Relationship between subarachnoid and central canal hemorrhage and spasticity: A first experimental study

Abstract

Objective: Spastic disorders are considered as important cerebral complications of subarachnoid hemorrhage (SAH). However, there has been no research concerning the pathophysiological mechanism of its link with the spinal cord. The present study aimed to assess the relationship between the development of spasticity and neuronal degeneration after SAH and increase in spinal cord pressure after central canal hemorrhage (CCH).

Participants: Twenty-three rabbits were included.

Outcome measures: Of all rabbits, 5, 5, and 13 were allocated in the control, SHAM and study groups, respectively. Moreover, 1 cc of saline and 1 cc of autologous arterial blood were injected into the cisterna magna of the SHAM and study groups, respectively. The Muscle spasticity tension values (MSTVs) were determined according to the modified Ashworth scale. Degenerated neuron densities (DND) in the gray matter (GM) of each animal's spinal cord were stereologically calculated.

Results: The average MSTV of each group was as follows: control group (n = 5) 2; SHAM group (n = 5) 3-5; and study group (n = 13) 8–10. The DND values of the spinal cord of each group were as follows: control group, 2 ± 1/mm³; SHAM group, 12 ± 3/mm³; and study group, 34 ± 9/mm³. Results showed an important linear relationship between the MSTVs and the DND of the spinal cord (P < 0.001).

Conclusion: Spasticity may be attributed to other causes such as ischemic neurodegenerative process that develops after spinal SAH and the de-synchronization of the flexor-extensor muscles due to the spontaneous discharge of interneuronal structures, which are crossed within the spinal cord owing to the build-up of pressure after CCH.

Keywords:

• Spasticity
• Spinal cord injury
• Subarachnoid hemorrhage
• Central canal
• Stereology

Acknowledgements

We would like to thank Atatürk University experimental research laboratory staff for their contribution.

Disclaimer statements

Disclosure Selim Kayaci, Mehmet Dumlu Aydin, Baris Ozoner, Tayfun Cakir, Orhan Bas, Sare Sipal have nothing to disclose in relation to this article.

Funding This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest The authors declare no potential conflicts of interest with respect to the research, authorship and/or publication of this article.