Published Online
on August 7, 2003

A more recent version of this article appeared on September 1, 2003

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Submitted on May 9, 2003
Accepted on May 28, 2003

Hyperglycemia Exacerbates Brain Edema and Perihematomal Cell Death After Intracerebral Hemorrhage

Eun-Chol Song MD; Kon Chu MD; Sang-Wuk Jeong MD; Keun-Hwa Jung MD; Seong-Hoon Kim MD, PhD; Manho Kim MD, PhD; and Byung-Woo Yoon MD, PhD^*

From the Department of Neurology and Clinical Research Institute, Seoul National University Hospital, Seoul (E-C.S., K.C., K-H.J., M.K., B-W.Y.); Neuroscience Research Institute of Seoul National University Medical Research Center, Seoul (E-C.S., K.C., K-H.J., M.K., B-W.Y.); Department of Neurology, Seoul National Hospital, Seoul (K.C.); Department of Neurology, Ilsan Paik Hospital, Inje University, Ilsan (S-W.J.); and Department of Neurology, Gangwon University, Chunchon (S-H.K.), South Korea. Dr Song and Dr Chu contributed equally to this work.

^* To whom correspondence should be addressed. E-mail: bwyoon{at}snu.ac.kr.

Background and Purpose--Hyperglycemia has a deleterious effect on brain ischemia. However, the effect of hyperglycemia in intracerebral hemorrhage (ICH) is not well known. We investigated the effect of hyperglycemia on the development of brain edema and perihematomal cell death in ICH.

Methods--Hyperglycemia was induced by intraperitoneal injection of streptozotocin (60 mg/kg) in adult Sprague-Dawley male rats. ICH was induced by stereotaxic infusion of 0.23 U of collagenase into the left striatum. Seventy-two hours after ICH, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining was performed for perihematomal cell death. We also measured brain water content to evaluate edema formation.

Results--The serum glucose level of the hyperglycemic group was 394.0±180.3 mg/dL (n=31), and that of the normoglycemic group was 97.5±27.4 mg/dL (n=31). The size of hemorrhage was similar between groups, without any significant difference (n=8 in each group). The brain water content of hyperglycemic rats (n=17) increased in both lesioned (81.0±0.5%) and nonlesioned hemispheres (78.7±0.6%) compared with the normoglycemic group (n=17; lesioned: 78.9±0.8%; nonlesioned: 77.3±1.1%). In the hyperglycemic group, more TUNEL-positive cells were found in the perihematomal regions (n=6).

Conclusions--Hyperglycemia caused more profound brain edema and perihematomal cell death in experimental ICH.

Key words: brain edema • hyperglycemia • intracerebral hemorrhage • neuronal death • streptozotocin

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