title: Ultrastructural Changes of Brain Tissues Surrounding Hematomas after Intracerebral Hemorrhage.
abstract: Our knowledge about pathophysiology of intracerebral hemorrhage (ICH) mainly originates from preclinical models of ICH. In this study, cerebral ultrastructure surrounding hematoma and its correlation with clinical severity were investigated in ICH patients. Thirty patients with basal ganglia hemorrhage and 6 control subjects were enrolled. Surgical evacuation was performed for patients with a blood loss >30 ml. Stroke severity was assessed using the Glasgow Coma Scale (GCS) and the National Institute of Health Stroke Scale (NIHSS). Transmission electron microscopy (TEM) was used to evaluate the ultrastructural characteristics of tissue specimens. Neural cells surrounding the hematomas showed evidence of cell swelling and necrosis. Decreased numbers of organelles and mitochondrial cristae were accompanied by cytoplasmic vacuolization, nuclear membrane invagination and breakdown, and intranuclear chromatic agglutination. These changes resulted in disintegration together with malacia, disappearance of the nucleus and nucleolus, and karyopyknosis. More serious ultrastructural damage was seen in patients with greater NIHSS scores, lower GCS scores, and greater bleeding volumes (p < 0.001). These findings suggest that neural cells undergo unfavorable ultrastructural changes that are responsible for dysfunction after ICH.
authors.affiliation: Department of Neurosurgery, Fujian Provincial Hospital, Fuzhou, China.
authors.forename: Kai-Yu
authors.initials: KY
authors.lastname: Wang
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Wu
authors.forename: Lin-Ying
authors.initials: LY
authors.lastname: Zhou
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Yan
authors.forename: Rui-Ling
authors.initials: RL
authors.lastname: Yang
authors.forename: Lian-Ming
authors.initials: LM
authors.lastname: Liao
authors.forename: Xiu-Min
authors.initials: XM
authors.lastname: Ge
authors.forename: Yuan-Sheng
authors.initials: YS
authors.lastname: Liao
authors.forename: Shi-Ju
authors.initials: SJ
authors.lastname: Li
authors.forename: Hui-Zhong
authors.initials: HZ
authors.lastname: Li
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Gao
authors.forename: Ju-Shan
authors.initials: JS
authors.lastname: Lin
authors.forename: Sheng-Yue
authors.initials: SY
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D020145:Basal Ganglia Hemorrhage / Q000473:pathology*; D001921:Brain / Q000648:ultrastructure*; D005260:Female; D015600:Glasgow Coma Scale; D006406:Hematoma / Q000473:pathology; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D020521:Stroke / Q000473:pathology