bromochloroacetic-acid and Subarachnoid-Hemorrhage

Subarachnoid haemorrhage (SAH) often leads to subarachnoid fibrosis and resultant normal pressure hydrocephalus; however, how subarachnoid fibrosis occurs is unknown. We examined the changes within arachnoid granulations (AGs) and the subarachnoid space (SAS) chronologically at the parasagittal region obtained from patients with SAH at autopsy and made comparison with controls by immunostaining for cytokeratin, specific marker for leptomeningeal cells and by the elastica Masson-Goldner methods. Within a week some AGs were torn, and many inflammatory cells filled the AGs and SAS. Cytokeratin positive cells were scarce. During the next two weeks cytokeratin positive cells increased. After three weeks, AGs and SAS were filled by dense deposits of extracellular matrices surrounded by multiple layers of leptomeningeal cells.

Topics: Arachnoid; Cell Division; Extracellular Matrix; Fibrosis; Granulation Tissue; Humans; Hydrocephalus, Normal Pressure; Immunoenzyme Techniques; Keratins; Meninges; Subarachnoid Hemorrhage; Subarachnoid Space; Time Factors

Visual impairment resulting from retinal, subhyaloid, or vitreous hemorrhages in association with Tersons syndrome is often significant. The most common long-term sequelae that may result in permanent visual deficit is the formation of an epimacular membrane.. This report provides clinicopathologic documentation of epiretinal membrane proliferation secondary to Tersons syndrome. Pars plana vitrectomy was performed in 16 eyes of 11 patients with Tersons syndrome. After removal of vitreous hemorrhage, epimacular membranes were found in 10 eyes (62.5%). The posterior cortical vitreous and the epiretinal tissue were examined histologically.. Immunostainings with glial and retinal pigment epithelial cell markers showed that the majority of cells derived form the glia. Perls staining, specific for iron, showed that the high melanic-like component contained in the histopathologic samples corresponded to degradation of blood products secondary to chronic hemorrhage.. The high risk of epiretinal membrane formation and the toxicity of blood breakdown products over the inner retina worsen the long-term visual prognosis in Tersons syndrome. Early surgery is advocated in such cases.

Topics: Adolescent; Adult; Cell Membrane; Child, Preschool; Female; Fundus Oculi; Glial Fibrillary Acidic Protein; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Neuroglia; Retina; Retinal Diseases; S100 Proteins; Subarachnoid Hemorrhage; Syndrome; Vitrectomy; Vitreous Hemorrhage