Early-stage minimally invasive procedures decrease perihematomal endothelin-1 levels and improve neurological functioning in a rabbit model of intracerebral hemorrhage

Abstract

Introduction:

To determine the effects of minimally invasive surgery (MIS) at various stages after intracerebral hemorrhage (ICH) on perihematomal endothelin (ET)-1 levels and neurological functioning. Methods: Sixty rabbits were randomly distributed into a model control group (MC group, 30 rabbits) or a MIS group (MI group, 30 rabbits). An ICH model was established in all animals. In the MI group, ICH was evacuated by MIS at 6, 12, 18, 24, and 48 hours (six rabbits at each time point) after the ICH was established. The animals in the MC group underwent the same procedures for ICH evacuation, but with a sham operation without hematoma aspiration. All the animals were sacrificed 7 days after the ICH was established. Neurological deficit scores were determined, and the perihematomal brain tissue was removed to determine the ET-1 levels, blood–brain barrier (BBB) permeability, and brain water content (BWC).

Results:

The neurological deficit scores, perihematomal ET-1 levels, BBB permeability, and BWC all decreased significantly in the MI group compared to the MC group. Performing the MIS for evacuating the ICH at 6 hours resulted in the most remarkable decreases in these indices, followed by a significant difference observed at 12 hours within the MI subgroups.

Conclusions:

Performing MIS at 6–12 hours after ICH resulted in the most significant decreases in neurological deficit scores, ET-1 levels, BBB permeability, and brain edema. The optimal time window for performing MIS for ICH evacuation might be within 6–12 hours after hemorrhage.

Keywords:

• Intracerebral hemorrhage
• Minimally invasive surgery
• A neurological deficit score
• Endothelin-1
• Blood–brain barrier
• Brain water content

Acknowledgements

This research was partially supported by the Guizhou Science and Technology fund (2013–2043). We are grateful for the technical help in the Real Time-PCR provided by Sangong Biotech (Shanghai) Co., Ltd. We are also indebted to the Medical Imaging Department of the Affiliated Hospital of Guiyang Medical University for the preparation of the ICH model. We thank Professor Zhu from the Department of Biostatistics of Guiyang Medical University for the statistical analysis. We also wish to thank all the involved physicians for their hard work during the study.

Disclaimer Statements

Contributors Likun Wang drafted the manuscript. Jing shi and Fan Wang established the animal model of ICH and performed the experiment. Guofeng Wu designed the experiment, revised the manuscript, and approved the submission.

Funding This research was supported by The Guizhou Science and Technology Fund (2013–2043).

Conflicts of interest There are no conflicts of interest.

Ethics approval The protocols of this study were approved by the Animal Care and Use Committee of Guiyang Medical University.