Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 5, September-October, p. 699–704

Publication type: original article

Language: English

Parallel Development of Choroid Plexus Degeneration and Meningeal Inflammation in Subarachnoid Hemorrhage – Experimental Study

Dilcan Kotan1,A,B,D,E,F, Mehmet D. Aydin2,A,E,F, Cemal Gundogdu3,C,F, Recep Aygul4,B,F, Nazan Aydin5,E,F, Hızır Ulvi5,E,F

1 Department of Neurology, Faculty of Medicine, Sakarya University, Turkey

2 Department of Neurosurgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey

3 Department of Pathology, Faculty of Medicine, Ataturk University, Erzurum, Turkey

4 Department of Neurology, Ataturk University, Faculty of Medicine, Erzurum, Turkey

5 Department of Psychiatry, Ataturk University, Faculty of Medicine, Erzurum, Turkey


Background. The choroid plexuses (CPs) are brain structures located in the brain ventricles, involved in the production and reabsorption of cerebrospinal fluid (CSF) components, cerebral immune surveillance, and various endocrine-enzymatic activities and acts as a CSF-blood barrier. This study investigated to determine if there is a link between ischemic CP injury and meningo-cerebral inflammation processes.
Material and Methods. This study was conducted on 18 rabbits. Four rabbits were used as the baseline group to examine the normal structures. Fourteen of the rabbits were used as the study group by injecting 1.00cc of homologous blood into their cisterna magna. The animals were followed by daily monitoring for ten days and then slaughtered. Apoptotic degeneration of the CP cells was determined and statistical analyses were carried out using normal and apoptotic CP cell numbers. Data analyses were comprised of Mann-Whitney U tests. Differences were considered to be significant if p < 0.005.
Results. Five animals belonging to the study group died between the 5th and 8th days. Unconsciousness, neck stiffness, convulsion, fever, apnea, cardiac arrhythmia, and breathing disturbances were observed in all of the animals who subsequently died. Intraventricular blood leakage was detected in all the dead and three surviving animals. Choroidal artery spasm, choroidal ependymal cell injury, choroidal cell apoptosis, pia-arachnoid thickening, meningocortical adhesions and blood cell density in the subarachnoid spaces were more severe in the more CP degenerated animals than those of the others. There were significant differences between the apoptotic CP cell density and blood cell density in the subarachnoid spaces (p < 0.005).
Conclusion. Subarachnoid hemorrhage (SAH) extending to brain ventricles causes ischemic degeneration of the CP by way of triggered choroidal artery vasospasm. It should be emphasized that the prevention of CP function may be an important part of the protection of the brain in SAH.

Key words

choroid plexuses, subarachnoid hemorrhage, vasospasm.

References (27)

  1. Bederson JB, Guarino L, Germano IM: Failure of changes in cerebral perfusion pressure to account for ischemia caused by subarachnoid haemorrhage: A new experimental model. Soc Neurosci Abstr 1995, 20, 224–230.
  2. Blay P, Nilsson C, Hansson S, Owman C, Aldred AR, Schreiber G: An in vivo study of the effect of 5-HT and sympathetic nerves on transferrin and transthyretin mRNA expression in rat choroid plexus and meninges. Brain Res 1994, 31, 662, 148–154.
  3. Broderick JP, Brott TG, Duldner JE, Tomsick T, Leach A: Initial and recurrent bleeding are the major causes of death following subarachnoid haemorrhage. Stroke 1994, 25, 1342–1347.
  4. Dauphin F, Richard JW, Seylaz J, Quirion R, Hamel E: Acetylcholine levels and choline acetyltransferase activity in rat cerebrovascular bed after unior bilateral sphenopalatine ganglionectomy. J Cereb Blood Flow Metab 1991, 11, 253–260.
  5. Dohrmann GJ: Choroid plexus: A Historical Review. Brain Res 1970, 18, 197–218.
  6. Drake MF: Cell death in the choroids plexus following transient forebrain global ischemia in the rat. Microsc Res and Tech 2001, 52, 130–136.
  7. Engelhardt B, Sorokin L: The blood–brain and the blood–cerebrospinal fluid barriers: function and dysfunction. Semin Immunopathol 2009, 31, 497–511.
  8. Gillardon F, Lenz C, Kuschinsky W, Zimmermann M: Evidence for apoptotic cell death in the choroid plexus following focal cerebral ischemia. Neurosci Lett 1996, 29, 207,113–116.
  9. Hänggi D, Eicker S, Beseoglu K, Rapp M, Perrin J, Nawatny J: Dose-related efficacy of a continuous intracisternal nimodipine treatment on cerebral vasospasm in the rat double subarachnoid haemorrhage model. Neurosurgery 2009, 64, 1155–1159, discussion 1159–1161.
  10. Katsumura H, Kabuto M, Hosotani K, Handa Y, Kobayashi H, Kubota T: The influence of total body hyperthermia on brain haemodynamics and blood-brain barrier in dogs. Acta Neurochir (Wien) 1995, 135, 62–69.
  11. Kubo Y, Ogasawara K, Kakino S, Kashimura H, Yoshida K, Ogawa A: Cerebrospinal fluid adrenomedullin concentration correlates with hyponatremia and delayed ischemic neurological deficits after subarachnoid haemorrhage. Cerebrovasc Dis 2008, 25, 164–169.
  12. Kvitnitskaya RT, Shinkai T, Ooka H, Ohtsubo K: Immunocytochemical demonstration of prolactine interaction with choroids plexus in aging and acute hyprprolactinemia. Mech Aging Dev 1994, 76, 65–72.
  13. Majno G, Joris I: Apoptosis, oncosis and necrosis. An overview of cell death. Am J Pathol 1995, 146, 3–15.
  14. Marques F, Sousa JC, Correia-Neves M, Oliveira P, Sousa N, Palha JA: The choroid plexus response to peripheral inflammatory stimulus. Neurosci 2007, 144, 424–430.
  15. Masuzava T, Sato H: The Enzyme Histochemistry of Choroids Plexus. Brain 1982, 106, 55–99.
  16. Matyszak MK, Lawson LJ, Perry WH, Cordon S: Stromal Macrophages of the Choroid Plexus State at the Interface between the Brain and Peripheral Immune System Constituvely Express Major Histocompatibility Class II Antigen. J Neuroimmun 19992, 40, 173–181.
  17. Maxwell WL, Hardy LG, Watt C, McGadey J, Graham DI, Adams JH: Changes in the choroids plexus, responses by intrinsic epiplexus cells and recruitment from monocytes after experimental head acceleration injury in the non-human primate. Acta Neuropath 1992, 84, 78–84.
  18. Nagahiro S, Goto S, Korematsu K, Sumi M, Takahashi M, Ushio Y: Disruption the blood cerebrospinal fluid barrier by transient cerebral ischemia. Brain Res 1994, 633, 305–311.
  19. Rothberg C, Weir B, Overton T, Grace M: Responses to experimental subarachnoid haemorrhage in the spontaneously breathing primate. J Neurosurg 1980, 52, 302–308.
  20. Serot JM, Christmann D, Dubost T, Bene MC, Faure GC: Low CSF folate levels in late onset Alzheimer’s disease patients. J Neural Trans 2001, 108, 93–99.
  21. Serot JM, Foliquet B, Bene MC, Faure GC: Choroid plexus and ageing in rats: A morphometric and ultrastructural study. Eur J Neurosci 2001, 14, 794–798.
  22. Shaddock LC, Hamernik RP, Axelsson A: Cochlear vascular and sensory cell changes induced by elevated temperature and noise. Am J Otolaryngol 1984, 5, 99–107.
  23. Sharma HS, Duncan JA, Johanson CE: Whole-body hyperthermia in the rat disrupts the blood-cerebrospinal fluid barrier and induces brain oedema. Acta Neurochir Suppl 2006, 96, 426–431.
  24. Smith AL: Pathogenesis of Haemophilus influenzae meningitis. Pediatr Infect Disease J 1987, 6, 733–786.
  25. Szmydynger-Chodobska J, Strazielle N, Zink BJ, Ghersi-Egea JF, Chodobski A: The role of the choroid plexus in neutrophil invasion after traumatic brain injury. J Cereb Blood Flow Metab 2009, 29, 1503–1516.
  26. Wolburg H, Paulus W: Choroid plexus: biology and pathology. Acta Neuropathol 2010, 119, 75–88.
  27. Yılmaz A, Aydın MD, Kanat A, Musluman AM, Atlas S, Aydın Y, Çalık M, Gursan N: The Effect of Choroidal Artery Vasospasm on Choroid Plexus Injury in Subarachnoid Haemorrhage: Experimental Study. Turk Neurosurg 2011, 21, 477–482.