From the Oregon Stroke Center, Oregon Health Sciences University,
Portland, Ore.
Correspondence to Wayne M. Clark, MD, Oregon Stroke Center, L104, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201. E-mail clarkw{at}ohsu.edu
Background and
Purpose—Citicoline sodium (cytidine-5'-diphosphocholine) has been
shown previously to reduce ischemic injury in focal central
nervous system models. Intracerebral hemorrhage
(ICH) appears to be associated with an area of edema and
ischemic injury surrounding the hematoma that may be reduced by
neuroprotective therapy. The present study was designed to test
whether treatment with citicoline reduces ischemic injury and
improves functional neurological outcome in an experimental model
of ICH.
Methods—In 68 Swiss albino mice (26 to 36 g), ICH was
induced by collagenase injection into the caudate nucleus.
Animals were randomized to receive either: citicoline 500 mg/kg or
saline IP prior to collagenase and at 24 and 48 hours.
Animals were rated on a 28-point neurological scale and sacrificed at
54 hours. The brains were sectioned, and the volume of hematoma,
total lesion, and surrounding ischemic injury was
determined.
Results—In terms of functional outcome, animals treated with
citicoline had improved neurological outcome scores compared with
placebo-treated animals: 10.4±2.0 versus 12.1±2.4
(P<0.01). Regarding ischemic injury, although
there was no difference in the underlying hematoma volumes, animals
treated with citicoline had a smaller surrounding volume of
ischemic injury than placebo-treated animals: citicoline,
13.8±5.8 mm3 (10.8±4.3% of hemisphere); placebo,
17.0±7.1 mm3 (13.3±5.1%)
(P<0.05).
Conclusions—In this animal model of ICH, treatment with
citicoline significantly improved functional outcome and reduced the
volume of ischemic injury surrounding the hematoma. This study
supports a potential role for citicoline in clinical ICH treatment.
Section
of Neurosurgery,
University of Chicago Medical Center,
Chicago, Illinois
© 1998 American Heart Association, Inc.
Original Contributions
Citicoline Treatment for Experimental Intracerebral Hemorrhage in Mice
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