• World Neurosurg · Nov 2021

    Local Application of Magnesium Sulfate Solution Suppressed Cortical Spreading Ischemia and Reduced Brain Damage in a Rat Subarachnoid Hemorrhage-Mimicking Model.

    • Sho Nishida, Satoko Kawauchi, Terushige Toyooka, Kosuke Kumagai, Satoru Takeuchi, Shunichi Sato, Akihide Kondo, Kojiro Wada, and Kentaro Mori.
    • Department of Neurosurgery, Social Medical Corporation Shijinkai Ken-o-Tokorozawa Hospital, Tokorozawa, Saitama, Japan; Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan; Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: nishida_muscle@yahoo.co.jp.
    • World Neurosurg. 2021 Nov 1; 155: e704-e715.

    ObjectiveCortical spreading depolarization (CSD), cortical spreading ischemia (CSI), and early brain injury are involved in the occurrence of delayed brain ischemia after subarachnoid hemorrhage (SAH). We tested whether local application of magnesium (Mg) sulfate solution suppressed CSD and CSI, and decreased brain damage in a rat SAH-mimicking model.MethodsNitric oxide synthase inhibitor L-NG-nitroarginine methyl ester (L-NAME) and high concentration potassium solution were topically applied to simulate the environment after SAH. We irrigated the parietal cortex with artificial cerebrospinal fluid (ACSF), containing L-NAME (1 mM), K+ (35 mM), and Mg2+ (5 mM). Forty-five rats were divided into 3 groups: sham surgery (sham group), L-NAME + [K+]ACSF (control group), and L-NAME + [K+]ACSF + [Mg2+] (Mg group). CSD was induced by topical application with 1 M KCl solution in 3 groups. The effects of Mg administration on CSD and cerebral blood flow were evaluated. Histological brain tissue damage, body weight, and neurological score were assessed at 2 days after insult.ResultsMg solution significantly shortened the total depolarization time, and reduced CSI, histological brain damage, and brain edema compared with those of the control group (P < 0.05). Body weight loss was significantly suppressed in the Mg group (P < 0.05), but neurological score did not improve.ConclusionsLocal application of Mg suppressed CSI and reduced brain damage in a rat SAH-mimicking model. Mg irrigation therapy may be beneficial to suppress brain damage due to CSI after SAH.Copyright © 2021 Elsevier Inc. All rights reserved.

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