Head Down Tilt 15U00B0 in The Acute Phase of Experimental intracerebral Hemorrhage : a Randomized Non-inferiority Safety Trial

• Main Author: Martini, Beatrice
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017
• DOI: 10.26226/morressier.5cb58d01c668520010b5708f

Background and Aims:Head down tilt 15u00b0 (HDT15u00b0), applied before recanalization, is a safe and effective collateral therapeutic in experimental ischemic stroke due to large vessel occlusion. Safety of HDT15u00b0 in the acute phase of experimental intracerebral hemorrhage is unknown and needs to be investigated, with a view to develop of HDT15u00b0 for pre-hospital emergency treatment in human stroke.Methods:Intracerebral haemorrhage was produced by stereotaxic injection of collagenase in the left putamen of adult male Wistar rats. A randomized non-inferiority trial design (n=64; non-inferiority limit 15%) was used to assign rats to HDT15u00b0 or flat body position. HDT15u00b0 was applied for 1 hour during the time window of hematoma expansion.Results:HDT15u00b0 achieved the specified criteria of non-inferiority for hematoma volume at 24 hours (HDT15u00b0 97+/-17 mm3 versus flat position 116+/-23 mm3). Mortality at 24 hours was identical in the two groups (12.5%). Functional deficit at 24 hours, assessed with Garcia sensorimotor neuroscore and corner turning test, showed no difference between HDT15u00b0 and flat position. Intracranial pressure was measured in a separate set of randomized animals (n=22) and showed a minimal increase during HDT15u00b0 application, compared to flat position.Conclusions:Our findings indicate that application of HDT15u00b0 in the hyperacute phase of experimental intracerebral haemorrhage does not worsen early outcome. Further research is needed to translate HDT15u00b0 into an emergency collateral therapeutic in acute stroke.