• Mustafa Yavuz Samanci, Gennaro Calendo, Sandy T Baker, Kadir Erkmen, Michael W Weaver, and Marla R Wolfson.
• Department of Neurosurgery, Temple Neurosciences Center, Translational and Clinical Lung Research, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA; Department of Physiology, Translational and Clinical Lung Research, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA. Electronic address: mysamanci@hotmail.com.
• World Neurosurg. 2019 Jan 1; 121: e481-e492.

ObjectiveSubarachnoid hemorrhage (SAH) frequently results in severe morbidity, even mortality. Hypothermia is known to have a neuroprotective effect in ischemic injuries. The aim of this study was to determine whether nasopharyngeal (NP) perfluorochemical (PFC) cooling could be used in a rat model of SAH model for neuroprotection.MethodsSAH was induced in 16 male Sprague-Dawley rats by cisterna magna injection of 0.3 mL autologous blood. Vital signs, temperatures, cerebral blood flow (CBF), and brain histology were assessed. Brain cooling was performed on the treatment group using the NP-PFC method starting from 20 minutes after SAH.ResultsNo SAH-related deaths were observed in either group. SAH caused an immediate decrease in mean arterial pressure (17.0% ± 4.90% below baseline values). SAH induction caused a significant and rapid decrease in CBF from baseline (approximately -65%, ranging from -32% to -85%) in both hemispheres. In the left hemisphere, cooling facilitated the return of CBF to baseline values within 20 minutes of treatment with further increase in CBF that stabilized by the 2 hours after injury time point. Quantitative immunohistochemistry showed that there were significantly more NeuN-positive cells in the cortex and significantly fewer IBA-1-positive microglia and glial fibrillary acidic protein-positive astrocytes cells in both cortex and hippocampus in the animals that received NP-PFC cooling compared with no treatment, reflecting preserved neuronal integrity and reduced inflammation.ConclusionsThe data from this study indicate that local hypothermia by NP-PFC cooling supports return of CBF and neuronal integrity and suppresses the inflammatory response in SAH, suggestive of a promising neuroprotective approach in management of SAH.Copyright © 2018 Elsevier Inc. All rights reserved.

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