7 / 20
Page 22
Notes:
June 10-11, 2019 | Edinburgh, Scotland
Central Nervous System and Therapeutics
2
nd
International Conference on
Journal of Neurology and Neurorehabilitation Research | Volume 4
allied
academies
Nitrite and other NO donors for treatment of Subarachnoid Hemorrhage
Ryszard M Pluta
National Institute of Health, USA
F
ollowing aneurysmal subarachnoid hemorrhage (aSAH),
oxygenated, high-pressure blood forms a clot in the
subarachnoid space increasing intracranial pressure (ICP),
evoking early brain injury (EBI), ultra-early (<6hr) vasospasm
and cortical and/or global cerebral ischemia. During the
subsequent week(s), 70% of patients develop delayed
vasospasm, and up to 50%-delayed cerebral ischemia (DCI)
both fortelling poor outcome. The exact pathomechanism(s)
responsible for those events remains debated. However, it
is widely accepted that oxyhemoglobin and its degradation
products being neurotoxic and NO scavengers, derail
vasodilatory activity of endothelial and neuronal NO-
synthases evoking endothelial dysfunction. Decreased
NO - availability in the arterial wall endothelium coupled
with depletion of brain NO storages by a transient ischemia
increasing a local concentration of deoxy-hemoglobin
affects conductive arteries and microcirculation, limits
perfusion of the cortex, triggers local vasospasm as well as
spreading depolarizations leading to spreading ischemia.
In experimental and clinical settings an intravenous infusion
and local administration of NO gas and different NO-donors
demonstratedbeneficial effect limiting braindamage, delayed
cerebral infarctions, vasospasm and improving the outcome.
This presentation addresses historical data of NO-dependent
relief of vasospasm, prevention of delayed brain infarctions,
presents its impact on the outcome in the experimental and
clinical setting after SAH, and suggests some future venues of
NO-related research.
Speaker Biography
Ryszard M Pluta was born and educated in Warsaw, Poland where I
obtained my medical, neurosurgical, doctoral degrees and postdoctoral
award in the field of Neurosurgery from the Medical Research Center
of Polish Academy of Sciences and the Jerzy and Krystyna Chorobski
Foundation. In 1989 I joined the Surgical Neurology Branch at the National
Institute of Neurological Disorders and Stroke of the National Institutes
of Health, Bethesda, MD, USA, at first as the International Fogarty Fellow
then as the Clinical Associate and Clinical Staff Researcher. In 2010 I joined
JAMA Editorial Board as the Fishbein Fellow. In 2009 our patent “Nitrite
for vascular diseases” got the “Deal of Distinction” Award. In 2013 I
retired from the National Institute of Health. Over years of my clinical and
research carrier, I presented over 120 lectures at national and international
conferences, over 80 invited lectures andworkshops at the universities and
conferences and published over 130 articles in the leading medical and
scientific journals. I am on the Editorial Board of several leading medical
journals and the reviewer for numerous scientific and medical entities.
e:
ryszardpluta@icloud.com