Die histopathologische Darstellung einer intrazerebralen Blutung unter fibrinolytischer Therapie : eine tierexperimentelle Studie

INTRODUCTION: The treatment of cerebral hemorrhage is still controversial, and clinical experience with local lysis of the blood clot by rtPA is sparse. In our study we induced intracerebral hematomas in the frontal lobe of pigs, in order to investigate the changes in the perihematomal brain tissue with regard to secondary brain damage. METHODS: After injection of autologous blood into the right frontal white matter of 16 pigs, rtPA was administered in a dosis equivalent to the volume of blood found on MRI. 20 minutes later, the liquified parts of the clot were carefully aspirated. The hematoma volume was again quantified by MRI on the 2nd, 4th and 10th postoperative day. The relevant brain slices were stained with HE, Giemsa, Turnbulls Blue, Klüver Barrera and immunochemically marked for heat shock protein (HSP). RESULTS: The hematoma volume reduced to 66.4% in animals treated with rtPA opposed to 37.6% in the control animals. In regard to edema, necrosis and the expression of HSP, both groups did not differ significantly. However, the animals treated with rtPA showed a much more pronounced inflammatory response. CONCLUSION: Although rtPA markedly reduces the hematoma volume within ten days, an equivalent reduction of brain damage could not be found. This can partly be due to the role of rtPA in thrombin-induced neuronal cell damage or an allergic reaction to this substance. KEYWORDS: Cerebral Hemorrhage, Lysis, Recombinant Tissue Plasminogen Activator, HSP, Inflammatory Response, Necrosis , Edema.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2002

Author dc:creator

• Röttger, Carina

Contributors dc:contributor

• Gilsbach, Joachim M.

• info:eu-repo/classification/ddc/610
• Medizin

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-120822%22

OAI identifier oai:identifier

oai:publications.rwth-aachen.de:59002