the SHAM without the sympatectomy; 0.732±0.121 in the study group with the sympatectomy and 0.343±0.760 in the study group.

    Conclusions: Sympathetic blockage may be a useful effect in the prevention of cerebral vasospasm and other complications of SAH.

    Patient Care: Treatment for vasospasm

    Learning Objectives: The aim of this study is to investigate the effect of sympatectomy on vasospasm of the middle cerebral artery.


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