Glymphatıc System And Subarachnoid Hemorrhage: Investigation Of The Effect Of Enoxaparin Sodıum And Nimodipine On Physiopathologıc Changes In A Rabbit Model 

Background Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition with high morbidity and mortality; only 35% of survivors return to their previous functional status. The glymphatic system, responsible for clearing metabolic waste from the brain, becomes impaired after aSAH due to disrupted cerebrospinal fluid (CSF) flow in the paravascular space. This dysfunction hampers the clearance of blood breakdown products, contributing to neuroinflammation and lasting neurological deficits. Objective In this study, we examined glymphatic system alterations and the effects of nimodipine and enoxaparin sodium in a rabbit SAH model. Method Neurological function and nutritional status were assessed using Endo neurological examination and nutritional scoring. Biochemical markers (S100B, NSE) were measured in brain, blood, and cervical lymph nodes via Western blot; Aqp-4 gene expression was evaluated by RT-PCR. Morphometric evaluations included brain wet/dry weight and vascular/perivascular area ratios. Results Results showed significantly better neurological and nutritional scores in nimodipine and enoxaparin groups versus controls. Both treatment groups exhibited lower wet/dry weight ratios, indicating reduced cerebral edema. Aqp-4 expression was decreased in the nimodipine group, while S100B and NSE levels increased in both treatment groups. Vascular/perivascular area ratios were reduced with treatment. Conclusions These findings suggest that nimodipine and enoxaparin partially restore glymphatic function and may help reduce neuroinflammation and its long-term consequences after aSAH.