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J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2273-5418
Original Article

Intimal Hemorrhage of Basilar Artery Induced by Severe Vasospasm Following Subarachnoid Hemorrhage: The Experimental Analysis

Ahmet Gökyar 
1   Department of Neurosurgery, Amasya University Faculty of Medicine, Amasya, Turkey
,
Mehmet Hakan Şahin
2   Department of Neurosurgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Mehmet Kürşat Karadağ
2   Department of Neurosurgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Sinan Bahadır 
1   Department of Neurosurgery, Amasya University Faculty of Medicine, Amasya, Turkey
,
Mete Zeynal
2   Department of Neurosurgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Sare Altas Sipal
3   Department of Pathology, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Mehmet D. Aydin
2   Department of Neurosurgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
› Author Affiliations Funding None.
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Abstract

Background Cerebral vasospasm, a serious complication of subarachnoid hemorrhage (SAH), has been extensively studied for its neurochemical and pathophysiologic mechanisms. However, the contribution of inner elastic membrane dissection and subintimal hemorrhage to basilar artery occlusion remains underexplored. This study investigates inner elastic membrane-related changes in the basilar artery after SAH.

Methods Twenty-four hybrid rabbits were divided into control, sham, and SAH groups, with SAH induced by autologous blood injection. After 2 weeks, basilar artery changes, vasospasm indexes (VSIs), and dissections were evaluated.

Results The SAH group showed significantly higher VSI, with vascular wall thickening, luminal narrowing, convoluted smooth muscle cells, intimal elastic membrane disruption, endothelial cell desquamation, and apoptosis. Some SAH animals exhibited subintimal hemorrhage, inner elastic membrane dissection, and ruptures. Basilar arteries with subintimal hemorrhage had notably higher VSI.

Conclusions These findings highlight the role of subintimal hemorrhage and inner elastic membrane dissection in basilar artery occlusion post-SAH, offering valuable insights into vasospasm pathophysiology.

Keywords

subarachnoid hemorrhage - basilar artery - inner elastic membrane - subintimal hemorrhage - stereological analysis

Ethical Approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.




Publication History

Received: 02 November 2023

Accepted: 19 February 2024

Accepted Manuscript online:
21 February 2024

Article published online:
22 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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