Neural Regeneration Research ›› 2023, Vol. 18 ›› Issue (1): 170-175.doi: 10.4103/1673-5374.344838

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Early brainstem hemorrhage progression: multi-sequence magnetic resonance imaging and histopathology

Xi Guo1, #, Jia-Ke Xu1, #, Xin Qi1, Yang Wei1, Cheng-Wei Wang2, 3, Hao Li1, Lu Ma1, Chao You1, 4, Meng Tian1, 4, *   

  1. 1Department of Neurosurgery and Neurosurgery Research Laboratory, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; 2Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; 3Department of Rehabilitation, People’s Hospital of Karamay, Karamay, Xinjiang Uygur Autonomous Region, China; 4West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
  • Online:2023-01-15 Published:2022-06-17
  • Contact: Meng Tian, PhD, tianmeng@scu.edu.cn.
  • Supported by:
    This study was supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2020D01A13 (to CWW); Chengdu Science and Technology Bureau, No. 2019-YF05-00511-SN (to MT); and 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, Nos. ZY2016102 (to MT), and ZY2016203 (to CY). 

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Abstract: According to clinical statistics, the mortality of patients with early brainstem hemorrhage is high. In this study, we established rat models of brainstem hemorrhage by injecting type VII collagenase into the right basotegmental pontine and investigated the pathological changes of early brainstem hemorrhage using multi-sequence magnetic resonance imaging and histopathological methods. We found that brainstem hematoma gradually formed in the injured rats over the first 3 days and then reduced after 7 days. The edema that occurred was mainly of the vasogenic type. No complete myelin sheath structure was found around the focus of the brainstem hemorrhage. The integrity and continuity of nerve fibers gradually deteriorated over the first 7 days. Neuronal degeneration was mild in the first 3 days and then obviously aggravated on the 7th day. Inflammatory cytokines, interleukin-1β, and tumor necrosis factor α appeared on the 1st day after intracerebral hemorrhage, reached peak levels on the 3rd day, and decreased from the 7th day. Our findings show the characteristics of the progression of early brainstem hemorrhage.

Key words: brainstem hemorrhage, diffuse tensor imaging, diffusion-weighted imaging, Fluoro-Jade C staining, hematoxylin-eosin staining, interleukin-1β, luxol fast blue, rat model, T2-weighted imaging, tumor necrosis factor-α