title: Unraveling of the Effect of Nodose Ganglion Degeneration on the Coronary Artery Vasospasm After Subarachnoid Hemorrhage: An Experimental Study.
abstract: BACKGROUND
  Cardiac arrest is a major life-threatening complication of subarachnoid hemorrhage (SAH). Although medullary cardiocirculatuar center injury and central sympathetic overactivity have been suspected of initiating coronary artery spasm-induced cardiac arrest, we aimed to elucidate the effects of vagal ischemia at the brainstem on coronary vasospasm and sudden death in SAH.
  
  
  METHODS
  Twenty-six rabbits were randomly divided into 3 groups. Control (n = 5); SHAM (n = 8), and SAH group (n = 13). Experimental SAH was applied by injecting homologous blood into the cisterna magna, and the SHAM group was injected with isotonic saline solution also in the cisterna magna., Twenty-one days after the injection, histopathologic changes of the neuron density of nodose ganglia, the vasospasm index values of the coronary arteries, and the electrocardiographic events were analyzed.
  
  
  RESULTS
  Increased vasospasm index of the coronary arteries and degenerated neuron density of nodose ganglion were significantly different between animals with SAH, control, and SHAM groups (P < 0.005). If neurons of the nodose ganglia are lesioned due to ischemic insult during SAH, the heart rhythm regulation by vagus afferent reflexes is disturbed.
  
  
  CONCLUSIONS
  We found that there is causal relationship between nodose ganglion degeneration and coronary vasospasm. Our finding could be the reason that many cardiac events occur in patients with SAH. Vagal pathway paralysis induced by indirect sympathetic overactivity may trigger coronary vasospasm and heart rhythm disturbances. Our findings will aid in the planning of future experimental studies and in determining the clinical relevance of such studies.
authors.affiliation: Department of Neurosurgery, Erzurum Regional Research and Education Hospital, Erzurum, Turkey.
authors.forename: Coskun
authors.initials: C
authors.lastname: Yolas
authors.affiliation: Department of Neurosurgery, Recep Tayyip Erdogan University, Medical Faculty, Rize, Turkey. Electronic address: ayhankanat@yahoo.com.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Kanat
authors.affiliation: Department of Neurosurgery, Ataturk University, Medical Faculty, Erzurum, Turkey. Electronic address: nmda11@hotmail.com.
authors.forename: Mehmet Dumlu
authors.initials: MD
authors.lastname: Aydin
authors.affiliation: Plandoken Goverment Hospital, Department of Cardiology, Erzurum, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Altas
authors.affiliation: Department of Internal Medicine, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Ilyas Ferit
authors.initials: IF
authors.lastname: Kanat
authors.affiliation: Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Medical Faculty, Rize, Turkey.
authors.forename: Hizir
authors.initials: H
authors.lastname: Kazdal
authors.affiliation: Department of Pathology, Giresun University, Medical Faculty, Giresun, Turkey.
authors.forename: Aslihan
authors.initials: A
authors.lastname: Duman
authors.affiliation: Department of Pathology, Ataturk University, Medical Faculty, Erzurum, Turkey.
authors.forename: Betul
authors.initials: B
authors.lastname: Gundogdu
authors.affiliation: Department of Pathology, Ataturk University, Medical Faculty, Erzurum, Turkey.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Gursan
mesh_terms: D000818:Animals; D002946:Cisterna Magna; D003329:Coronary Vasospasm / Q000209:etiology* / Q000473:pathology; D004195:Disease Models, Animal; D009410:Nerve Degeneration / Q000150:complications* / Q000473:pathology*; D009620:Nodose Ganglion / Q000473:pathology*; D011817:Rabbits; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000473:pathology
keywords: Coronary artery vasospasm; Nodose ganglion; Subarachnoid hemorrhage