Assessment of Microthromboembolism After Subarachnoid Hemorrhage - Animal Models of Acute Neurological Injuries: Injury and Mechanistic Assessments - page 368

Chapter 26
Assessment of Microthromboembolism
After Subarachnoid Hemorrhage
Mervyn D.I. Vergouwen and R. Loch Macdonald
Abstract
Delayed cerebral ischemia is a common complication after aneurysmal subarachnoid hemorrhage (SAH).
Besides arterial narrowing (vasospasm), microthromboembolism has been suggested as an additional
explanation for the occurrence of delayed cerebral ischemia. This chapter discusses the rationale for studying
microthromboembolism after SAH, and describes the limited experience with the assessment of microthrom-
boembolism in an SAH mouse model.
Key words: Subarachnoid hemorrhage, Delayed cerebral ischemia, Microthromboembolism, Assessment,
Mouse
1. Introduction
Aneurysmal subarachnoid hemorrhage (SAH) is a life-threatening
disease. One of the most feared complications is delayed cerebral
ischemia (DCI) which occurs in about 30% of patients who survive
the ictus of the hemorrhage. Clinical features of DCI mostly consist
of focal neurological signs, such as aphasia or hemiparesis, or a
decrease in the level of consciousness, typically with gradual and
often fl uctuating onset. DCI is sometimes reversible, but may also
progress to cerebral infarction, which is associated with an increased
risk of severe disability and death. The pathogenesis of DCI remains
incompletely understood. Despite the undisputed association
between arterial narrowing (vasospasm) and DCI, in the last decades
there has been debate if this association implies causality. It has
been suggested that the pathogenesis of DCI after SAH should
include additional hypotheses, such as microthromboembolism,
spasm of the microcirculation, cortical spreading ischemia, and