Effect of Carotid Stenosis on the Development of Subarachnoid Hemorrhage: An Experimental Study

Subarachnoid hemorrhage (SAH) may be seen after the invasive procedures of occlusive carotid artery disease. The objective of this experimental study is to investigate the effect of bilateral common carotid artery ligation (BCCAL) on the development of subarachnoid hemorrhage (SAH).Twenty Wistar adult rats (150-200g) were randomly divided into two groups, as follows: (ı) Control group (without BCCAL, n = 5), (II) BCCAL group (n = 15). All rats were sacrificed three months later. The basilar artery with surrounding tissue was removed from the cranium and processed for paraffin embedding. Histopathological and Stereological examinations of the basilar artery were made. During the experimental period, six rats died within twenty days after BCCAL, and SAH was detected in four of them. The mean cross sectional area of basilar arteries was 0.28 mm2 in the control, whereas in the rats that did not develop SAH and These that developed SAH were 0.33 mm2 and 0.23 mm2 (P < 0.01), respectively. Luminal enlargement, vascular wall thinning, endothelial injury and flattening of inner elastic lamina were examined histopathologically. There were red blood cells in the cisterna magna of animals that developed SAH. Carotid stenosis or invasive applications such as carotid angioplasty and carotid stenting may cause fatal SAH.

Effect of Carotid Stenosis on the Development of Subarachnoid Hemorrhage: An Experimental Study

Subarachnoid hemorrhage (SAH) may be seen after the invasive procedures of occlusive carotid artery disease. The objective of this experimental study is to investigate the effect of bilateral common carotid artery ligation (BCCAL) on the development of subarachnoid hemorrhage (SAH).Twenty Wistar adult rats (150-200g) were randomly divided into two groups, as follows: (ı) Control group (without BCCAL, n = 5), (II) BCCAL group (n = 15). All rats were sacrificed three months later. The basilar artery with surrounding tissue was removed from the cranium and processed for paraffin embedding. Histopathological and Stereological examinations of the basilar artery were made. During the experimental period, six rats died within twenty days after BCCAL, and SAH was detected in four of them. The mean cross sectional area of basilar arteries was 0.28 mm2 in the control, whereas in the rats that did not develop SAH and These that developed SAH were 0.33 mm2 and 0.23 mm2 (P < 0.01), respectively. Luminal enlargement, vascular wall thinning, endothelial injury and flattening of inner elastic lamina were examined histopathologically. There were red blood cells in the cisterna magna of animals that developed SAH. Carotid stenosis or invasive applications such as carotid angioplasty and carotid stenting may cause fatal SAH.

___

  • Savas HA, Unal B, Erbagci E et al. Hippocampal volume in schizophrenia and its relationship with risperidone treatment: a stereological study. Neuropsychobiology 46:61-66, 2002.
  • Natarjan P, Sano H, Ogosawara M et al. Effects of Elastase on Experimentally Induced Aneurysms in Rats. No Shinkei Geka 14:301-304 (abstract), 1986.
  • Salar G, Migroni S. Development of Intracranial Saccular Aneurysms: Report of two Cases. Neurosurgery 8:462-465, 1987.
  • Sorteberg A, Sorteberg W, Lindegaard KF et al. Cerebral Haemodynamic Considerations in Obstructive Carotid Artery Disease. Acta Neurochi 138:68-76, 1996.
  • Batjer H, Mickey B, Samson D. Enlargement and Rupture of Distal Basilar Artery Aneurysm after Iatrogenic Carotid Occlusion. Neurosurgery 20:624-628, 1987.
  • Kataoka K, Taneda M. Cerebral Aneurysm with Bilateral Carotid Occlusion. Neurol Med Chir 22:744-750, 1997.
  • Dyste GN, Beck DW. De novo Aneurysm Formation following Carotid Ligation: Case Report and Review of the Literature. Neurosurgery 24:88-92, 1989.
  • Hartman M, Weber R, Zoubaa S et al. Fatal Subarachnoid Hemorrhage After Carotid Stenting. J Neuroradıol 31:63-66, 2004.
  • Hashimoto N, Kim C, Kikuchi H et al. Experimental Induction of Cerebral Aneurysms in Monkeys. J Neurosurg 67:903-905, 1987.
  • Koeleveld RF, Heilman CB, Klucznik RP et al. De novo Development of an Aneurysm. Case Report. Neurosurgery 29:756-759, 1991.
  • Larson JJ, Tew JM Jr, Tomsick TA et al. Treatment of Aneurysms of the Internal Carotid Artery by Intravascular Balloon Occlusion: Long term follow up of 58 patients. Neurosurgery 33:981-985, 1995.
  • Marchel A, Bidzinski J, Bojarski P. Formation of New Aneurysms. Report of Five Cases. Acta Neurochir 112:96-99, 1991
  • Yamanaka C, Hirohata T, Kiya K et al. Basilar Bifurcation Aneurysm Associated with Bilateral Internal Carotid Occlusion. Neuroradiology 29:84-88, 1987.
  • Al-Mubarak N, Roubin GS, Vitek JJ et al. Subarachnoidal hemorrhage following carotid stenting with the distal balloon protection. Catheter Cardiovasc Interv 54:524-525, 2001.