Hydrogen peroxide at a concentration used during neurosurgery disrupts ciliary function and causes extensive damage to the ciliated ependyma of the brain

Objectives Hydrogen peroxide [H2O2: 3% w/v (1.1 M)] has been used as a haemostatic agent during neurosurgery applied to both the external and ventricular surface of the brain. We hypothesised that H2O2 would be toxic to the ciliated ependyma, a single layer of cells that separates cerebrospinal fluid from the neuronal tissue of the brain. Materials and methods The effect of H2O2 was assessed by determining ependymal ciliary beat frequency (CBF) using high-speed video analysis and ultrastructure by electron microscopy. Results Brief exposure to H2O2 caused cessation of ciliary beat frequency and extensive damage of the ependyma. Conclusions Damage to the ciliated ependyma is of concern, as regeneration following damage is very poor and if breached underlying neuronal tissue and a population of neuronal progenitor cells that lie immediately beneath may also be exposed to H2O2.