Significant Prognostic Pathophysiology of Subarachnoid Hemorrhage Focusing on Hypothalamic Injury

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K09459
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: International University of Health and Welfare
• Principal Investigator: Hasegawa Yu 国際医療福祉大学, 福岡薬学部, 教授 (40599114)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: Subarachnoid hemorrhage / hypothalamus / sympathetic nerve / Perivascular macrophage / arterial instability / venous congestion / cerebral blood flow / rat

Outline of Final Research Achievements

In the previous study, renal denervation reduced hypothalamic injury via sympathetic nerve deactivation and improved cerebral vasospasm after SAH. In this study, we investigated the morphological changes in cerebral vessels post-SAH due to hypothalamic injury. The results demonstrated that instability in cerebral arteries and congestion in cerebral veins during the hyperacute phase, and vasospasm in both cerebral arteries and veins at 24 hours after SAH. Next, pharmacological deactivation of perivascular macrophages, which are involved in sympathetic activation, improved neurological function after SAH. This effect was associated with the suppression of cerebral blood flow reduction in the hyperacute phase, rather than cytotoxic changes in the brain parenchyma. These findings suggest that hypothalamic injury after SAH is linked to cerebral vasculature damage and hyperacute cerebral blood flow reduction, both of which directly impact prognosis.

Free Research Field

基礎脳卒中学

Academic Significance and Societal Importance of the Research Achievements

カテコラミンサージと関連すると考えられるSAH後視床下部傷害について、予後と直結する脳血管動静脈傷害や超急性期脳血流低下に影響することが考えられた。一方、SAH後の早期脳損傷と脳血管攣縮はそれぞれ全脳虚血と局所脳虚血により脳損傷が起こる。視床下部傷害は超急性期の病態形成に加えて、その二大予後決定病態のトリガーとなっている可能性も示唆される結果となった。