Abstract
Background: Intracerebral hemorrhage (ICH) is one of the most common causes of maternal deaths related to the postpartum period. This is a devastating form of stroke for which there is no available treatment. Although premenopausal females tend to have better outcomes after most forms of brain injury, the effects of pregnancy and child birth lead to wide maternal physiological changes that may predispose the mother to an increased risk for stroke and greater initial injury.
Methods: Three different doses of collagenase were used to generate models of mild, moderate and severe cerebellar hemorrhage in postpartum female and male control rats. Brain water, blood-brain barrier rupture, hematoma size and neurological evaluations were performed 24 h later.
Results: Postpartum female rats had worsened brain water, blood-brain barrier rupture, hematoma size and neurological evaluations compared to their male counterparts.
Conclusion: The postpartum state reverses the cytoprotective effects commonly associated with the hormonal neuroprotection of (premenopausal) female gender, and leads to greater initial injury and worsened neurological function after cerebellar hemorrhage. This experimental model can be used for the study of future treatment strategies after postpartum brain hemorrhage, to gain a better understanding of the mechanistic basis for stroke in this important patient subpopulation.
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References
Bateman BT, Schumacher HC, Bushnell CD, Pile-Spellman J, Simpson LL, Sacco RL, Berman MF (2006) Intracerebral hemorrhage in pregnancy: frequency, risk factors, and outcome. Neurology 67:424–429. doi:67/3/424 [pii] 10.1212/01.wnl.0000228277.84760.a2
Ciccone A, Pozzi M, Motto C, Tiraboschi P, Sterzi R (2008) Epidemiological, clinical, and therapeutic aspects of primary intracerebral hemorrhage. Neurol Sci 29(Suppl 2):S256–257. doi:10.1007/s10072-008-0955-9
Skriver EB, Olsen TS (1986) Tissue damage at computed tomography following resolution of intracerebral hematomas. Acta Radiol Diagn (Stockh) 27:495–500
Broderick JP, Adams HP Jr, Barsan W, Feinberg W, Feldmann E, Grotta J, Kase C, Krieger D, Mayberg M, Tilley B, Zabramski JM, Zuccarello M (1999) Guidelines for the management of spontaneous intracerebral hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 30:905–915
Gebel JM, Broderick JP (2000) Intracerebral hemorrhage. Neurol Clin 18:419–438
Kittner SJ, Stern BJ, Feeser BR, Hebel R, Nagey DA, Buchholz DW, Earley CJ, Johnson CJ, Macko RF, Sloan MA, Wityk RJ, Wozniak MA (1996) Pregnancy and the risk of stroke. N Engl J Med 335:768–774
Sharshar T, Lamy C, Mas JL (1995) Incidence and causes of strokes associated with pregnancy and puerperium. A study in public hospitals in Ile France. Stroke Pregnancy Study Group. Stroke 26:930–936
Quick AM, Cipolla MJ (2005) Pregnancy-induced up-regulation of aquaporin-4 protein in brain and its role in eclampsia. FASEB J 19:170–175. doi:19/2/170 [pii]10.1096/fj.04-1901hyp
Verkman AS (2002) Physiological importance of aquaporin water channels. Ann Med 34:192–200
Wiegman MJ, Bullinger LV, Kohlmeyer MM, Hunter TC, Cipolla MJ (2008) Regional expression of aquaporin 1, 4, and 9 in the brain during pregnancy. Reprod Sci 15:506–516. doi:15/5/506 [pii]10.1177/1933719107311783
Foerch C, Arai K, Jin G, Park KP, Pallast S, van Leyen K, Lo EH (2008) Experimental model of warfarin-associated intracerebral hemorrhage. Stroke 39:3397–3404. doi:STROKEAHA.108.517482 [pii]10.1161/STROKEAHA.108.517482
MacLellan CL, Silasi G, Poon CC, Edmundson CL, Buist R, Peeling J, Colbourne F (2008) Intracerebral hemorrhage models in rat: comparing collagenase to blood infusion. J Cereb Blood Flow Metab 28:516–525. doi:9600548 [pii]10.1038/sj.jcbfm.9600548
Lekic T, Hartman R, Rojas H, Manaenko A, Chen W, Ayer R, Tang J, Zhang JH (2010) Protective effect of melatonin upon neuropathology, striatal function, and memory ability after intracerebral hemorrhage in rats. J Neurotrauma 27:627–637. doi:10.1089/neu.2009.1163
Hartman R, Lekic T, Rojas H, Tang J, Zhang JH (2009) Assessing functional outcomes following intracerebral hemorrhage in rats. Brain Res 1280:148–157. doi:S0006-8993(09)00957-3 [pii]10.1016/j.brainres.2009.05.038
Andaluz N, Zuccarello M, Wagner KR (2002) Experimental animal models of intracerebral hemorrhage. Neurosurg Clin N Am 13:385–393
Thiex R, Mayfrank L, Rohde V, Gilsbach JM, Tsirka SA (2004) The role of endogenous versus exogenous tPA on edema formation in murine ICH. Exp Neurol 189:25–32. doi:10.1016/j.expneurol.2004.05.021S0014488604001840 [pii]
Rosenberg GA, Mun-Bryce S, Wesley M, Kornfeld M (1990) Collagenase-induced intracerebral hemorrhage in rats. Stroke 21:801–807
Rosenberg GA, Kaufman DM (1976) Cerebellar hemorrhage: reliability of clinical evaluation. Stroke 7:332–336
St Louis EK, Wijdicks EF, Li H (1998) Predicting neurologic deterioration in patients with cerebellar hematomas. Neurology 51:1364–1369
Kelly PJ, Stein J, Shafqat S, Eskey C, Doherty D, Chang Y, Kurina A, Furie KL (2001) Functional recovery after rehabilitation for cerebellar stroke. Stroke 32:530–534
Dolderer S, Kallenberg K, Aschoff A, Schwab S, Schwarz S (2004) Long-term outcome after spontaneous cerebellar haemorrhage. Eur Neurol 52:112–119. doi:10.1159/000080268 ENE2004052002112 [pii]
Thach WT (1996) On the specific role of the cerebellum in motor learning and cognition: clues from PET activation and lesion studies in man. Behav Brain Sci 19:411–431
Strick PL, Dum RP, Fiez JA (2009) Cerebellum and nonmotor function. Annu Rev Neurosci 32:413–434. doi:10.1146/annurev.neuro.31.060407.125606
Baillieux H, De Smet HJ, Paquier PF, De Deyn PP, Marien P (2008) Cerebellar neurocognition: insights into the bottom of the brain. Clin Neurol Neurosurg 110:763–773. doi:S0303-8467(08)00169-8 [pii]10.1016/j.clineuro.2008.05.013
NINDS ICH Workshop Participants (2005) Priorities for clinical research in intracerebral hemorrhage: report from a National Institute of Neurological Disorders and Stroke workshop. Stroke 36:e23–41. doi:doi:01.STR.0000155685.77775.4c [pii]10.1161/01.STR.0000155685.77775.4c
Tang J, Liu J, Zhou C, Alexander JS, Nanda A, Granger DN, Zhang JH (2004) Mmp-9 deficiency enhances collagenase-induced intracerebral hemorrhage and brain injury in mutant mice. J Cereb Blood Flow Metab 24:1133–1145. doi:00004647-200410000-00007 [pii]
Choudhri TF, Hoh BL, Solomon RA, Connolly ES Jr, Pinsky DJ (1997) Use of a spectrophotometric hemoglobin assay to objectively quantify intracerebral hemorrhage in mice. Stroke 28:2296–2302
Saria A, Lundberg JM (1983) Evans blue fluorescence: quantitative and morphological evaluation of vascular permeability in animal tissues. J Neurosci Methods 8:41–49
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Lekic, T. et al. (2011). The Postpartum Period of Pregnancy Worsens Brain Injury and Functional Outcome After Cerebellar Hemorrhage in Rats. In: Zhang, J., Colohan, A. (eds) Intracerebral Hemorrhage Research. Acta Neurochirurgica Supplementum, vol 111. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0693-8_7
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