Etablierung eines Grading-Systems zur Beurteilung des Schweregrades experimenteller Subarachnoidalblutungen im Rattenmodell

Definition of grading system for the evaluation of the severity of experimental subarachnoid hemorrhage in a rat model

von Vesna Malinova
Dissertation
Datum der mündl. Prüfung:2019-02-28
Erschienen:2019-02-12
Betreuer:Prof. Dr. Dorothee Mielke
Gutachter:PD Dr. Marios-Nikos Psychogios
Gutachter:Prof. Dr. Thomas Meyer
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-7278

 

 

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Zusammenfassung

Englisch

The severity of subarachnoid hemorrhage (SAH) correlates with the patients' outcome and hence is of great importance in clinical practice. Several clinical classifications for the evaluation of the SAH severity have been reported so far. The Fisher scale is the most used scale in clinical practice, that correlates with the morbidity and mortality after SAH. In contrast to that, no grading system for the evaluation of the severity of experimental SAH has been established so far. The aim of this doctoral thesis was the definition of a grading system for the evaluation of the SAH severity based on the Fisher scale and using the double blood injection SAH model in rats. SAH was induced in male Sprague-Dawley rats using the double blood injection SAH model. For this reason, 0.25 ml autologous arterial blood was injected on two consecutive days into the cisterna magna. In the sham group, the same amount of saline solution was injected. Transcardial perfusion was performed on day 5 after SAH induction, the brain was removed and prepared for histological examination. HE-staining was done and the amount of blood, as well as the blood distribution, were analyzed. A total of 52 rats were included in the analysis of this doctoral thesis, of whom 47 were in the SAH group and 5 rats were in the sham group. The following SAH grades were defined: grade 1 SAH = no visible blood, grade 2 SAH = a small amount of blood locally of diffusely distributed, grade 3 SAH = a large amount of blood locally or diffusely distributed, grade 4 SAH = intraventricular hemorrhage. We found no visible blood in the sham group (grade 1). In the SAH group, a grade 1 SAH was found in 4.3 % (2/47) of the rats, a grade 2 SAH in 34 % (16/47), a grade 3 SAH in 23.4 % (11/47) and a grade 4 SAH in 38.3 % (18/47) of the rats. The Fisher scale could be reliably reproduced in the histological examination using the double blood injection SAH model in rats. A severe SAH could be induced in 62 % (29/47) of the rats in the SAH group. The results of this doctoral thesis support the assumption that the double blood injection model is suitable for the assessment of late complications after SAH such as delayed cerebral ischemia. 
Keywords: grading system; experimental subarachnoid hemorrhage
 
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