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KMID : 0377619760300010101
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Korean Jungang Medical Journal
1976 Volume.30 No. 1 p.101 ~ p.106
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Effect of Cisternospinal Washout of Experimental Hydrocephalus after Cisterno-Subarachnoid Hemorrhage in the dogs
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Abstract
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Since the initial work of Baglev, a number of investigators have clarified the clinical and experimental correlates of subarachnoid bleeding and hydrocephalus. Hydrocephalus follows subarachnoid hemorrhage as an acute complication in an unknown percentage of cases; and as a late complication in 5 to 10 percent of cases. The bleeding is severe and when a significant portion of the subarachnoid pathways are occluded by extravasated blood, acute hydrocephalus may result. Under usual conditions the blood is absorbed within one to two weeks, however, the residuals of blood-breakdown may remain, and lead to scarring and adhesions of arachnoid villi or obstructions of the subarachnoid space. It is still controversial but it is almost acceptable that the removal of relatively large amount of cerebrospinal fluid will eliminate a significant quantities of extravasated red blood cells, although a few observers raise doubts as to its real value in this report. Our clinical experience with cisternosrinal washout in the treatment of 2 cases of subarachnoid hemorrhage suggests that subarachnoid hemorrhage can be treated by alleviating the red blood cells from cerebrospinal fluid.
This present study was designed to explore the possibility of preventing the evolution of significant, hydrocephalus after subarachnoid hemorrhage by attempting to modify the induced red blood cells in the subarachnoid space by cisternospinal washout. The animals used were 17 dogs. The average age was 3 months and their weight ranged from 3 to 5 kg. Autogenous fresh blood was injected into the cisterna magna of dogs to simulate subarachnoid hemorrhage from ruptured aneurysm. In the control group receiving whole blood injected through a punctured cisternal needle but not washout; the second group, dexamethasone was adminished intramuscular to 6 dogs 3 times a daily maintained for 7 days, and the remains, cisternospinal washout only.
control and pathological finding, from control, cisternospinal washout, and "therapy"
control dogs was examined by macroscopic and light microscopy. Comparison has been made between conservative series of dog and untreated dogs. Intramuscular injection dexamethasone was less effective than cisternospinal washout lead to alleviated in cerebral edema and hydrocephalic complication during first 3 weeks after subarachnoid pathway or arachnoid villi remains conjectural. the use of cisternospinal washout seems to be a valuable method in management of patient with subarachnoid hemorrhage.
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