Decreased Intracranial Pressure Elevation and Cerebrospinal Fluid Outflow Resistance: A Potential Mechanism of Hypothermia Cerebroprotection Following Experimental Stroke

Omileke, Daniel, Bothwell, Steven W, Pepperall, Debbie, Beard, Daniel J, Coupland, Kirsten, Patabendige, Adjanie ORCID: 0000-0003-1550-3084 and Spratt, Neil J (2021) Decreased Intracranial Pressure Elevation and Cerebrospinal Fluid Outflow Resistance: A Potential Mechanism of Hypothermia Cerebroprotection Following Experimental Stroke. BRAIN SCIENCES, 11 (12). 1589-.

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Official URL: http://dx.doi.org/10.3390/brainsci11121589

Abstract

<h4>Background</h4>Elevated intracranial pressure (ICP) occurs 18-24 h after ischaemic stroke and is implicated as a potential cause of early neurological deterioration. Increased resistance to cerebrospinal fluid (CSF) outflow after ischaemic stroke is a proposed mechanism for ICP elevation. Ultra-short duration hypothermia prevents ICP elevation 24 h post-stroke in rats. We aimed to determine whether hypothermia would reduce CSF outflow resistance post-stroke.<h4>Methods</h4>Transient middle cerebral artery occlusion was performed, followed by gradual cooling to 33 °C. At 18 h post-stroke, CSF outflow resistance was measured using a steady-state infusion method.<h4>Results</h4>Hypothermia to 33 °C prevented ICP elevation 18 h post-stroke (hypothermia ∆ICP = 0.8 ± 3.6 mmHg vs. normothermia ∆ICP = 4.4 ± 2.0 mmHg, <i>p</i> = 0.04) and reduced infarct volume 24 h post-stroke (hypothermia = 78.6 ± 21.3 mm<sup>3</sup> vs. normothermia = 108.1 ± 17.8 mm<sup>3</sup>; <i>p</i> = 0.01). Hypothermia to 33 °C did not result in a significant reduction in CSF outflow resistance compared with normothermia controls (0.32 ± 0.36 mmHg/µL/min vs. 1.07 ± 0.99 mmHg/µL/min, <i>p =</i> 0.06).<h4>Conclusions</h4>Hypothermia treatment was protective in terms of ICP rise prevention, infarct volume reduction, and may be implicated in CSF outflow resistance post-stroke. Further investigations are warranted to elucidate the mechanisms of ICP elevation and hypothermia treatment.

Item Type:	Article
Uncontrolled Keywords:	hypothermia, cerebrospinal fluid, outflow resistance, ischaemia, intracranial pressure, stroke
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	27 Jan 2022 15:21
Last Modified:	03 Feb 2024 09:48
DOI:	10.3390/brainsci11121589
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3147718