Download PDF
J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2104-1520
Original Article

The Enigma of Basilar Artery Dissections Secondary to Vasospasm Following Subarachnoid Hemorrhage. Exploration of the Unknown Effect of Superior Cervical Ganglia: A Preliminary Experimental Study

Mete Zeynal 
1   Department of Neurosurgery, Medical Faculty of Ataturk University, Erzurum, Turkey
,
Mehmet Hakan Sahin
1   Department of Neurosurgery, Medical Faculty of Ataturk University, Erzurum, Turkey
,
Ayhan Kanat 
2   Department of Neurosurgery, Medical Faculty of Recep Tayyip Erdogan University, Rize, Turkey
,
Mehmet Kursat Karadag 
1   Department of Neurosurgery, Medical Faculty of Ataturk University, Erzurum, Turkey
,
Sare Sipal
3   Department of Pathology, Medical Faculty of Ataturk University, Erzurum, Turkey
,
Saban Ergene
4   Department of Cardiovascular Surgery, Medical Faculty of Recep Tayyip Erdogan University, Rize, Turkey
,
Mehmet Dumlu Aydin
1   Department of Neurosurgery, Medical Faculty of Ataturk University, Erzurum, Turkey
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Background Life-threatening basilar artery dissection (BAD) can be seen following subarachnoid hemorrhage (SAH), but it is not clear whether SAH causes dissection, or not. This study aims to investigate the relationship between degenerative changes in the superior cervical ganglia and the dissection rate of the basilar artery.

Method In this study, after 3 weeks of experimental SAH, animals were decapitated. Eighteen rabbits were divided into three groups according to their vasospasm indices. The basilar arteries were examined by anatomical and histopathologic methods.

Results Basilar dissection with high vasospasm index (VSI) value (VSI > 3) was detected in six animals (group I); severe basilar edema and moderate VSI value (>2.4) were detected in seven rabbits (group II); and slight VSI value (<1.5) was detected in five subjects (group III). The degenerated neuron densities of the superior cervical ganglia were 12 ± 4 n/mm3 in group I, 41 ± 8 n/mm3 in group II, and 276 ± 78 n/mm3 in group III. The dissected surface values/lumen values were calculated as (42 ± 1)/(64 ± 11) in G-I, (21 ± 6)/(89 ± 17) in group II, and (3 ± 1)/(102 ± 24) in group III. If we look at these ratios as a percentage, it was 62% in group I, 23% in group II, and 5% in group III.

Conclusion Inverse relationship between the degenerated neuron densities of the superior cervical ganglia and the dissected surface values of the basilar artery was observed. Common knowledge is that BAD may lead to SAH; however, this study indicates that SAH is the cause of BAD.

Keywords

basilar artery vasospasm - dissections - subarachnoid hemorrhage - superior cervical ganglia


Publication History

Received: 06 March 2023

Accepted: 30 May 2023

Accepted Manuscript online:
01 June 2023

Article published online:
11 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Kanat A, Tsianaka E, Gasenzer ER, Drosos E. some interesting points of competition of X-ray using during the Greco-Ottoman War in 1897 and development of neurosurgical radiology: a reminiscence. Turk Neurosurg 2022; 32 (05) 877-881
    PubMedGoogle Scholar
  • 2 Sahin B, Kanat A, Karadag MK, Demirtas R, Aydin MD. Protective felix culpa effect of superior sympathetic cervical ganglion degenerations on prevention of basilar artery spasm after subarachnoid hemorrhage: a preliminary experimental study. World Neurosurg 2022; 164: e861-e867
    CrossrefPubMedGoogle Scholar
  • 3 Kilic M, Kilic B, Aydin MD. et al. Paradoxic relations between basilar artery reconfiguration and superior cervical ganglia ischemia after bilateral common carotid artery ligation. World Neurosurg 2019; 125: e658-e664
    CrossrefPubMedGoogle Scholar
  • 4 Zhu X, Han J, Zang R, Qiu S, Chang G, Zuo J. Functional pathway between cervical spinal and sympathetic ganglia: a neurochemical foundation between neck pain and vertigo. Pain Physician 2019; 22 (06) E627-E633
    PubMedGoogle Scholar
  • 5 Ozdemir B, Kanat A, Ozdemir V, Batcik OE, Yazar U, Guvercin AR. The effect of neuroscientists on the studies of autonomic nervous system dysfunction following experimental subarachnoid hemorrhage. J Craniofac Surg 2019; 30 (07) 2184-2188
    CrossrefPubMedGoogle Scholar
  • 6 Aydin MD, Kanat A, Sahin B, Sahin MH, Ergene S, Demirtas R. New experimental finding of dangerous autonomic ganglia changes in cardiac injury following subarachnoid hemorrhage; a reciprocal culprit-victim relationship between the brain and heart. Int J Neurosci 2022; 1-12
    PubMedGoogle Scholar
  • 7 Lee C-H, Jeon S-H, Shin B-S, Kang HG. asilar artery dissection in myotonic dystrophy type 1. J Clin Neurol 2022; 18 (02) 227-229
    CrossrefPubMedGoogle Scholar
  • 8 Aydin MD, Kanat A, Yolas C. et al. Spinal subarachnoid hemorrhage induced intractable miotic pupil. A reminder of ciliospinal sympathetic center ischemia based miosis: an experimental study. Turk Neurosurg 2019; 29 (03) 434-439
    PubMedGoogle Scholar
  • 9 Kepoglu U, Kanat A, Dumlu Aydin M. et al. New histopathologic evidence for the parasympathetic innervation of the kidney and the mechanism of hypertension following subarachnoid hemorrhage. J Craniofac Surg 2020; 31 (03) 865-870
    CrossrefPubMedGoogle Scholar
  • 10 Findik H, Kanat A, Aydin MD. et al. Describing a new mechanism of retinal detachment secondary to ophthalmic artery vasospasm following subarachnoid hemorrhage: an experimental study. J Neurol Surg A Cent Eur Neurosurg 2019; 80 (06) 430-440
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Kayacı S, Çakir T, Aydın MD. et al. Brachial artery vasospasm caused by cervical dorsal root ganglion degeneration after subarachnoid hemorrhage: an experimental study. World Neurosurg 2019; 126: e895-e900
    CrossrefPubMedGoogle Scholar
  • 12 Kayaci S, Kanat A, Aydin MD. et al. Role of neuron density of the stellate ganglion on regulation of the basilar artery volume in subarachnoid hemorrhage: an experimental study. Auton Neurosci 2011; 165 (02) 163-167
    CrossrefPubMedGoogle Scholar
  • 13 Yilmaz A, Aydin MD, Kanat A. et al. The effect of choroidal artery vasospasm on choroid plexus injury in subarachnoid hemorrhage: experimental study. Turk Neurosurg 2011; 21 (04) 477-482
    PubMedGoogle Scholar
  • 14 Brawanski N, Kashefiolasl S, Won S-Y. et al. Beware of nihilism: favorable outcome despite poor admission status in posterior circulation aneurysms after aneurysmal subarachnoid hemorrhage. J Neurol Surg A Cent Eur Neurosurg 2021; 82 (06) 512-517
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Strange F, Kienzler J, Muehleisen B. et al. Early rupture of a giant basilar artery aneurysm after LEO stenting: case report and review of the literature. J Neurol Surg A Cent Eur Neurosurg 2020; 81 (02) 177-184
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Kanat A, Aydin MD, Sahin B. et al. Important finding for COVID-19 pandemic; hydrocephalus producing effect of vaporised alcohol disinfectant. J Neurol Surg A Cent Eur Neurosurg 2023; (e-pub ahead of print). DOI: 10.1055/a-1962-1491.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Kanat A. Brain oxygenation and energy metabolism: part 1—biological function and pathophysiology. Neurosurgery 2003; 52 (06) 1508-1509 , author reply 1509
    CrossrefPubMedGoogle Scholar
  • 18 Ozdemir NG, Aydin MD, Yolas C. et al. Predictive role of external carotid artery vasospasm on cerebral ischemia after subarachnoid hemorrhage: experimental study. Turk Neurosurg 2017; 27 (06) 874-883
    PubMedGoogle Scholar
  • 19 Aydin MD, Kanat A, Yolas C, Calik M. New insights of the fever following subarachnoid hemorrhage and introducing a new thermoregulator like structure in choroid plexuses; preliminary study. Acta Neurol Taiwan 2019; 28 (01) 1-11
    PubMedGoogle Scholar
  • 20 Ozmen S, Altinkaynak K, Aydin MD. et al. Toward understanding the causes of blood pH irregularities and the roles of newly described binuclear neurons of carotid bodies on blood pH regulation during subarachnoid hemorrhage: experimental study. Neuropathology 2019; 39 (04) 259-267
    CrossrefPubMedGoogle Scholar
  • 21 Debette S, Compter A, Labeyrie M-A. et al. Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection. Lancet Neurol 2015; 14 (06) 640-654
    CrossrefPubMedGoogle Scholar
  • 22 Kanat A, Turgut M, de Divitiis O. Letter to the Editor regarding “Kissing aneurysms: radiological and surgical difficulties in 30 operated cases and a proposed classification.”. World Neurosurg 2022; 160: 120-121
    CrossrefPubMedGoogle Scholar
  • 23 Nouh A, Remke J, Ruland S. Ischemic posterior circulation stroke: a review of anatomy, clinical presentations, diagnosis, and current management. Front Neurol 2014; 5: 30
    CrossrefPubMedGoogle Scholar
  • 24 Kanat A, Yazar U, Kazdal H, Yilmaz A, Musluman M. Neurosurgery is a profession. Neurol Neurochir Pol 2009; 43 (03) 286-288
    PubMedGoogle Scholar
  • 25 Aydin MD, Kanat A, Aydin A, Aydin A, Demirci T, Ozmen S. Estimating basilar artery upper rupture limit by dangerous alarming diameter of arteries (DADA) following bilateral common carotid artery ligation; a new theorem. Int J Neurosci 2020; ; (Jul): 1-10
    PubMedGoogle Scholar
  • 26 Caglar O, Firinci B, Aydin ME. et al. First emerging evidence of the relationship between Onuf's nucleus degeneration and reduced sperm number following spinal subarachnoid haemorrhage: experimental study. Andrologia 2021; 53 (05) e14030
    CrossrefPubMedGoogle Scholar
  • 27 Kilic M, Aydin MD, Demirci E. et al. Unpublished neuropathologic mechanism behind the muscle weakness/paralysis and gait disturbances induced by sciatic nerve degeneration after spinal subarachnoid hemorrhage: an experimental study. World Neurosurg 2018; 119: e1029-e1034
    CrossrefPubMedGoogle Scholar