Iron-chelating agent alleviates chronic hydrocephalus in an experimental model of subarachnoid hemorrhage

Abstract

Background. The iron-chelating agent is being tested in this research to see whether or not it may aid rats with experimental communicating hydrocephalus caused by an intraventricular blood clot. Subarachnoid hemorrhage (SAH) causes chronic post-hemorrhagic hydrocephalus (CPHH) in one-third of patients, and up to 45 % of patients require permanent cerebrospinal fluid diversion during follow-up, with about 50 % shunt failures within a year. Hemoglobin degradation products induce subarachnoid fibrosis and consequent hydrocephalus, with iron as a critical factor. Iron-chelating agents reduce iron overload after SAH. ­Materials and methods. Our study used Wistar rats weighing 250–500 g. The first group (the controls) was without surgery. In the sham group, 0.15 ml of normal saline was administered into the cisterna magna, followed by a second injection 48 hours later. A 0.15 ml blood injection into cisterna magna was followed by a 0.15 ml blood injection 48 hours later, which was performed in the third treatment group, a blood group minus minocycline (BGMM). The fourth double hemorrhagic group (blood group plus minocycline — BGPM) received iron-chelating agent — minocycline. Transcranial ultrasonography was used in all groups, assessing the Levene index (LI) in the rats before and after surgery. CPHH was defined as a ventricular index above the 97th percentile of the pre-intervention LI (1.297). Morphological signs of SAH (blood in subarachnoid space and ventricular wall damage) were evaluated histologically. Results. Ninety-seven operations were done in 50 rats with a 15% posthemorrhagic postoperative mortality. Hydrocephalus in the BGMM group occurred in 56 % of rats, according to the ultrasonography, and all had SAH features with ependymal integrity disruption, according to histological investigations. The introduction of minocycline in the BGPM group prevented an increase in LI after autologous blood injection (similar values of preoperative mean LI = 1.079 ± 0.096 and postoperative mean LI = 1.034 ± 0.058). The difference between BGMM and BGPM groups was highly significant, with a mean of 0.179 ± 0.029, t(41) = 6.12, p < 0.00001. Conclusions. Based on the findings, minocycline alleviates ventriculomegaly in rats. The data suggests that iron-chelating agents may be utilized to treat and prevent CPHH. By illustrating vascular disorders, the technology may become more valuable.