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Multifocal haemorrhagic brain damage following hypoxia and blood pressure lability: case report and rat model.
MedLine Citation:
PMID:  22288434     Owner:  NLM     Status:  Publisher    
Aims: Haemorrhagic brain damage is frequently encountered as a complication of premature birth. Much less frequently, multifocal petechial haemorrhage is identified in asphyxiated term newborns. Our goal was to develop an experimental rat model to reproduce this pattern of brain damage. Methods: Neonatal rat pups were exposed to a 24-hour period of 10% or 8% hypoxia followed by a single dose of phenylephrine. Acute and subacute changes, as well as long-term outcomes were investigated by histology, brain magnetic resonance imaging, and behavioural assessment. Immunostaining for vascular endothelial growth factor and caveolin-1 was performed in the rat brains as well as in a 17-day human case. Results: Small foci of haemorrhage were identified in almost all regions of the rat brain subjected to hypoxia plus phenylephrine, but not hypoxia alone. Exposure to 8% hypoxia was associated with more haemorrhagic foci than 10% hypoxia. With rare exceptions, the blood deposits were too small to be detected by magnetic resonance imaging. Altered immunohistochemical detection of vascular endothelial growth factor and caveolin-1 in the child and the rat model suggest a role for blood-brain barrier compromise. There were no clear behavioural changes and no residual morphological abnormalities in the 78-day follow-up of the rats. Conclusions: We conclude that transient hypoxia, in a dose-dependent manner, can weaken the vasculature and predispose to brain haemorrhage in the situation of labile blood pressure. Persistent hypoxia is likely to be important in the genesis of permanent severe brain damage. © 2012 The Authors. Neuropathology and Applied Neurobiology © 2012 British Neuropathological Society.
Payam S Pahlavan; Wesley Sutton; Richard J Buist; Marc R Del Bigio
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-31
Journal Detail:
Title:  Neuropathology and applied neurobiology     Volume:  -     ISSN:  1365-2990     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609829     Medline TA:  Neuropathol Appl Neurobiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Neuropathology and Applied Neurobiology © 2012 British Neuropathological Society.
Department of Pathology, University of Manitoba, Winnipeg, Canada Current affiliation: Department of Psychiatry, University of Toronto Department of Radiology, University of Manitoba, Winnipeg, Canada Manitoba Institute of Child Health, Winnipeg, Canada.
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