k 2022

The role of brain barriers after subarachnoid hemorrhage

SOLÁR, Peter

Basic information

Original name

The role of brain barriers after subarachnoid hemorrhage

Name in Czech

Role mozkových bariér po subarachnoidálním krvácení

Name (in English)

The role of brain barriers after subarachnoid hemorrhage

Authors

Edition

Morphology 2023, 2022

Other information

Language

Czech

Type of outcome

Prezentace na konferencích

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Organization unit

Faculty of Medicine
Změněno: 10/9/2023 12:22, MUDr. Peter Solár, Ph.D.

Abstract

V originále

Introduction: Subarachnoid hemorrhage accounts for approximately 5% of all strokes. This type of intracranial hemorrhage remains a life-threatening condition with high morbidity and mortality despite current knowledge and treatment. The aim of my dissertation was to describe morphological changes in brain barriers using an experimental model of subarachnoid hemorrhage and to assess the clinical effect of various anti-inflammatory drugs on outcomes in patients after spontaneous subarachnoid hemorrhage. Methods: In the experimental part of my dissertation, the cellular immune and enzymatic changes in the choroid plexus were assessed using an animal model of subarachnoid hemorrhage with the application of blood into the cisterna magna. Current knowledge about brain barriers was the basis for two review publications. The basis for the clinical part of my dissertation was a retrospective study and critical review evaluating the effect of non-steroidal anti-inflammatory drugs on outcome in patients after spontaneous subarachnoid hemorrhage. Results: We demonstrated a significant effect of subarachnoid hemorrhage on the choroid plexus and blood-cerebrospinal fluid barrier. Subarachnoid hemorrhage induced immune changes in the choroid plexus that may alter the blood-cerebrospinal fluid barrier and contribute to the hypersecretion of cerebrospinal fluid. On the other hand, enzymatic changes are likely to be involved in the degradation and elimination of toxic hemoglobin and contribute to the protective function of the blood-cerebrospinal fluid barrier after subarachnoid hemorrhage. In a follow-up study, we demonstrated a lower chance of a poor outcome and development of ischemic deficit in patients after subarachnoid hemorrhage receiving metamizole for at least three consecutive days. Conclusion: In my dissertation, I proved the importance the cerebrovascular inflammation in the pathophysiology of spontaneous subarachnoid hemorrhage and the possibility of its influence by drugs with anti-inflammatory effects. This approach may be one of the possible treatments in the future.