Endoscopic technique: a new model of subarachnoid hemorrhage in rats

Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: Is There a Relevant Experimental Model? A Systematic Review of Preclinical Literature

Delayed cerebral ischemia (DCI) is one of the main prognosis factors for disability after aneurysmal subarachnoid hemorrhage (SAH). The lack of a consensual definition for DCI had limited investigation and care in human until 2010, when a multidisciplinary research expert group proposed to define DCI as the occurrence of cerebral infarction (identified on imaging or histology) associated with clinical deterioration. We performed a systematic review to assess whether preclinical models of SAH meet this definition, focusing on the combination of noninvasive imaging and neurological deficits. To this aim, we searched in PUBMED database and included all rodent SAH models that considered cerebral ischemia and/or neurological outcome and/or vasospasm. Seventy-eight publications were included. Eight different methods were performed to induce SAH, with blood injection in the cisterna magna being the most widely used (n = 39, 50%). Vasospasm was the most investigated SAH-related complication (n = 52, 67%) compared to cerebral ischemia (n = 30, 38%), which was never investigated with imaging. Neurological deficits were also explored (n = 19, 24%). This systematic review shows that no preclinical SAH model meets the 2010 clinical definition of DCI, highlighting the inconsistencies between preclinical and clinical standards. In order to enhance research and favor translation to humans, pertinent SAH animal models reproducing DCI are urgently needed.

Biomathematical modeling and analysis of blood flow in an intracranial aneurysm

The basic hypothesis of this study is that the intracranial aneurysm may enlarge and rupture due to dynamic instabilities of the blood flow and pressure inside the aneurysm. The specific question we attempted to answer is: which parameter(s) of aneurysmal geometry can serve as a reliable predictor(s) for aneurysmal rupture? We consider an idealized cylindrical aneurysm of the human common carotid artery and develop a mathematical model of blood flow through a normal artery and aneurysm connected in series. The mathematical model is nonlinear. It comprises nonlinear rheological properties of the normal artery and aneurysmal materials, and the inertial and resistance properties of the blood flow. The model equations were solved numerically and analyzed by methods of nonlinear dynamics. The critical aneurysmal diameter (CAD) is defined as a boundary point between the stable and unstable states of the model equations. The results confirm that a limit point of flow stability can occur only for a certain difference between aneurysmal and artery radii which are pre-disposed from a difference in their material properties. It was shown that CAD is dependent on both aneurysmal length and age of patient. Finally, the results suggest that the ratio between aneurysmal and normal artery diameters is a more reliable predictor of the aneurysmal rupture than the diameter alone. We conclude that an aneurysm diameter twice that of the normal artery could be dangerous.