Spinal Subarachnoid Hemorrhage Induced Intractable Miotic Pupil. A Reminder of Ciliospinal Sympathetic Center lschemia Based Miosis: An Experimental Study
Spinal Subarachnoid Hemorrhage Induced Intractable Miotic Pupil. A Reminder of Ciliospinal Sympathetic Center lschemia Based Miosis: An Experimental Study
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DOI：
10.5137/1019-5149.jtn.24446-18.1
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发表时间：
2019-01-01
影响因子：
0.8
通讯作者：
Ramazanoglug, Leyla
中科院分区：
文献类型：
--
作者：
Aydin, Mehmet Dumlu;Kanat, Ayhan;Ramazanoglug, Leyla
目的：目的：研究蛛网膜下腔出血（SAH）后永久性瞳孔缩小时睫状体脊髓中枢的缺血性神经变性。实验动物分为对照组（GI组，n=5）、假手术组（GII组，n=5）和实验组（GIII组，n=9）。颈胸段蛛网膜下腔注入0.5mL生理盐水（假手术组）和自体动脉血（实验组）后测量瞳孔直径。术后随访3周，切除颈胸髓和双侧颈上上级交感神经节。结果：对照组（GI）动物的平均瞳孔直径为5180 ± 370 μ m，睫状体脊髓中枢的平均变性神经元密度为4 ± 1/mm（3）。这些数值在假手术组（GII）为9850 +/- 610 μ m，10 +/- 3/mm（3），在研究组（GIII）为7.010 +/- 440 μ m，98 +/- 21/mm（3）。有退化的神经元密度的ciliospinal核和瞳孔diffussions.CONCLUSION之间呈反比关系：虽然有一个广泛的信念，瞳孔缩小的主要原因是眼神经损伤在SAH，我们表明，并首次报道，ciliospinal交感神经中枢缺血引起的神经变性可能是负责永久性瞳孔缩小以下SAH。
AIM: To examine ischemic neurodegeneration of the ciliospinal center on permanent miosis following subarachnoid hemorrhage (SAH).MATERIAL and METHODS: Nineteen rabbits were examined in this study. The animals were divided into three groups, as control (GI, n=5), sham (GII, n=5) and study group (GIII, n=9). Pupil diameters were measured after giving 0.5 mL physiological saline for sham and autologous arterial blood for the study group into the cervico-thoracic subarachnoid space. After three weeks of follow up, the cervico-thoracic cord and bilateral superior cervical sympathetic ganglia were removed. The pupil diameter values were compared with degenerated neuron volumes of sympathetic ganglia and degenerated neuron densities of thoracic sympathetic nuclei which were studied by stereological methods.RESULTS: The mean pupil diameter was 5180 +/- 370 pm and the mean degenerated neuron density of the ciliospinal center was 4 +/- 1/mm(3) in animals of the control group (GI). These values were 9850 +/- 610 mu m, 10 +/- 3/mm(3) in sham (GII), and 7.010 +/- 440 mu m and 98 +/- 21/mm(3) in the study (GIII) groups. There was an inverse relationship between degenerated neuron density of the ciliospinal nuclei and pupil diameters.CONCLUSION: Although there is a widespread belief that the main cause of miosis is oculomotor nerve injury during SAH, we showed and reported for the first time that ciliospinal sympathetic center ischemia-induced neurodegeneration may have been responsible for permanent miosis following SAH.