Neurobehavioral Assessments of Cerebral Vasospasm - Animal Models of Acute Neurological Injuries: Injury and Mechanistic Assessments - page 539

Chapter 45

Neurobehavioral Assessments of Cerebral Vasospasm

Ryszard M. Pluta , Boris Skopets , and Jerald D. Kralik

Abstract

For many years, neurosurgeons and neurointerventionalists have been focused on the neurological
functionality of the patients as a main measure assessing the effects of treatment of intracranial aneurysms.
But, individual experience, sporadic series of patients operated in a delayed fashion, as well as the patients
operated before an aneurysm rupture indicate a necessity for better neurological, psychological, and
Quality Of Life (QOL) assessments because the Glasgow Outcome Scale and QOL scale have become
inadequate in the face of everyday life challenges for many patients. But to develop and test reliability of
new tools, we need to develop a better understanding of pathomechanism(s) of neurobehavioral changes
after aneurismal subarachnoid hemorrhage (aSAH) and at this moment we are lacking proper experimental
models. Fortunately, animal models that have been developed to investigate delayed cerebral vasospasm
should help to examine neurobehavioral changes after aSAH. Therefore, albeit many limitations that must
be kept in mind, a systematic research, especially using a nonhuman primate model, should continue to
play a critical role in the understanding of cognitive and behavioral function after aSAH.

Key words: Subarachnoid hemorrhage, Vasospasm, Nonhuman primates, Animal models,
Neurobehavior

1. Introduction:
A Tale of Two
Patients

Mr. AB, age 65, right-handed Caucasian, and internationally known
artist, was incidentally diagnosed with multilobulated anterior cere-
bral artery aneurysm (Fischer's grade 0, Hunt and Hess grade 1;
Tables 1 and 2 ). His aneurysm could not be treated via endovascu-
lar coiling due to the presence of a wide neck, shape of the dome(s),
and tortuosity of the anterior cerebral arteries. Thus, it was success-
fully and uneventfully clipped. Two weeks after surgery, he required
a ventriculo-peritoneal shunt placement due to the development of
communicating hydrocephalus. Three months after surgery, he
returned to his studio and continued his successful highly creative
career with no diffi culties. His Glasgow Outcome Scale (GOS;
Table 4 ) was 5 both at 6 months and 1 year after surgery.