Mathematical modelling of haemorrhagic transformation after ischaemic stroke

J Theor Biol. 2021 Dec 21:531:110920. doi: 10.1016/j.jtbi.2021.110920. Epub 2021 Sep 25.

Abstract

With an increasingly elderly population globally, the impacts of cerebrovascular diseases, such as stroke and dementia, become increasingly significant. Haemorrhagic transformation (HT) is one of the most common complications of ischaemic stroke that is caused by dysfunction of endothelial cells in the blood-brain barrier (BBB) and that can be exacerbated by thrombolytic therapy. Recent studies also suggest that HT can lead to an increase in intracranial pressure (ICP) and result in capillary compression. The aim of this study is to develop a mathematical model that can be used to simulate the consequence of HT over a range of vasculature length scales. We use a 2D vasculature model to investigate the severity of HT with different vascular geometry. The resulting model shows that the haematoma radius is approximately constant across different length scales (100-1000μm) and in good agreement with the available experimental data. In addition, this study identified that the effects of capillary compression do appear to have a significant impact on the leakage fraction of blood and hence act to restrain the development of a haematoma.

Keywords: Capillary compression; Haematoma volume; Haemorrhagic transformation.

MeSH terms

  • Aged
  • Brain Ischemia* / complications
  • Cerebral Hemorrhage / complications
  • Endothelial Cells
  • Humans
  • Ischemic Stroke*
  • Models, Theoretical
  • Stroke* / complications
  • Tissue Plasminogen Activator

Substances

  • Tissue Plasminogen Activator