Download PDF
Minim Invasive Neurosurg 2001; 44(3): 167-171
DOI: 10.1055/s-2001-18149
ORIGINAL PAPER
Georg Thieme Verlag Stuttgart · New York

High Cervical Spinal Cord Stimulation (CSCS) Increases Regional Cerebral Blood Flow After Induced Subarachnoid Haemorrhage in Rats

H. Ebel1 , K. Schomäcker2 , A. Balogh3 , M. Volz1 , J. Funke1 , H. Schicha2 , N. Klug1
  • 1Department of Neurosurgery, University of Cologne, Germany
  • 2Department of Nuclear Medicine, University of Cologne, Germany
  • 3Department of Neurosurgery, Debrecen University, Debrecen, Hungary
Further Information

Publication History

Publication Date:
31 October 2001 (online)

    Permissions and Reprints

The effects of high cervical spinal cord stimulation (cSCS) on regional cerebral blood flow (rCBF) were investigated after experimentally induced subarachnoid haemorrhage (SAH) in rats by the means of 99mTc-HMPAO. The experiments were carried out on a total of 24 Wistar rats, divided in three groups [group I: control without SAH, group II: SAH, group III: SAH and cSCS]. 99mTc-HMPAO was administered intravenously (group II/group III) 48 hours after induction of SAH. In group III, 99mTc-HMPAO was given after 3 hours of cSCS. All animals were sacrificed 30 minutes after application on 99mTc-HMPAO. Radioactivities were determined in blood, cerebrum and cerebellum. The ratio cerebrum/blood and cerebellum/blood was calculated to ascertain “extraction rate” in the sample differentially. The following mean values were calculated for the cerebellum/blood ratio: Group I: 1.06, SD: 0.21; Group II: 0.66, SD: 0.21; Group III: 1.00, SD: 0.37. Comparing the mean values a highly significant difference could be found between group II and III (p = 0.007) and between group I and II (p = 0.0019), respectively. Calculations of the cerebrum/blood ratio revealed similar results. After SAH cSCS enhances cerebral and cerebellar blood flow in rats. Possibly, cSCD constitutes a new therapeutic approach in the treatment of disturbed regional cerebral blood flow after SAH.

Key words:

Subarachnoid Haemorrhage - Spinal Cord Stimulation - Regional Cerebral Blood Flow - 99mTc-HMPAO - Cerebral Vasospasm

References

  • 1 Kassell N F, Torner J C. The International Cooperative Study on timing of aneurysm surgery - an update.  Stroke. 1984;  15 566-570
    PubMedGoogle Scholar
  • 2 Yonas H, Wolfson jr S K, Gur D, Latchaw R E, Good W F, Leanza H, Jackson D L, Janetta P J, Reinmuth O M. Clinical experience with the use of xenon-enhanced CT blood flow mapping in cerebrovascular disease.  Stroke. 1984;  15 443-450
    PubMedGoogle Scholar
  • 3 Matsuda H, Tsuji S, Shuke N. Noninvasive measurements of regional cerebral blood flow using technetium-99m hexamethylpropyleneamine oxime.  Eur J Nucl Med. 1993;  20 391-401
    PubMedGoogle Scholar
  • 4 Powsner R A, O'Tuama L A, Jabre A, Melhem E R. SPECT imaging in cerebral vasospasm following subarachnoid hemorrhage.  J Nucl Med. 1998;  39 765-769
    PubMedGoogle Scholar
  • 5 Heiss W D, Herholz K, Podreka I. Comparison of 99mTc HMPAO SPECT with 18F fluoromethane PET in cerebrovascular disease.  J Cereb Blood Flow Metab. 1990;  10 687-697
    PubMedGoogle Scholar
  • 6 Holmes R A. The reawakening interest in radionuclide brain imaging.  J Nucl Med. 1986;  27 299-301
    PubMedGoogle Scholar
  • 7 Neirinck R D, Canning L R, Piper I M, Nowotnik D P, Pickett R D, Holmes R A, Volkert W A, Forster A M, Weisner P S, Mariott J A, Chaplin S B. Technetium 99m d,1-HMPAO: a new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion.  J Nucl Med. 1987;  28 191-202
    PubMedGoogle Scholar
  • 8 Andersen A R, Friberg H, Lassen N A, Kristensen K, Neirinck R D. Serial studies on cerebral blood flow using 99mTc HM-PAO: a comparison with 133Xe.  Nucl Med Comm. 1987;  8 549-557
    PubMedGoogle Scholar
  • 9 Büll U, Stirner H, Braun H, Kreiten K, Ferbert A. SPECT with 99mTc-HM PAO and 99Tc M-pertechnetate to assess regional cerebral blood flow (rCBF) and blood volume (rCBV). Preliminary results in cerebrovascular disease and interictal epilepsy.  Nucl Med Comm. 1987;  8 519-524
    PubMedGoogle Scholar
  • 10 Meyer F B, Morita A, Puumala M R, Nichols D A. Medical and surgical management of intracranial aneurysms.  Mayo Clin Proc. 1995;  70 153-172
    PubMedGoogle Scholar
  • 11 Augustinson L E, Carlsson C A, Holm J, Jivegard L. Epidural electrical stimulation in severe limb ischemia.  Ann Surg. 1985;  202 104-110
    PubMedGoogle Scholar
  • 12 Broseta J , Barbera J A, De Vera J A. Spinal cord stimulation in peripheral arterial disease. A cooperative study.  J Neurosurg. 1986;  64 71-80
    PubMedGoogle Scholar
  • 13 Sandrio S, Meglio M, Bellocci F, Montenero A S, Scabbia E, D'Annunzio V. Clinical and electrocardiographic improvement of ischemic heart disease after spinal cord stimulation.  Acta Neurochir. [Suppl.]. 1984;  33 543-546
    PubMedGoogle Scholar
  • 14 Hosobuchi Y. Electrical stimulation of the cervical spinal cord increases cerebral blood flow in humans.  Appl Neurophysiol. 1986;  48 372-376
    PubMedGoogle Scholar
  • 15 Robaina F, García-March G, Diaz Sainz F, Diaz de Durana J I, Sánchez-Ledesma M J, Broseta J. Modification of regional cerebral blood flow and metabolism detected by single photon emission computed tomography following cervical spinal cord stimulation in humans.  Stereotact Funct Neurosurg. 1989;  54/55 239-243
    PubMedGoogle Scholar
  • 16 Goadsby P J. Sphenopalatine ganglion stimulation increases regional cerebral blood flow independent of glucose utilization in the cat.  Brain Res. 1990;  506 145-148
    CrossrefPubMedGoogle Scholar
  • 17 Solomon R A, Antunes J L, Chen R YZ. Decrease in cerebral blood flow in rats after experimental subarachnoid haemorrhage: a new model.  Stroke. 1985;  16 58-64
    PubMedGoogle Scholar
  • 18 Svendgaard N A, Brismar J, Delgado T J, Rosengren E. Subarachnoid haemorrhage in the rat: effect on the development of vasospasm of selective lesions of the catecholamine systems in the lower brain stem.  Stroke. 1985;  16 602-608
    PubMedGoogle Scholar
  • 19 Ram Z, Sahar A, Hadani M. Vasospasm due to massive subarachnoid haemorrhage: a rat model.  Acta Neurochir (Wien). 1991;  110 181-184
    CrossrefPubMedGoogle Scholar
  • 20 Delgado T J, Brismar J, Svendgaard N AA. Subarachnoid haemorrhage in the rat: Angiography and fluorescence microscopy of the major cerebral arteries.  Stroke. 1985;  16 595-602
    PubMedGoogle Scholar
  • 21 Edvinsson L, Hara H, Uddman R. Retrograde tracing of nerve fibers to the rat middle cerebral artery with true blue: colocalization with different peptides.  J Cereb Blood Flow Metab. 1989;  9 212-218
    PubMedGoogle Scholar
  • 22 Liu-Chen L Y, Mayberg M R, Moskowitz M A. Immunohistochemical evidence for a substance P containing trigeminovascular pathway to pial arteries in cats.  Brain Res. 1983;  268 162-166
    CrossrefPubMedGoogle Scholar
  • 23 Liu-Chen L Y, Gillespie S A, Norregaart T V, Moskowitz M A. Colocalization of retrogradely transported wheat germ agglutinin and the putative neurotransmitter substance P within trigeminal ganglion cells projecting to cat middle cerebral artery.  J Comp Neurol. 1984;  225 187-192
    CrossrefPubMedGoogle Scholar
  • 24 Juul R, Aakhus S, Björnstad K, Gisvold S E, Brubakk A O, Edvinson L. Cacitonin gene-related peptide (human α-CGRP) counteracts vasoconstriction in human subarachnoid haemorrhage.  Neurosci Lett. 1994;  170 67-70
    CrossrefPubMedGoogle Scholar
  • 25 Juul R, Hara H, Gisvold S E, Brubakk A O, Fredriksen T A, Waldemar G, Schmidt J F, Ekman R, Edvinson L. Alterations in perivascular neuropeptides (CGRP, SP, VIP) in the external jugular vein and in the cerebrospinal fluid following subarachnoid haemorrhage in man.  Acta Neurochir (Wien). 1995;  132 32-41
    CrossrefPubMedGoogle Scholar
  • 26 Roldan P, Joanes V, Santamaria J, Barcia-Salorio J L, Casans I, Carbonell C, Tejerina E. Haemodynamic changes from spinal cord stimulation for vascular pain.  Acta Neurochir (Suppl). 1987;  39 166-169
    PubMedGoogle Scholar
  • 27 Hosobuchi Y. Treatment of cerebral ischemia with electrical stimulation of the cervical spinal cord.  Pace. 1991;  14 122-126
    PubMedGoogle Scholar
  • 28 Meglio M, Cioni B, Visocchi M. Cerebral hemodynamics during spinal cord stimulation.  Pace. 1991;  14 127-130
    PubMedGoogle Scholar
  • 29 Meglio M, Cioni B, Visocchi M, Nobili F, Rodriguez G, Rosadini G, Chiappini F, Sandric S. Spinal cord stimulation and cerebral haemodynamics.  Acta Neurochir (Wien). 1991;  111 43-48
    CrossrefPubMedGoogle Scholar
  • 30 Matsui T, Hosobuchi Y. The effect of cervical spinal cord stimulation (cSCS) on experimental stroke.  Pace Pacing Clin Electrophysiol. 12;  1989 726-732
    PubMedGoogle Scholar
  • 31 Broseta J, García-March M J, Sánchez-Ledesma J, Gonçalves J, Silva I, Barcia J A, Llácer J L, Barcia-Salorio J L. High cervical spinal cord electrical stimulation in brain low perfusion syndromes: experimental basis and preliminary clinical report.  Stereotact Funct Neurosurg. 1994;  62 171-178
    PubMedGoogle Scholar
  • 32 Mazzone P, Pisani R, Pizio N, Arrigo A, Nobili F. Cerebral blood flow and somatosensory evoked response changes induced by spinal cord stimulation: preliminary follow-up observations.  Stereotact Funct Neurosurg. 1994;  62 179-185
    PubMedGoogle Scholar
  • 33 Visocchi M, Cioni B, Pentimalli L, Meglio M. Increase of cerebral blood flow and improvement of brain motor control following spinal cord stimulation in ischemic spastic hemiparesis.  Stereotact Funct Neurosurg. 1994;  62 103-107
    PubMedGoogle Scholar
  • 34 Salar G, Ori C, Iob I, Costalla G B, Battaggia C, Peserico L. Cerebral blood flow changes induced by electrical stimulation of the gasserian ganglion after eperimentally induced subarachnoid haemorrhage in pigs.  Acta Neurochir (Wien). 1992;  119 115-120
    CrossrefPubMedGoogle Scholar
  • 35 Linderoth B, Gheradini G, Ren B, Lundeberg T. Preemptive spinal cord stimulation reduces ischemia in an animal model of vasospasm.  Neurosurgery. 1995;  37 266-272
    PubMedGoogle Scholar
  • 36 Naderi S, Özgüven M A, Bayhan H, Gökalp H, Erdogan A, Egemen N. Evaluation of cerebral vasospasm in patients with subarachnoid hemorrhage using single photon emission computed tomography.  Neurosurg Res. 1994;  17 261-265
    PubMedGoogle Scholar
  • 37 Rosen J, Butala A, Oropello J. Postoperative changes on brain SPECT imaging after aneurysmal subarachnoid hemorrhage.  Clin Nucl Med. 1994;  19 595-597
    PubMedGoogle Scholar
  • 38 Tranquart F, Ades P E, Groussin P, Rieant J F, Jan M, Baulieu J L. Postoperative assessment of cerebral blood flow in subarachnoid haemorrhage by means of 99mTc-HMPAO tomography.  Eur J Nucl Med. 1993;  20 53-58
    PubMedGoogle Scholar
  • 39 Brinker T, Seifert V, Dietz H. Cerebral blood flow and intracranial pressure during experimental subarachnoid haemorrhage.  Acta Neurochir (Wien). 1992;  115 47-52
    CrossrefPubMedGoogle Scholar

Corresponding Author

Dr. med. H. Ebel

Neurochirurgische Klinik
Universität zu Köln

Joseph-Stelzmann-Str. 9

50924 Köln

Germany

Phone: +49-221-4784557

Fax: +49-221-4785921

Email: heinrich.ebel@t-online.de

      >