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Sample records for cerebral ischemic small

  1. Cerebrovascular dysfunction and microcirculation rarefaction precede white matter lesions in a mouse genetic model of cerebral ischemic small vessel disease

    OpenAIRE

    Joutel, A.; Monet-Lepretre, M.; Gosele, C.; Baron-Menguy, C.; Hammes, A.; Schmidt, S.; Lemaire-Carrette, B.; Domenga, V.; Schedl, A; Lacombe, P.; Huebner, N.

    2010-01-01

    Cerebral ischemic small vessel disease (SVD) is the leading cause of vascular dementia and a major contributor to stroke in humans. Dominant mutations in NOTCH3 cause cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a genetic archetype of cerebral ischemic SVD. Progress toward understanding the pathogenesis of this disease and developing effective therapies has been hampered by the lack of a good animal model. Here, we report the developmen...

  2. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  3. Asymptomatic ischemic cerebral lesions

    International Nuclear Information System (INIS)

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)

  4. Acute ischemic cerebral attack

    Directory of Open Access Journals (Sweden)

    Franco-Garcia Samir

    2010-12-01

    Full Text Available The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violent death in the world and the first of disability. Many risk factors favor the presentation of these events and some of them are susceptible of modification and therfore are objetives of primary prevention just as the control of diabetes, hypertension and the practice of healthy habits of life. The advances in the knowledge of the physiopatology, had taken to sustantial change in the nomenclature and management of ischemic ACS. Within these changes it was substituted the term cerebrovascular accident fo acute stroke, making emphasis in the key rol of a timely management with goals of time similiar to the acute coronary syndrome. It was redefined the time of acute ischemic attack to a one hour. Once stablished the cerebrovascular attack the semiology of symtoms with frecuency will led us make a topographic diagnosis of the in injury that joined to the cerebral TAC will allow us to exclude an hemorragic event and to start the treatment. In the management of these patients its essential the coordination of the differents teams of work, from the early recognition of symtoms on the part of patients andthe family, the rapid activation and response of emergency systems and the gearing of health care institutions. Are pillars of treatment: the abcde of reanimatiion, to avoid the hiperpirexis, the seizures, the hipoglicemy, the hiperglicemy, to achieve the thrombolysis in the first three hours of the begining of symtoms, to use antiplatelets, antithrombotic profilaxis

  5. Role of thalamic diffusion for disease differentiation between multiple sclerosis and ischemic cerebral small vessel disease

    Energy Technology Data Exchange (ETDEWEB)

    Oeztoprak, Bilge; Oeztoprak, Ibrahim; Salk, Ismail [Cumhuriyet University School of Medicine, Department of Radiology, Sivas (Turkey); Topalkara, Kamil [Bayindir Hospital, Department of Neurology, Ankara (Turkey); Erkoc, Mustafa F. [Bozok University School of Medicine, Department of Radiology, Yozgat (Turkey)

    2015-04-01

    Cerebral small vessel disease (CSVD) and multiple sclerosis (MS) both harbor multiple, T2-hyperintense white matter lesions on conventional magnetic resonance imaging (MRI).We aimed to determine the microstructural changes via diffusion-weighted imaging (DWI) in normal appearing thalami. We hypothesized that the apparent diffusion coefficient (ADC) values would be different in CSVD and MS, since the extent of arterial involvement is different in these two diseases. DWI was performed for 50 patients with CSVD and 35 patients with MS along with gender- and age-matched controls whose conventional MRI revealed normal findings. DWI was done with 1.5 Tesla MR devices using echo planar imaging (EPI) for b = 0, 1000 s/mm{sup 2}. ADC values were obtained from the thalami which appeared normal on T2-weighted and FLAIR images. Standard oval regions of interest (ROIs) of 0.5 cm{sup 2} which were oriented parallel to the long axis of the thalamus were used for this purpose. The mean ADC value of the thalamus was (0.99 ± 0.16) x 10{sup -3} mm{sup 2}/s in patients with CSVD, whereas the mean ADC value was (0.78 ± 0.06) x 10{sup -3} mm{sup 2}/s in the control group. The mean ADC value was significantly higher in patients with CSVD compared to the controls (p < 0.001). The mean ADC values of the thalamus were (0.78 ± 0.08) x 10{sup -3} mm{sup 2}/s in MS patients, and (0.75 ± 0.08) x 10{sup -3} mm{sup 2}/s in the control group, which are not significantly different (p > 0.05). Our study revealed a difference in the diffusion of the thalami between CSVD and MS. DWI may aid in the radiological disease differentiation. (orig.)

  6. Role of thalamic diffusion for disease differentiation between multiple sclerosis and ischemic cerebral small vessel disease

    International Nuclear Information System (INIS)

    Cerebral small vessel disease (CSVD) and multiple sclerosis (MS) both harbor multiple, T2-hyperintense white matter lesions on conventional magnetic resonance imaging (MRI).We aimed to determine the microstructural changes via diffusion-weighted imaging (DWI) in normal appearing thalami. We hypothesized that the apparent diffusion coefficient (ADC) values would be different in CSVD and MS, since the extent of arterial involvement is different in these two diseases. DWI was performed for 50 patients with CSVD and 35 patients with MS along with gender- and age-matched controls whose conventional MRI revealed normal findings. DWI was done with 1.5 Tesla MR devices using echo planar imaging (EPI) for b = 0, 1000 s/mm2. ADC values were obtained from the thalami which appeared normal on T2-weighted and FLAIR images. Standard oval regions of interest (ROIs) of 0.5 cm2 which were oriented parallel to the long axis of the thalamus were used for this purpose. The mean ADC value of the thalamus was (0.99 ± 0.16) x 10-3 mm2/s in patients with CSVD, whereas the mean ADC value was (0.78 ± 0.06) x 10-3 mm2/s in the control group. The mean ADC value was significantly higher in patients with CSVD compared to the controls (p < 0.001). The mean ADC values of the thalamus were (0.78 ± 0.08) x 10-3 mm2/s in MS patients, and (0.75 ± 0.08) x 10-3 mm2/s in the control group, which are not significantly different (p > 0.05). Our study revealed a difference in the diffusion of the thalami between CSVD and MS. DWI may aid in the radiological disease differentiation. (orig.)

  7. Cerebral Ischemic Events with Sickle Cell Anemia

    OpenAIRE

    J Gordon Millichap

    2013-01-01

    Researchers at Cincinnati Children's Hospital and several additional centers in the US and UK studied the incidence of acute silent cerebral ischemic events (ASCIEs) in MRIs of children with asymptomatic sickle cell anemia (SCA).

  8. Immune mechanisms in cerebral ischemic tolerance

    Directory of Open Access Journals (Sweden)

    LidiaGarcia-Bonilla

    2014-03-01

    Full Text Available Stressor-induced tolerance is a central mechanism in the response of bacteria, plants, and animals to potentially harmful environmental challenges. This response is characterized by immediate changes in cellular metabolism and by the delayed transcriptional activation or inhibition of genetic programs that are not generally stressor specific (cross-tolerance. These programs are aimed at countering the deleterious effects of the stressor. While induction of this response (preconditioning can be established at the cellular level, activation of systemic networks is essential for the protection to occur throughout the organs of the body. This is best signified by the phenomenon of remote ischemic preconditioning, whereby application of ischemic stress to one tissue or organ induces ischemic tolerance in remote organs through humoral, cellular and neural signaling. The immune system is an essential component in cerebral ischemic tolerance acting simultaneously both as mediator and target. This dichotomy is based on the fact that activation of inflammatory pathways is necessary to establish ischemic tolerance and that ischemic tolerance can be, in part, attributed to a subdued immune activation after index ischemia. Here we describe the components of the immune system required for induction of ischemic tolerance and review the mechanisms by which a reprogrammed immune response contributes to the neuroprotection observed after preconditioning. Learning how local and systemic immune factors participate in endogenous neuroprotection could lead to the development of new stroke therapies.

  9. Cerebral Ischemic Preconditioning: the Road So Far….

    Science.gov (United States)

    Thushara Vijayakumar, N; Sangwan, Amit; Sharma, Bhargy; Majid, Arshad; Rajanikant, G K

    2016-05-01

    Cerebral preconditioning constitutes the brain's adaptation to lethal ischemia when first exposed to mild doses of a subtoxic stressor. The phenomenon of preconditioning has been largely studied in the heart, and data from in vivo and in vitro models from past 2-3 decades have provided sufficient evidence that similar machinery exists in the brain as well. Since preconditioning results in a transient protective phenotype labeled as ischemic tolerance, it can open many doors in the medical warfare against stroke, a debilitating cerebrovascular disorder that kills or cripples thousands of people worldwide every year. Preconditioning can be induced by a variety of stimuli from hypoxia to pharmacological anesthetics, and each, in turn, induces tolerance by activating a multitude of proteins, enzymes, receptors, transcription factors, and other biomolecules eventually leading to genomic reprogramming. The intracellular signaling pathways and molecular cascades behind preconditioning are extensively being investigated, and several first-rate papers have come out in the last few years centered on the topic of cerebral ischemic tolerance. However, translating the experimental knowledge into the clinical scaffold still evades practicality and faces several challenges. Of the various preconditioning strategies, remote ischemic preconditioning and pharmacological preconditioning appears to be more clinically relevant for the management of ischemic stroke. In this review, we discuss current developments in the field of cerebral preconditioning and then examine the potential of various preconditioning agents to confer neuroprotection in the brain. PMID:26081149

  10. Effects of rhynchophylline on monoamine transmitters of striatum and hippocampus in cerebral ischemic rats

    Institute of Scientific and Technical Information of China (English)

    LUYuan-Fu; XIEXiao-Long; WUQin; WENGuo-Rong; YANGSu-Fen; SHIJing-Shan

    2004-01-01

    AIM To investigate the effects of rhynchophylline ( Rhy on monoamine transmitters and its metabolites in striatum and hippocampus of cerebral ischemic rats. METItODS The cerebral ischemic injury of rat was induced by middle cerebral artery occlusion (MCAO). The extracellular fluid of striatum and hippocampus in cerebral ischemic rats was collected by using

  11. Cerebral blood flow and oxygen metabolism in ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Using positron emission tomography and 15O-steady state method, cerebral blood flow (CBF), oxygen consumption and oxygen extraction fraction were measured in patients with embolic occlusion and in those with thrombotic occlusion in the carotid system. By the study of patients with embolic occlusion, we evaluated ischemic threshold of CBF for infarction to be 16 ml/100 ml/min. The area of 'penumbra' could be estimated in regions with CBF value just above this threshold. In the patients with thrombotic occlusive lesion, we clarified that the efficiency of the collateral circulation was mainly related to the grade of peripheral atherosclerosis. These findings must be helpful to develop better strategy for treatment of cerebral ischemic disease. (author)

  12. Cerebrovascular ischemic changes associated with fetal posterior cerebral artery- descriptive retrospective study with magnetic resonance imaging and angiography of brain

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    Venkatraman Indiran

    2016-04-01

    Full Text Available Objectives: Circle of Willis, the main collateral pathway for cerebral circulation, is complete in only a portion of the population. There are many variations in the Circle of Willis. Fetal posterior cerebral artery, which is defined as posterior cerebral artery arising from internal carotid artery, is a common variant of the Circle of Willis. Though association between the fetal posterior cerebral artery and ischemia have been studied, no specific study has been conducted in the Indian population. We aim to identify the incidence of small and large vessel strokes in patients with fetal posterior cerebral artery using Magnetic Resonance Imaging (MRI and Magnetic Resonance Angiography (MRA of brain in the Indian population. Materials and methods: We retrospectively reviewed MR angiographies of the brain performed in our institution, in order to assess the posterior cerebral circulation and its association with small ischemic changes and large vessel strokes. Results: 92 of the 140 patients (65% with fetal posterior cerebral artery (PCA had small vessel ischemic changes. 72 patients (51.4% had large vessel infarcts in any of the vascular territories. 35% of the patients included in this study showed infarcts in the middle cerebral artery (MCA territory and 15 % showed infarcts in the PCA territory. Conclusion: Higher incidence of MCA infarcts in our study probably suggests that PCA cannot aid in collateral formation cases of reduced flow across the internal carotid artery and that fetal PCA could be an important risk factor in cerebrovascular ischemic diseases.

  13. Serum levels of hsCRP and SF in patients with ischemic cerebral vascular disease

    International Nuclear Information System (INIS)

    Objective: To investigate the significance of changes of serum levels of hsCRP and ferritin (SF) in patients with ischemic cerebral vascular disease. Methods: Serum hsCRP and SF levels were measured with scatter velocity turbidimetry in 120 patients with ischemic cerebral vascular accident and 100 controls. Results: The serum levels of hsCRP and SF in patients with ischemic cerebral vascular accident were significantly higher than those in controls (P<0.01). Conclusion: Serum hsCRP and SF levels were markedly increased after ischemic cerebral vascular accident. They might be regarded as independent risk factor and outcome predictor for the disease. (authors)

  14. Small vessel hematocrit in ischemic myocardium

    International Nuclear Information System (INIS)

    As blood enters the microvasculature of normally perfused myocardium, there is a progressive decrease in small vessel hematocrit (SV Hct) due to RBC streaming in smaller branching vessels and the Fahraeus-Lindqvist effect. We hypothesized that if the coronary collateral circulation was composed of very small vessels branching from large parent vessels, plasma streaming would result in a further decrease of SV Hct in ischemic myocardium. Six open chest anesthetized dogs were studied. Plasma was labelled with 59FeCl siderophilin and RBC's with 99mTc to estimate SV Hct from myocardial biopsies. The LAD was occluded and cannulated for measurement of retrograde flow (arising presumably from proximal collaterals). The ischemic region was identified using the microsphere shadow technique. Collateral flow after LAD occlusion was 30 +- 12 ml/min 100g (x +- SE). Systemic Hct was 40 +- 1%. The Hct of blood from retrograde flow was 39 +- 1% (p = NS). Activity of 59FeCl and 99mTc in known quantities of blood were compared to myocardial biopsies to estimate SV Hct. Ischemic SV Hct was 23 +- 2% and non-ischemic SV Hct was 21 +- 1% (p = NS). We conclude that the size and branching pattern of coronary collaterals is such that plasma streaming in collaterals does not result in an additional decrease in SV Hct in ischemic myocardium

  15. Bone Fracture Pre-Ischemic Stroke Exacerbates Ischemic Cerebral Injury in Mice.

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    Liang Wang

    Full Text Available Ischemic stroke is a devastating complication of bone fracture. Bone fracture shortly after stroke enhances stroke injury by augmenting inflammation. We hypothesize that bone fracture shortly before ischemic stroke also exacerbates ischemic cerebral injury. Tibia fracture was performed 6 or 24 hours before permanent middle cerebral artery occlusion (pMCAO on C57BL/6J mice or Ccr2RFP/+Cx3cr1GFP/+ mice that have the RFP gene knocked into one allele of Ccr2 gene and GFP gene knocked into one allele of Cx3cr1 gene. Behavior was tested 3 days after pMCAO. Infarct volume, the number of CD68+ cells, apoptotic neurons, bone marrow-derived macrophages (RFP+, and microgila (GFP+ in the peri-infarct region were quantified. Compared to mice subjected to pMCAO only, bone fracture 6 or 24 hours before pMCAO increased behavioral deficits, the infarct volume, and the number of CD68+ cells and apoptotic neurons in the peri-infarct area. Both bone marrow-derived macrophages (CCR2+ and microglia (CX3CR1+ increased in the peri-infarct regions of mice subjected to bone fracture before pMCAO compared to stroke-only mice. The mice subjected to bone fracture 6 hours before pMCAO had more severe injury than mice that had bone fracture 24 hours before pMCAO. Our data showed that bone fracture shortly before stroke also increases neuroinflammation and exacerbates ischemic cerebral injury. Our findings suggest that inhibition of neuroinflammation or management of stroke risk factors before major bone surgery would be beneficial for patients who are likely to suffer from stroke.

  16. What is cerebral small vessel disease?

    International Nuclear Information System (INIS)

    An accumulating amount of evidence suggests that the white matter hyperintensities on T2 weighted brain magnetic resonance imaging predict an increased risk of dementia and gait disturbance. This state has been proposed as cerebral small vessel disease, including leukoaraiosis, Binswanger's disease, lacunar stroke and cerebral microbleeds. However, the concept of cerebral small vessel disease is still obscure. To understand the cerebral small vessel disease, the precise structure and function of cerebral small vessels must be clarified. Cerebral small vessels include several different arteries which have different anatomical structures and functions. Important functions of the cerebral small vessels are blood-brain barrier and perivasucular drainage of interstitial fluid from the brain parenchyma. Cerebral capillaries and glial endfeet, take an important role for these functions. However, the previous pathological investigations on cerebral small vessels have focused on larger arteries than capillaries. Therefore little is known about the pathology of capillaries in small vessel disease. The recent discoveries of genes which cause the cerebral small vessel disease indicate that the cerebral small vessel diseases are caused by a distinct molecular mechanism. One of the pathological findings in hereditary cerebral small vessel disease is the loss of smooth muscle cells, which is an also well-recognized finding in sporadic cerebral small vessel disease. Since pericytes have similar character with the smooth muscle cells, the pericytes should be investigated in these disorders. In addition, the loss of smooth muscle cells may result in dysfunction of drainage of interstitial fluid from capillaries. The precise correlation between the loss of smooth muscle cells and white matter disease is still unknown. However, the function that is specific to cerebral small vessel may be associated with the pathogenesis of cerebral small vessel disease. (author)

  17. Epidemiology and Risk Factors of Cerebral Ischemia and Ischemic Heart Diseases: Similarities and Differences

    OpenAIRE

    Soler, Ernest Palomeras; Ruiz, Virgina Casado

    2010-01-01

    Cerebral ischemia and ischemic heart diseases, common entities nowadays, are the main manifestation of circulatory diseases. Cardiovascular diseases, followed by stroke, represent the leading cause of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. However, each entity has its own particularities. Ischemic stroke shows a variety of pathogenic mechanisms not present in ischemic heart disease. An ...

  18. Cerebral Small Vessel Disease and Risk of Death, Ischemic Stroke, and Cardiac Complications in Patients With Atherosclerotic Disease The Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) Study

    NARCIS (Netherlands)

    M.M.A. Conijn; R.P. Kloppenborg; A. Algra; W.P.T.M. Mali; L.J. Kappelle; K.L. Vincken; Y. van der Graaf; M.I. Geerlings

    2011-01-01

    Background and Purpose-Cerebral small vessel disease may be related to vascular and nonvascular pathology. We assessed whether lacunar infarcts and white matter lesions on MRI increased the risk of vascular and nonvascular death and future vascular events in patients with atherosclerotic disease. Me

  19. Magnetic Resonance Imaging in Ischemic Stroke and Cerebral Venous Thrombosis.

    Science.gov (United States)

    Krieger, Daniel A; Dehkharghani, Seena

    2015-12-01

    Imaging is indispensable in the evaluation of patients presenting with central nervous system emergencies. Although computed tomography (CT) is the mainstay of initial assessment and triage, magnetic resonance imaging (MRI) has become vital in expanding diagnostic capabilities, refining management strategies, and developing our understanding of disease processes. Ischemic stroke and cerebral venous thrombosis are 2 areas wherein MRI is actively revolutionizing patient care. Familiarity with the imaging manifestations of these 2 disease processes is crucial for any radiologist reading brain MR studies. In this review, the fundamentals of image interpretation will be addressed in-depth. Furthermore, advanced imaging techniques which are redefining the role of emergency MRI will be outlined, with a focus on the pathophysiological mechanisms that underlie image interpretation. In particular, emerging data surrounding the use of MR perfusion imaging in acute stroke management portend dramatic shifts in neurointerventional management. To this end, a review of the recent stroke literature will hopefully enhance the radiologist's role in both meaningful reporting and multidisciplinary teamwork. PMID:26636639

  20. Diet Induced Obesity Causes Cerebral Vessel Remodeling and Increases the Damage Caused by Ischemic Stroke

    OpenAIRE

    Deutsch, Christian; Portik-Dobos, Vera; Smith, Anita D; Ergul, Adviye; Dorrance, Anne M.

    2009-01-01

    Hypertension, elevated fasting blood glucose and plasma insulin develop in rats fed a high fat (HF) diet. Our goal was to assess the effects of obesity, beginning in childhood, on the adult cardiovascular system. We hypothesized that rats fed a HF diet would have larger ischemic cerebral infarcts and middle cerebral artery (MCA) remodeling. Three-week-old male Sprague Dawley rats were fed a HF (Obese) or control diet for 10 weeks. Cerebral ischemia was induced by MCA occlusion (MCAO). MCA str...

  1. Tomoscintigraphy for prediction of the results of angiosurgery for acute ischemic disorders of cerebral circulation

    International Nuclear Information System (INIS)

    Preoperative volume and degree of ischemic involvement of the brain shown by single-photon emission computer-aided tomoscintigraphy (SECT) and the time course of neurologic status following reconstructive surgery on the carotid arteries were studied in 20 patients with acute disorders of cerebral circulation. The volume of hypoperfused cerebral tissue and volumic index of cerebral tissue hypoperfision were calculated from the data of tomoscintigraphy of the brain. 7 refs.; 4 tabs

  2. Improvement in the Ultrastructures of Nervous Tissues Damaged in Cerebral Ischemic Rate by Picroside II

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    Li Zhao

    2015-01-01

    Full Text Available The aim of present study was to verify the neuroprotective effect of picroside II on cerebral ischemic injury in rats from the perspective of neuropathology. Healthy adult male Wistar rats were used to establish the forebrain ischemic model. Transmission Electron Microscopy (TEM was used to observe the ultrastructure of neurons, astrocytes, myelin and the Blood-Brain Barrier (BBB. There was morphological damage in neuron, astrocyte, myelin and BBB after cerebral ischemia. After treatment by picroside II, the degree of damage in neuron, astrocytes, myelin and BBB was reduced. These results suggest that picroside II could significantly improve the morphosis of nerve tissue after cerebral ischemia and play a neuroprotective effect on cerebral ischemic injury in rats.

  3. Radon inhalation protects against transient global cerebral ischemic injury in gerbils.

    Science.gov (United States)

    Kataoka, Takahiro; Etani, Reo; Takata, Yuji; Nishiyama, Yuichi; Kawabe, Atsushi; Kumashiro, Masayuki; Taguchi, Takehito; Yamaoka, Kiyonori

    2014-10-01

    Although brain disorders are not the main indication for radon therapy, our previous study suggested that radon inhalation therapy might mitigate brain disorders. In this study, we assessed whether radon inhalation protects against transient global cerebral ischemic injury in gerbils. Gerbils were treated with inhaled radon at a concentration of 2,000 Bq/m(3) for 24 h. After radon inhalation, transient global cerebral ischemia was induced by bilateral occlusion of the common carotid artery. Results showed that transient global cerebral ischemia induced neuronal damage in hippocampal CA1, and the number of damaged neurons was significantly increased compared with control. However, radon treatment inhibited ischemic damage. Superoxide dismutase (SOD) activity in the radon-treated gerbil brain was significantly higher than that in sham-operated gerbils. These findings suggested that radon inhalation activates antioxidative function, especially SOD, thereby inhibiting transient global cerebral ischemic injury in gerbils. PMID:24792782

  4. Interleukin-1 exacerbates focal cerebral ischemia and reduces ischemic brain temperature in the rat.

    Science.gov (United States)

    Parry-Jones, Adrian R; Liimatainen, Timo; Kauppinen, Risto A; Gröhn, Olli H J; Rothwell, Nancy J

    2008-06-01

    The proinflammatory cytokine interleukin-1 (IL-1) is a key mediator of inflammation in cerebral ischemia, but its precise mechanisms of action remain elusive. Temperature is critical to outcome in brain injury and given the importance of IL-1 in pyrogenesis this has clear mechanistic implications. IL-1 exacerbates ischemia independently of core (rectal) temperature. However, it is temperature in the ischemic brain that influences outcome and rectal temperature is likely to be a poor surrogate marker. This study tested the hypothesis that IL-1 exacerbates cerebral ischemia by increasing ischemic brain temperature. Wistar rats undergoing transient middle cerebral artery occlusion received either 4 microg/kg IL-1 (n=9) or vehicle (n=10) intraperitoneally. NMR-generated maps of brain temperature, tissue perfusion, and the trace of the diffusion tensor were collected during occlusion, early reperfusion, and at 24 hr. IL-1 significantly increased ischemic damage at 24 hr by 35% but rectal temperature did not vary significantly between groups. However, ischemic brain was 1.7 degrees C cooler on reperfusion in IL-1-treated animals (vs. vehicle) and a corresponding reduction in cerebral blood flow was identified in the ischemic striatum. Contrary to the stated hypothesis, IL-1 reduced ischemic brain temperature during reperfusion and this may be due to a reduction in tissue perfusion. PMID:18421691

  5. Current status and outlook of endovascular therapy for cerebral ischemic diseases

    International Nuclear Information System (INIS)

    Improvement of diagnostic technology and increasing advent of new materials for intervention has created a new area for endovascular therapy of cerebral ischemic diseases. Current research findings have shown that endovascular thrombolysis in acute stage of cerebral infarction can accelerate the rate of re-canalization of occluded arteries and greatly decrease the morbidity and mortality of cerebral ischemic vascular diseases. Stenting of arterial stenosis can the improve of blood supply distal to the lesion, prevent recurrent cerebral ischemic stroke. As a result, endovascular thrombolysis for acute cerebral infarction and stenting for intracranial and carotid arterial stenosis are booming both at home and abroad. Proper selection of patients of acute cerebral infarction for endovascular thrombolysis with less complications could be achieved through CT perfusion, MR perfusion-weighted image (PWI) and diffusion-weighted image (DWI), non-invasive vascular imaging technology including CEMRA and CTA for confirming and demonstrating the sites and causes of cerebral ischemia, and furthermore for evaluating the survival ability and etc. The research team administered albumin and magnesium sulfate as neurological protection drug to treat rat infarction model within 6 hours of onset resulting with the same effect of decreasing the damage of ischemic cerebral tissue and without hemorrhagic complication. It is certain that hemorrhagic complication in thrombolysis is a result of multiple factors with no single drug being able to solve the problem. It is predictable that, based on semi-quantitative or quantitative parameters of CT or MRI in conjunction with PWI/DWI mismatch model rather than simply on the onset time of infarction for proper selection of patients of cerebral infarction, mechanic thrombus-disruption and/or intra-arterial thrombolysis together with intervention of neurological protection drug will be the trend for treating acute cerebral infarction in the future

  6. Delayed ischemic electrocortical suppression during rapid repeated cerebral ischemia and kainate-induced seizures in rat

    DEFF Research Database (Denmark)

    Ilie, Andrei; Spulber, Stefan; Avramescu, Sinziana; Nita, Dragos Alexandru; Zagrean, Ana-Maria; Zagrean, Leon; Moldovan, Mihai

    2006-01-01

    Global cerebral ischemia induces, within seconds, suppression of spontaneous electrocortical activity, partly due to alterations in synaptic transmission. In vitro studies have found that repeated brief hypoxic episodes prolong the persistence of synaptic transmission due to weakened adenosine...... release. The aim of this study was to investigate in vivo whether the time to ischemic electrocortical suppression (T(ES)) could be altered during energy stress conditions such as rapid repeated global cerebral ischemia and kainate-induced seizures. Experiments were carried out in adult rats under chloral...... distinguish the alterations in spontaneous electrocortical activity we compared T(ES) with the ischemic suppression of visual evoked potentials (VEP). During the first ischemic episode, T(ES) was approximately 15 s and remained unchanged when five ischemic episodes were separated by 10-min reperfusion...

  7. Recombinant human erythropoietin increases cerebral cortical width index and neurogenesis following ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Zhongmin Wen; Peiji Wang

    2012-01-01

    The cerebral cortical expansion index refers to the ratio between left and right cortex width and is recognized as an indicator for cortical hyperplasia. Cerebral ischemia was established in CB-17 mice in the present study, and the mice were subsequently treated with recombinant human erythropoietin via subcutaneous injection. Results demonstrated that cerebral cortical width index significantly increased. Immunofluorescence detection showed that the number of nuclear antigen antibody/5-bromodeoxyuridine-positive cells at the infarction edge significantly increased. Correlation analysis revealed a negative correlation between neurological scores and cortical width indices in rats following ischemic stroke. These experimental findings suggested that recombinant human erythropoietin promoted cerebral cortical hyperplasia, increased cortical neurogenesis, and enhanced functional recovery following ischemic stroke.

  8. Dipyridamole cerebral flow stress test evaluating ischemic cerebrovascular diseases

    International Nuclear Information System (INIS)

    To detect the clinical value of dipyridamole cerebral blood flow stress test in cerebrovascular diseases (CVD). Nineteen patients (9 male, 10 female, mean age=65) who were diagnosed as CVD were included. One suffered from infarct, two suffered from thrombosis, one feel dizziness. All 4 performed rest and stress test. The other 15 were VBI, 9 of them performed stress test. Rest and stress test were done two-day method using Elscint Apex SP-6 SPECT equipped with low energy all purpose collimator. Rest perfusion imaging was started 30 min after injecting 1.11 GBq 99mTc-ECD. Dipyridamole stress test was done within one week. 0.56 mg/Kg dipyridamole was injected intravenously during 4 min the same dose of ECD was injected 2 min later. The acquisition started 30 min later with the same parameter. Heart rate, ECG and the patient's complaint were monitored 2 min before and after dipyridamole. After correction for attenuation, transverse, coronal and sagittal slices were reconstructed. Eighteen ROIs were drawn symmetrically on cingulate, frontal, temporal-parietal, temporal, occipital, vision cortex, basal ganglia, superior frontal and parietal on the 3rd, 6th, 9th transverse slices, selecting the contralateral as the reference region. The counts per pixel in each ROI were divided by the counts of the mirror region to obtain the relative uptake ratio. We think it abnormality when the ratio is above 1,1 or below 0.9. The sensitivity for rest and stress rCBF test was compared. rCBF was decreased at 10 of 19 patients (sensitivity 52.6%). 14 had low rCBF after dipyridamole (sensitivity 72.3%), Among the patients who studied stress test, 6 had normal rCBF at rest and low rCBF after stress. The abnormal area was enlarged after dipyridamole for 1 patients, 2 improved and 2 unchanged. 8 of 15 VBI had normal rCBF at rest (sensitivity 53.3%). 9 of 15 VBI performed stress test. rCBF was normal at rest for 5 patients, rCBF was decreased after stress, it was improved for one

  9. New asymptomatic ischemic lesions on diffusion-weighted imaging after cerebral angiography

    International Nuclear Information System (INIS)

    Conventional cerebral angiography (CAG) is relatively low risk for neurological complications. However, diffusion-weighted imaging (DWI) after CAG occasionally reveal an asymptomatic ischemic lesion on the brain. The aim of this study was to investigate the frequency of new asymptomatic or symptomatic DWI lesions after CAG and to clarify the factors associated with them. Fifty-six patients with acute ischemic stroke and transient ischemic attack were prospectively enrolled. Magnetic resonance imaging (MRI) studies including DWI were studied twice, within 48 hours before and after CAG. The following factors were assessed; age, gender, history of stroke, history of ischemic heart disease, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) score on admission, stroke subtype, treatment before stroke or transient ischemic attack (TIA) (antiplatelets or warfarin), approach for catheters (transbrachial or femoral artery), amount of contrast medium used, length of the angiographic procedure, and fluoroscophy time. We divided the patients into two groups according to the presence of new DWI lesions after CAG; Positive group had new DWI lesions, whereas the Negative group had none. After CAG, no patients had new neurological deficits. New asymptomatic DWI lesions were observed in 24 patients (42.9%). The significant differences observed between two groups were as follows; age (69.8±11.3 for the Positive group versus 61.9±11.3 for the Negative group, p=0.043), female (54% versus 28%, p=0.048), non-small vessel occlusion (100% versus 66%, p=0.009), catheter approach for transfemoral artery (63% versus 13%, p<0.001), mean length of the angiographic procedure (63.1±21.6 min versus 43.7±14.2 min, p<0.001), mean fluoroscopy time (26.5±13.0 min versus 14.9±5.9 mm, p<0.001). Sensitivity and specificity analysis to discriminate the positive and negative groups revealed 17 minutes to be the critical threshold point (sensitivity 66.6% and specificity 68

  10. Validation of hyperintense middle cerebral artery sign in acute ischemic stroke

    OpenAIRE

    Guo, Gang; Yang, Yonggui; Yang, Weiqun

    2012-01-01

    We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on ...

  11. Cerebral blood flow distribution and reactivity during the symptom-free stages of transient ischemic attacks

    International Nuclear Information System (INIS)

    Even during the symptom-free stages, patients with transient ischemic attacks (TIA) often show cerebral blood flow (CBF) disturbances. For evaluating the factors which cause these abnormalities, we studied CBF and CBF reactivity to acetazolamide (diamox) using a 99mTc-hexamethylpropyleneamine oxime (HMPAO) SPECT. The results from CBF-SPECT were compared with X-ray computed tomography (CT), cerebral arteriogram, clinical characteristics of TIA and cerebrovascular risk factors. The overall sensitivity rates in detecting the lesion were 68% in CBF-SPECT and 9% in CT. The size of the hypoperfused area tended to be wide in patients who had intracranial, severe stenotic or multiple arterial lesions on the ipsilateral side. No such relations were found between CBF and other examinations. Brain hypoperfusion was located in the subcortical region in eight patients; two patients showed a small hypodense lesion on CT which corresponded to the hypoperfusion on SPECT, and three patients showed no arteriographic abnormality. Hypoperfusion in the cortex was seen in seven patients; all patients showed arteriographic abnormality, but no CT abnormality. The severity rating of the vascular stenosis and hypoperfusion, and the incidence of the intracranial lesions were higher in this group than the group with subcortical hypoperfusion. Seven patients showed fixed normoperfusion before and after diamox injection. Two patients with a subcortical small infarction showed fixed hypoperfusion even after diamox injection. Twelve patients showed focal hypoperfusion before diamox with a new filling-in after diamox. Only one patient showed resting hypoperfusion and decreased CBF reactivity to diamox. The results suggest that most of the patients with a brain hypoperfusion in the symptom-free stages of TIAs have preserved cerebrovascular reactivity although a few patients show hypoperfusion having cerebral infarction or hemodynamically compromised tissue. (author)

  12. Extracranial cerebral arterial atherosclerosis in Iranian patients suffering ischemic strokes

    Directory of Open Access Journals (Sweden)

    Sayed Ali Mousavi

    2006-12-01

    Full Text Available BACKGROUND: To determine the distribution and severity of extracranial carotid arterial atherosclerosis in Iranian patients with ischemic stroke. METHODS: 328 patients with ischemic stroke were included in this study. Doppler ultrasound was used for evaluation of atherosclerosis in extracranial carotid arteries. The NASCET criteria were used to measure carotid stenosis. RESULTS: Ninety of 328 patients (27.4% were found to have atherosclerotic plaques; 40 of these patients were women and 50 were men. Sixty-eight patients (20.7% had artery stenosis <50%, 13 patients (3.95% had 50-70 % artery stenosis and 6 (1.8% had >70% artery stenosis. CONCLUSIONS: Extracranial atherosclerosis is not rare in Iranian patients with ischemic stroke, but most carotid artery lesions were plaques with <50% stenosis. KEY WORDS: Atherosclerosis, ischemic stroke, carotid stenosis.

  13. Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Paulson, O B; Lassen, N A

    1986-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They...

  14. Activation of cerebral sodium-glucose transporter type 1 function mediated by post-ischemic hyperglycemia exacerbates the development of cerebral ischemia.

    Science.gov (United States)

    Yamazaki, Y; Ogihara, S; Harada, S; Tokuyama, S

    2015-12-01

    The regulation of post-ischemic hyperglycemia plays an important role in suppressing neuronal damage in therapeutic strategies for cerebral ischemia. We previously reported that the cerebral sodium-glucose transporter (SGLT) was involved in the post-ischemic hyperglycemia-induced exacerbation of cerebral ischemic neuronal damage. Cortical SGLT-1, one of the cerebral SGLT isoforms, is dramatically increased by focal cerebral ischemia. In this study, we focused on the involvement of cerebral SGLT-1 in the development of cerebral ischemic neuronal damage. It was previously reported that activation of 5'-adenosine monophosphate-activated protein kinase (AMPK) increases SGLT-1 expression. Moreover, ischemic stress-induced activation of AMPK exacerbates cerebral ischemic neuronal damage. Therefore, we directly confirmed the relationship between cerebral SGLT-1 and cerebral AMPK activation using in vitro primary culture of mouse cortical neurons. An in vivo mouse model of focal cerebral ischemia was generated using a middle cerebral artery occlusion (MCAO). The development of infarct volume and behavioral abnormalities on day 3 after MCAO were ameliorated in cerebral SGLT-1 knock down mice. Cortical and striatal SGLT-1 expression levels were significantly increased at 12h after MCAO. Immunofluorescence revealed that SGLT-1 and the neuronal nuclear antigen (NeuN) were co-localized in the cortex and striatum of MCAO mice. In the in vitro study, primary cortical neurons were cultured for five days before each treatment with reagents. Concomitant treatment with hydrogen peroxide and glucose induced the elevation of SGLT-1 and phosphorylated AMPK/AMPK ratio, and this elevation was suppressed by compound C, an AMPK inhibitor in primary cortical neurons. Moreover, compound C suppressed neuronal cell death induced by concomitant hydrogen peroxide/glucose treatment in primary cortical neurons. Therefore, we concluded that enhanced cerebral SGLT-1 function mediated by post-ischemic

  15. In vivo characterization of ischemic small intestine using bioimpedance measurements.

    Science.gov (United States)

    Strand-Amundsen, R J; Tronstad, C; Kalvøy, H; Gundersen, Y; Krohn, C D; Aasen, A O; Holhjem, L; Reims, H M; Martinsen, Ø G; Høgetveit, J O; Ruud, T E; Tønnessen, T I

    2016-02-01

    The standard clinical method for the assessment of viability in ischemic small intestine is still visual inspection and palpation. This method is non-specific and unreliable, and requires a high level of clinical experience. Consequently, viable tissue might be removed, or irreversibly damaged tissue might be left in the body, which may both slow down patient recovery. Impedance spectroscopy has been used to measure changes in electrical parameters during ischemia in various tissues. The physical changes in the tissue at the cellular and structural levels after the onset of ischemia lead to time-variant changes in the electrical properties. We aimed to investigate the use of bioimpedance measurement to assess if the tissue is ischemic, and to assess the ischemic time duration. Measurements were performed on pigs (n = 7) using a novel two-electrode setup, with a Solartron 1260/1294 impedance gain-phase analyser. After induction of anaesthesia, an ischemic model with warm, full mesenteric arterial and venous occlusion on 30 cm of the jejunum was implemented. Electrodes were placed on the serosal surface of the ischemic jejunum, applying a constant voltage, and measuring the resulting electrical admittance. As a control, measurements were done on a fully perfused part of the jejunum in the same porcine model. The changes in tan δ (dielectric parameter), measured within a 6 h period of warm, full mesenteric occlusion ischemia in seven pigs, correlates with the onset and duration of ischemia. Tan δ measured in the ischemic part of the jejunum differed significantly from the control tissue, allowing us to determine if the tissue was ischemic or not (P < 0.0001, F = (1,75.13) 188.19). We also found that we could use tan δ to predict ischemic duration. This opens up the possibility of real-time monitoring and assessment of the presence and duration of small intestinal ischemia. PMID:26805916

  16. Radiotherapy for Small Cerebral Arteriovenous Malformation

    OpenAIRE

    Yamashita, Tetsuo; Kurokawa, Yasushi; Kashiwagi, Shiro; Abiko, Seisho; Shiroyama, Yujiro; Kamiryo, Toshifumi; Nakano, Shigeki; Eguchi, Yuuki; Tsurutani, Toru; Ito, Haruhide

    1991-01-01

    The result of two types of radiation therapy for small cerebral arteriovenous malformations (AVM) were analyzed, and the indications and limitations of radiation therapy for small AVMs discussed. Four patients with small AVMs received radiation therapy. There were three males and one female, ranging in age from 7 to 44 years with an average of 29 years. One cerebral AVM was located in the right thalamus, two were in the left central sulcus and one was in the left parietal lobe. Three AVMs wer...

  17. Validation of hyperintense middle cerebral artery sign in acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Gang Guo; Yonggui Yang; Weiqun Yang

    2012-01-01

    We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on magnetic resonance angiography and digital subtraction angiography. No patients in the non-hemorrhagic group had hyperintense middle cerebral artery sign on MRI. The sensitivity, specificity, and positive predictive values of the hyperintense middle cerebral artery sign on MRI T1-weighted image for subsequent hemorrhagic transformation were 54.5%, 100%, and 100% respectively. Hyperdense middle cerebral artery sign on non-contrast CT was observed in nine patients, five of who developed hemorrhagic transformation. These data suggest that hyperintense middle cerebral artery sign on MRI T1-weighted image is a highly specific and moderately sensitive indicator of subsequent hemorrhagic transformation in patients after acute ischemic stroke, and its specificity is superior to CT.

  18. A Randomized trial comparing ticlopidine with aspirin fof the prevention of ischemic cerebral stroke

    Institute of Scientific and Technical Information of China (English)

    Li Yizhao; Li Danian; Wang Lei

    2000-01-01

    OBJECTIVE To assess the effect and cafety of t iclopidine in the prevention of ischemic cerebral stroke and to compare theeffect of low-dose aspirin with t iclopidine. BACKGROUND The effect and safety of ticlopidine irn the prevention of ischemic cerebral stroke in China has not been reported. METHODS 329 patients with TIA or mild ischemic cevebral stroke wasrandonmly assigned to ticlopidine group(165 case) or aspirin group (164 case) in this study.These patrents were randomly allocated to receive either 250mg trclopidine or 50mg aspirin daily and didnd take any other platelet antiaggregating drugs. Time of eacn follow up visit was one to two months. Follow up lasted for 6 to 18 months. RESULTS The event rate for stroke or death from any cause was 8.3% in ticlopidine group arid 14.9% in aspirin group. This repesented a risk reduction of 44.3%(95% cofidence interval, 0.29-0.94) for ticiopidine group as compared with aspirin group. The event raite for ischemic cerebral stroke or myocarction of ticlopidine group(7.0%)was lower than that cf aspirin group(14.8%)(P<0.05).A riskreduction of 52.7%(95% confidence interval,0.24-0.92) for ticlopidine group compared with aspirin group. The rate of adverse effects of ticlopidine group and aspirin group were 6.9% and 11.0% during the trial ,but this was not statistically significant(P<0.05).DISCUSSION and CONCLUSION Therapeutic efficacy for the prevention oi ischemic stroke of ticlopidine was better than that of aspirin, the rate of side effects in ticlopidine group and aspirin group are not statistically significant. So ticiopidine could serve as a first-line drug for the prevention of ischemic stroke.

  19. Acute Posterior Ischemic Optic Neuropathy Mimicking Posterior Cerebral Artery Stroke Visualized by 3-Tesla MRI

    Directory of Open Access Journals (Sweden)

    Tilman Menzel

    2012-11-01

    Full Text Available Acute ischemic lesions of the posterior optic nerve and optic tract can produce a variety of visual field defects. A 71-year-old woman presented with acute hemianopia, which led to rt-PA thrombolysis for suspected posterior cerebral artery ischemia. 3-Tesla cMRI, however, revealed the cause to be an acute posterior ischemic optic neuropathy. Cases like this may be more common than thought and quite regularly overlooked in clinical practice, especially when there is no high-resolution MRI available. This case strengthens the importance of repeat MR imaging in patients with persistent visual field defects.

  20. Acute Posterior Ischemic Optic Neuropathy Mimicking Posterior Cerebral Artery Stroke Visualized by 3-Tesla MRI

    OpenAIRE

    Menzel, Tilman; Kern, Rolf; Griebe, Martin; Hennerici, Michael; Fatar, Marc

    2012-01-01

    Acute ischemic lesions of the posterior optic nerve and optic tract can produce a variety of visual field defects. A 71-year-old woman presented with acute hemianopia, which led to rt-PA thrombolysis for suspected posterior cerebral artery ischemia. 3-Tesla cMRI, however, revealed the cause to be an acute posterior ischemic optic neuropathy. Cases like this may be more common than thought and quite regularly overlooked in clinical practice, especially when there is no high-resolution MRI avai...

  1. Ischemic Postconditioning Alleviates Neuronal Injury Caused by Relief of Carotid Stenosis in a Rat Model of Cerebral Hypoperfusion

    OpenAIRE

    Pengfei Ge; Yinan Luo; Boyu Wang; Tianfei Luo; Li Qi; Chunsheng Feng

    2012-01-01

    The effects of early relief of heavy bilateral carotid stenosis and ischemic postconditioning on hippocampus CA1 neurons are still unclear. In this study, we used a rat model to imitate severe bilateral carotid stenosis in humans. The rats were divided into sham group, carotid stenosis group, stenosis relief group and ischemic postconditioning group. Ischemic postconditioning consisted of three cycles of 30 s ischemia and 30 s reperfusion. The cerebral blood flow was measured with a laser Dop...

  2. Acetylbritannilactone Modulates MicroRNA-155-Mediated Inflammatory Response in Ischemic Cerebral Tissues

    OpenAIRE

    Wen, Ya; Zhang, Xiangjian; Dong, Lipeng; Zhao, Jingru; Zhang, Cong; Zhu, Chunhua

    2015-01-01

    Inflammatory responses play a critical role in ischemic brain injury. MicroRNA-155 (miR-155) induces the expression of inflammatory cytokines, and acetylbritannilactone (ABL) exerts potent antiinflammatory actions by inhibiting expression of inflammation-related genes. However, the functions of miR-155 and the actual relationship between ABL and miR-155 in ischemia-induced cerebral inflammation remain unclear. In this study, cerebral ischemia of wild-type (WT) and miR-155−/− mice was induced ...

  3. Effects of minocycline on learning and memory of mice following ischemic-hypoxic cerebral injuries

    Institute of Scientific and Technical Information of China (English)

    Hongling Fan; Yuanyin Zheng; Lijuan Xu; Zhichao Zhong; Shining Cai; Shuling Zhang; Quanzhong Chang

    2012-01-01

    An ischemic-hypoxic animal model was established using right common carotid artery occlusions and inhalation of low concentrations of oxygen in mice. At 10 days after the ischemic-hypoxic injuries, saline-treated mice exhibited significantly prolonged escape latencies in water-maze tests and significantly shorter memory latencies and more mistakes in step-down tests. In contrast, mice treated with 5 mg/kg minocycline exhibited significant reversals of each of these effects compared with the saline-treated control mice. Moreover, we found that minocycline can relieve brain water content and morphological changes in mice following ischemic-hypoxic cerebral injuries. Accordingly, our findings indicate that minocycline provides some protections against the deleterious effects of these injuries in mice.

  4. Early exercise training improves ischemic outcome in rats by cerebral hemodynamics.

    Science.gov (United States)

    Tian, Shan; Zhang, Youcan; Tian, Song; Yang, Xiaojiao; Yu, Kewei; Zhang, Yuling; Shen, Xiafeng; Zhang, Liping; Sun, Yu; Xie, Hongyu; He, Zhijie; Guo, Zhenzhen; Jia, Jie; Wu, Yi; Bai, Yulong; Zhu, Yulian; Cheng, Yong; Wang, Xinggang; Wu, Junfa; Wang, Nianhong; Yu, Huixian; Hu, Yongshan

    2013-10-01

    This study examined whether very early initiated physical rehabilitation (VEIPR), as a recommended therapy for postischemia, could improve motor performance and cerebral blood flow (CBF). Adult male rats with ischemic injury caused by middle cerebral artery occlusion (MCAO) were trained to run on a treadmill for 30min per day at 12m/min. Through such exercise training for 3 days, the ischemic rats exhibited increased motor function and decreased infarct volume, as measured by a behavioral score and 2,3,5-triphenyltetrazolium chloride (TTC) staining method, as well as accelerated CBF, as detected with laser speckle imaging (LSI). Furthermore, to determine whether the observed improved CBF provided the protective factor for motor function recovery, we investigated the apoptosis of ischemic rat brain microvascular endothelial cells (rBMECs), which accepted the mechanical force of CBF directly, under flow intervention. The findings indicated that a modest flow decreased cell apoptosis in the ischemic condition and that this effect is magnitude dependent, as excessive flow increased apoptosis. PMID:23948104

  5. Reduction in cerebral blood flow volume in infants complicated with hypoxic ischemic encephalopathy resulting in cerebral palsy.

    Science.gov (United States)

    Fukuda, Sumio; Mizuno, Keisuke; Kawai, Satomi; Kakita, Hiroki; Goto, Tatenobu; Hussein, Mohamed Hamed; Daoud, Ghada A; Ito, Tetsuya; Kato, Ineko; Suzuki, Satoshi; Togari, Hajime

    2008-04-01

    Hypoxic ischemic brain can result in cerebral palsy, mental retardation, and learning disabilities in surviving children. The purpose of this study was to elucidate the cerebral blood flow volume in infants complicated with brain damage after the birth. Nine term infants with hypoxic ischemic encephalopathy and 41 normal term infants were studied. Four infants with HIE suffered from CP or mental retardation, and the other five infants exhibited normal neurodevelopment. The mean blood flow velocity and diameter of the internal carotid artery and the vertebral artery were measured for 28 days. The intravascular flow volume was determined by calculating the flow velocity and the cross-sectional area. The ejection fraction and cardiac output were obtained, and the mean blood pressures were recorded. The summed flow volumes in both the ICA and VA, and the total CBFV increased after the birth in both the normal infants and the infants diagnosed with HIE with no disability complications. The total blood flow volume was significantly lower in infants with HIE and CP than in normal infants on days 0, 2, 5, 7, 10, 21, and 28, and significantly lower in infants with HIE and CP than in normal infants with HIE on days 2, 4, and 7. The ejection fraction was significantly lower in infants with HIE than in normal infants only on day 0. Our results suggest that the total cerebral blood supply is decreased in infants with HIE in those complicated with brain damage. PMID:17950550

  6. Animal Models of Ischemic Stroke. Part Two: Modeling Cerebral Ischemia

    OpenAIRE

    Bacigaluppi, Marco; Comi, Giancarlo; Dirk M Hermann

    2010-01-01

    Animal models of stroke provide an essential tool for the understanding of the complex cellular and molecular pathophysiology of stroke and for testing novel recanalyzing, neuroprotective, neuroregenerative or anti- inflammatory drugs in pre- clinical setting. Since the first description of the distal occlusion of the middle cerebral artery (MCA) in rats, different techniques and methods to induce focal and global ischemia of the brains have been developed and optimized. The different models,...

  7. Acetylbritannilactone Modulates MicroRNA-155-Mediated Inflammatory Response in Ischemic Cerebral Tissues.

    Science.gov (United States)

    Wen, Ya; Zhang, Xiangjian; Dong, Lipeng; Zhao, Jingru; Zhang, Cong; Zhu, Chunhua

    2015-01-01

    Inflammatory responses play a critical role in ischemic brain injury. MicroRNA-155 (miR-155) induces the expression of inflammatory cytokines, and acetylbritannilactone (ABL) exerts potent antiinflammatory actions by inhibiting expression of inflammation-related genes. However, the functions of miR-155 and the actual relationship between ABL and miR-155 in ischemia-induced cerebral inflammation remain unclear. In this study, cerebral ischemia of wild-type (WT) and miR-155(-/-) mice was induced by permanent middle cerebral artery occlusion (MCAO). pAd-miR-155 was injected into the lateral cerebral ventricle 24 h before MCAO to induce miR-155 overexpression. MCAO mice and oxygen-glucose deprivation (OGD)-treated BV2 cells were used to examine the effects of ABL and miR-155 overexpression or deletion on the expression of proinflammatory cytokines. We demonstrated that ABL treatment significantly reduced neurological deficits and cerebral infarct volume by inhibiting tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) expression in ischemic cerebral tissue and OGD-treated BV2 cells. Mechanistic studies suggested that the observed decrease in TNF-α and IL-1β expression was attributable to the ABL-induced suppression of the expression of nuclear factor-kappa B (NF-κB) and Toll-like receptor 4 (TLR4). We further found that miR-155 promoted TNF-α and IL-1β expression by upregulating TLR4 and downregulating the expression of suppressor of cytokine signaling 1 (SOCS1) and myeloid differentiation primary response gene 88 (MyD88), while ABL exerted an inhibitory effect on miR-155-mediated gene expression. In conclusion, miR-155 mediates inflammatory responses in ischemic cerebral tissue by modulating TLR4/MyD88 and SOCS1 expression, and ABL exerts its antiinflammatory action by suppressing miR-155 expression, suggesting a novel miR-155-based therapy for ischemic stroke. PMID:25811992

  8. Doppler examination and cerebral arterial stricture in patients with ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Shouchun Wang; Yingqi Xing; Fang Deng; Yuerong Cao; Jiachun Feng

    2006-01-01

    BACKGROUND: With the development of interventional therapy, it is necessary for evaluating cerebral vessels to instruct treatment and determine prognosis of patients with ischemic stroke; however, correlation of distribution of infarction focus and clinical symptoms with degrees of cerebrovasoular stricture is still unclear.OBJECTIVE: To evaluate the characteristics of cerebral arterial stricture of patients with ischemic stroke with transcranial Doppler (TCD) and color duplex flow imaging (CDFI) and compare the correlation between distribution of cerebral infarction focus and clinical types with magnetic resonance imaging (MRI).DESIGN: Contrast observation.SETTING: Department of Neurology, the First Hospital of Jilin University.PARTICIPANTS: A total of 159 patients with ischemic stroke were selected from the Department of Neurology, the First Hospital of Jilin University from January to December 2005, including 106 males and 53 females aged from 27 to 88 years. Bases on diagnostic criteria of cerebrovascular disease established by Rao et al, clinical manifestations of all patients were evaluated with CT or nuclear magnetic resonance. All patients provided the confirmed consent.METHODS: The accepted patients received TCD and CDFI examination at 1 week after onset of ischemic stroke. Among them, 112 patients received cerebrovascular imaging examination simultaneously. MRI was used to check cerebral infarction focus and cerebrovascular stricture > 50% was regarded as the accepted vessels. In addition, DWI-T2 TCD (Germany) was used to check middle cerebral artery, and degrees of middle cerebral artery were classified into mild, moderate and severe stricture based on blood velocity (140 cm/s,180 cm/s). Stroke was classified based on characteristics of infarction focus and clinical symptoms showed with MRI and correlation with degrees of cerebrovascular stricture was analyzed simultaneously.MAIN OUTCOME MEASURES: Correlation between the characteristics of ischemic

  9. Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2012-04-15

    We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

  10. Cerebral hemodynamics in human acute ischemic stroke: a study with diffusion- and perfusion-weighted magnetic resonance imaging and SPECT.

    Science.gov (United States)

    Liu, Y; Karonen, J O; Vanninen, R L; Ostergaard, L; Roivainen, R; Nuutinen, J; Perkiö, J; Könönen, M; Hämäläinen, A; Vanninen, E J; Soimakallio, S; Kuikka, J T; Aronen, H J

    2000-06-01

    Nineteen patients with acute ischemic stroke (<24 hours) underwent diffusion-weighted and perfusion-weighted (PWI) magnetic resonance imaging at the acute stage and 1 week later. Eleven patients also underwent technetium-99m ethyl cysteinate dimer single-photon emission computed tomography (SPECT) at the acute stage. Relative (ischemic vs. contralateral control) cerebral blood flow (relCBF), relative cerebral blood volume, and relative mean transit time were measured in the ischemic core, in the area of infarct growth, and in the eventually viable ischemic tissue on PWI maps. The relCBF was also measured from SPECT. There was a curvilinear relationship between the relCBF measured from PWI and SPECT (r = 0.854; P < 0.001). The tissue proceeding to infarction during the follow-up had significantly lower initial CBF and cerebral blood volume values on PWI maps (P < 0.001) than the eventually viable ischemic tissue had. The best value for discriminating the area of infarct growth from the eventually viable ischemic tissue was 48% for PWI relCBF and 87% for PWI relative cerebral blood volume. Combined diffusion and perfusion-weighted imaging enables one to detect hemodynamically different subregions inside the initial perfusion abnormality. Tissue survival may be different in these subregions and may be predicted. PMID:10894174

  11. Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

    Science.gov (United States)

    Amiri-Nikpour, Mohammad Reza; Nazarbaghi, Surena; Ahmadi-Salmasi, Babak; Mokari, Tayebeh; Tahamtan, Urya; Rezaei, Yousef

    2014-01-01

    Background Cerebrolysin, a brain-derived neuropeptide, has been shown to improve the neurological outcomes of stroke, but no study has demonstrated its effect on cerebral blood flow. This study aimed to determine the cerebrolysin impact on the neurological outcomes and cerebral blood flow. Methods In a randomized, double-blinded, placebo-controlled trial, 46 patients who had acute focal ischemic stroke were randomly assigned into two groups to receive intravenously either 30 mL of cerebrolysin diluted in normal saline daily for 10 days (n=23) or normal saline alone (n=23) adjunct to 100 mg of aspirin daily. All patients were examined using the National Institutes of Health Stroke Scale and transcranial Doppler to measure the mean flow velocity and pulsatility index (PI) of their cerebral arteries at baseline as well as on days 30, 60, and 90. Results The patients’ mean age was 60±9.7 years, and 51.2% of patients were male. The National Institutes of Health Stroke Scale was significantly lower in the cerebrolysin group compared with the placebo group on day 60 (median 10, interquartile range 9–11, P=0.008) and day 90 (median 11, interquartile range 10–13.5, P=0.001). The median of PI in the right middle cerebral artery was significantly lower in the cerebrolysin group compared with the placebo group on days 30, 60, and 90 (P<0.05). One patient in the cerebrolysin group and two patients in the placebo group died before day 30 (4.3% versus 8.7%). Conclusion Cerebrolysin can be useful to improve the neurological outcomes and the PI of middle cerebral artery in patients with acute focal ischemic stroke. PMID:25516711

  12. Subarachnoid hemorrhage with transient ischemic attack: Another masquerader in cerebral venous thrombosis

    Directory of Open Access Journals (Sweden)

    Bhawna Sharma

    2010-01-01

    Full Text Available Cerebral venous thrombosis has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to frequent misdiagnoses or delay in diagnosis. The most frequent symptoms and signs are headache, seizures, focal deficits, and papilledema. A number of rare atypical manifestations have been described. Cerebral venous thrombosis may present with an isolated intracranial hypertension type picture, thunderclap headache, attacks of migraine with aura, isolated psychiatric disturbances, pulsatile tinnitus, isolated or multiple cranial nerve involvement, and occasionally as subarachnoid hemorrhage (SAH or transient ischemic attack. Our patient presented with thunderclap headache and transient ischemic attack like episode with obvious SAH on CT scan. Acute SAH suggests the presence of a vascular lesion, such as ruptured aneurysm, and CVT is not generally considered in the diagnostic workup of SAH. The case emphasizes the importance of cerebral venous study in nonaneurysmal cases of SAH. It is important to have a high index of suspicion in such atypical cases to avoid delay in diagnosis.

  13. Changes in Cerebral Oxidative Metabolism during Neonatal Seizures Following Hypoxic-Ischemic Brain Injury.

    Science.gov (United States)

    Mitra, Subhabrata; Bale, Gemma; Mathieson, Sean; Uria-Avellanal, Cristina; Meek, Judith; Tachtsidis, Ilias; Robertson, Nicola J

    2016-01-01

    Seizures are common following hypoxic-ischemic brain injury in newborn infants. Prolonged or recurrent seizures have been shown to exacerbate neuronal damage in the developing brain; however, the precise mechanism is not fully understood. Cytochrome-c-oxidase is responsible for more than 90% of ATP production inside mitochondria. Using a novel broadband near-infrared spectroscopy system, we measured the concentration changes in the oxidation state of cerebral cytochrome-c-oxidase (Δ[oxCCO]) and hemodynamics during recurrent neonatal seizures following hypoxic-ischemic encephalopathy in a newborn infant. A rapid increase in Δ[oxCCO] was noted at the onset of seizures along with a rise in the baseline of amplitude-integrated electroencephalogram. Cerebral oxygenation and cerebral blood volume fell just prior to the seizure onset but recovered rapidly during seizures. Δ[oxCCO] during seizures correlated with changes in mean electroencephalogram voltage indicating an increase in neuronal activation and energy demand. The progressive decline in the Δ[oxCCO] baseline during seizures suggests a progressive decrease of mitochondrial oxidative metabolism. PMID:27559538

  14. Changes in Cerebral Oxidative Metabolism during Neonatal Seizures Following Hypoxic–Ischemic Brain Injury

    Science.gov (United States)

    Mitra, Subhabrata; Bale, Gemma; Mathieson, Sean; Uria-Avellanal, Cristina; Meek, Judith; Tachtsidis, Ilias; Robertson, Nicola J.

    2016-01-01

    Seizures are common following hypoxic–ischemic brain injury in newborn infants. Prolonged or recurrent seizures have been shown to exacerbate neuronal damage in the developing brain; however, the precise mechanism is not fully understood. Cytochrome-c-oxidase is responsible for more than 90% of ATP production inside mitochondria. Using a novel broadband near-infrared spectroscopy system, we measured the concentration changes in the oxidation state of cerebral cytochrome-c-oxidase (Δ[oxCCO]) and hemodynamics during recurrent neonatal seizures following hypoxic–ischemic encephalopathy in a newborn infant. A rapid increase in Δ[oxCCO] was noted at the onset of seizures along with a rise in the baseline of amplitude-integrated electroencephalogram. Cerebral oxygenation and cerebral blood volume fell just prior to the seizure onset but recovered rapidly during seizures. Δ[oxCCO] during seizures correlated with changes in mean electroencephalogram voltage indicating an increase in neuronal activation and energy demand. The progressive decline in the Δ[oxCCO] baseline during seizures suggests a progressive decrease of mitochondrial oxidative metabolism. PMID:27559538

  15. Ischemic stroke in patient with existing congenital hypoplasia of the middle cerebral artery

    International Nuclear Information System (INIS)

    Presented is a clinical case of a woman 29 years old with ischemic stroke (IS), which has developed abruptly in existing congenital hypoplasia and occlusion of the middle cerebral artery. There are no other well or less well documented risk factors for cerebrovascular disease. In family history noted that the father of the patient died suddenly at the age of 45 years from stroke, also without evidence of vascular disease. On magnetic resonance imaging (MRI) of the brain is found high signal zone in the left nucleus lentiformis. We discussed the possibilities for implementing conventional angiography and eventually surgical procedures unfortunately rejected due to the high risk to the patient. Key words: Ischemic Stroke. Magnetic Resonance Imaging. Hypoplasia

  16. Early cerebral hemodynamic, metabolic and histological changes in hypoxic-ischemic fetal lambs during postnatal life

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    Carmen eRey-Santano

    2011-09-01

    Full Text Available The hemodynamic, metabolic and biochemical changes produce during transition from fetal to neonatal life could be aggravated if asphyctic event occur during fetal life. The aim of the study was to examine the regional cerebral blood flow (RCBF, histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress for the first hours of postnatal life following severe fetal asphyxia. 18 chronically instrumented fetal lambs were assigned to: hypoxic-ischemic group, following fetal asphyxia animals were delivered and maintained on intermittent-positive-pressure-ventilation for 3 hours, and non-injured animals that were managed similarly to the previous group and used as control group. During hypoxic-ischemic insult, injured group developed acidosis, hypoxia, hypercapnia, latacidaemia and tachycardia in comparison to control group, without hypotension. Intermittent-positive-pressure-ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilation-support, the increased RCBF in inner zones was maintained for hypoxic-ischemic group, but cortical flow did not exhibit differences compared to the control group. Also, the increase of TUNEL positive cells (apoptosis and antioxidant enzymes, and decrease of ATP reserves was significantly higher in the brain regions where the RCBF were not increased.In conclusion, early metabolic, histological and hemodynamic changes involved in brain damage have been intensively investigated and reported in premature asphyctic lambs for the first 3 hours of postnatal life. Those changes have been described in human neonates, so our model could be useful to test the security and the effectiveness of different neuroprotective or ventilatory strategies when are applied in the first hours after fetal hypoxic-ischemic injury.

  17. Eriodictyol-7-O-glucoside activates Nrf2 and protects against cerebral ischemic injury

    International Nuclear Information System (INIS)

    Stroke is a complex disease that may involve oxidative stress-related pathways in its pathogenesis. The nuclear factor erythroid-2-related factor 2/antioxidant response element (Nrf2/ARE) pathway plays an important role in inducing phase II detoxifying enzymes and antioxidant proteins and thus has been considered a potential target for neuroprotection in stroke. The aim of the present study was to determine whether eriodictyol-7-O-glucoside (E7G), a novel Nrf2 activator, can protect against cerebral ischemic injury and to understand the role of the Nrf2/ARE pathway in neuroprotection. In primary cultured astrocytes, E7G increased the nuclear localization of Nrf2 and induced the expression of the Nrf2/ARE-dependent genes. Exposure of astrocytes to E7G provided protection against oxygen and glucose deprivation (OGD)-induced oxidative insult. The protective effect of E7G was abolished by RNA interference-mediated knockdown of Nrf2 expression. In vivo administration of E7G in a rat model of focal cerebral ischemia significantly reduced the amount of brain damage and ameliorated neurological deficits. These data demonstrate that activation of Nrf2/ARE signaling by E7G is directly associated with its neuroprotection against oxidative stress-induced ischemic injury and suggest that targeting the Nrf2/ARE pathway may be a promising approach for therapeutic intervention in stroke. - Highlights: • E7G activates Nrf2 in astrocytes. • E7G stimulates expression of Nrf2-mediated cytoprotective proteins in astrocytes. • E7G protects astrocytes against OGD-induced cell death and apoptosis. • The neuroprotective effect of E7G involves the Nrf2/ARE pathway. • E7G protects rats against cerebral ischemic injury

  18. Eriodictyol-7-O-glucoside activates Nrf2 and protects against cerebral ischemic injury

    Energy Technology Data Exchange (ETDEWEB)

    Jing, Xu [Department of Pharmacology, School of Medicine, Shandong University, Jinan 250012 (China); Ren, Dongmei [Department of Natural Product Chemistry, Key Lab of Chemical Biology of Ministry of Education, Shandong University, Jinan 250012 (China); Wei, Xinbing; Shi, Huanying; Zhang, Xiumei [Department of Pharmacology, School of Medicine, Shandong University, Jinan 250012 (China); Perez, Ruth G. [Health Science Center, Paul L. Foster School of Medicine, Texas Tech University, El Paso, TX, 79905 (United States); Lou, Haiyan, E-mail: louhaiyan@sdu.edu.cn [Department of Pharmacology, School of Medicine, Shandong University, Jinan 250012 (China); Lou, Hongxiang [Department of Natural Product Chemistry, Key Lab of Chemical Biology of Ministry of Education, Shandong University, Jinan 250012 (China)

    2013-12-15

    Stroke is a complex disease that may involve oxidative stress-related pathways in its pathogenesis. The nuclear factor erythroid-2-related factor 2/antioxidant response element (Nrf2/ARE) pathway plays an important role in inducing phase II detoxifying enzymes and antioxidant proteins and thus has been considered a potential target for neuroprotection in stroke. The aim of the present study was to determine whether eriodictyol-7-O-glucoside (E7G), a novel Nrf2 activator, can protect against cerebral ischemic injury and to understand the role of the Nrf2/ARE pathway in neuroprotection. In primary cultured astrocytes, E7G increased the nuclear localization of Nrf2 and induced the expression of the Nrf2/ARE-dependent genes. Exposure of astrocytes to E7G provided protection against oxygen and glucose deprivation (OGD)-induced oxidative insult. The protective effect of E7G was abolished by RNA interference-mediated knockdown of Nrf2 expression. In vivo administration of E7G in a rat model of focal cerebral ischemia significantly reduced the amount of brain damage and ameliorated neurological deficits. These data demonstrate that activation of Nrf2/ARE signaling by E7G is directly associated with its neuroprotection against oxidative stress-induced ischemic injury and suggest that targeting the Nrf2/ARE pathway may be a promising approach for therapeutic intervention in stroke. - Highlights: • E7G activates Nrf2 in astrocytes. • E7G stimulates expression of Nrf2-mediated cytoprotective proteins in astrocytes. • E7G protects astrocytes against OGD-induced cell death and apoptosis. • The neuroprotective effect of E7G involves the Nrf2/ARE pathway. • E7G protects rats against cerebral ischemic injury.

  19. Computerized tomography of five cases with global cerebral ischemic-anoxia

    International Nuclear Information System (INIS)

    Among eight cases with global cerebral ischemic-anoxia which were monitored with a serial computerized tomography (CT) scan, five had characteristic CT findings. It was revealed by the CT scan that, after diffuse brain swelling which had occurred immediately or a week after injury, remarkable brain atrophy appeared in two cases; these cases remained in the persistent vegetative state. In three other cases which were resuscitated one hour or more after injury, the CT scan showed symmetric low-density areas of the bilateral basal ganglia, and their prognoses were very poor: two died, while one remained in a near-brain-death state. (author)

  20. Canine model of ischemic stroke with permanent middle cerebral artery occlusion: clinical features, magnetic resonance imaging, histopathology, and immunohistochemistry

    OpenAIRE

    Jeon, Joon-Hyeok; JUNG, Hae-Won; Jang, Hyo-Mi; MOON, Jong-Hyun; Park, Ki-Tae; Lee, Hee-Chun; Lim, Ha-Young; Sur, Jung-Hyang; KANG, Byeong-Teck; HA, Jeongim; Jung, Dong-In

    2015-01-01

    The purpose of this study was to identify time-related changes in clinical, MRI, histopathologic, and immunohistochemical findings associated with ischemic stroke in dogs. Additionally, the association of cerebrospinal fluid (CSF) and tissue levels of interleukin (IL)-6 with clinical prognosis was assessed. Ischemic stroke was induced by permanent middle cerebral artery occlusion (MCAO) in nine healthy experimental dogs. The dogs were divided into three groups according to survival time and d...

  1. Electroacupuncture acutely improves cerebral blood flow and attenuates moderate ischemic injury via an endothelial mechanism in mice.

    Directory of Open Access Journals (Sweden)

    Ji Hyun Kim

    Full Text Available Electroacupuncture (EA is a novel therapy based on traditional acupuncture combined with modern eletrotherapy that is currently being investigated as a treatment for acute ischemic stroke. Here, we studied whether acute EA stimulation improves tissue and functional outcome following experimentally induced cerebral ischemia in mice. We hypothesized that endothelial nitric oxide synthase (eNOS-mediated perfusion augmentation was related to the beneficial effects of EA by interventions in acute ischemic injury. EA stimulation at Baihui (GV20 and Dazhui (GV14 increased cerebral perfusion in the cerebral cortex, which was suppressed in eNOS KO, but there was no mean arterial blood pressure (MABP response. The increased perfusion elicited by EA were completely abolished by a muscarinic acetylcholine receptor (mAChR blocker (atropine, but not a β-adrenergic receptor blocker (propranolol, an α-adrenergic receptor blocker (phentolamine, or a nicotinic acetylcholine receptor (nAChR blocker (mecamylamine. In addition, EA increased acetylcholine (ACh release and mAChR M3 expression in the cerebral cortex. Acute EA stimulation after occlusion significantly reduced infarct volume by 34.5% when compared to a control group of mice at 24 h after 60 min-middle cerebral artery occlusion (MCAO (moderate ischemic injury, but not 90-min MCAO (severe ischemic injury. Furthermore, the impact of EA on moderate ischemic injury was totally abolished in eNOS KO. Consistent with a smaller infarct size, acute EA stimulation led to prominent improvement of neurological function and vestibule-motor function. Our results suggest that acute EA stimulation after moderate focal cerebral ischemia, but not severe ischemia improves tissue and functional recovery and ACh/eNOS-mediated perfusion augmentation might be related to these beneficial effects of EA by interventions in acute ischemic injury.

  2. Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Amiri-Nikpour MR

    2014-12-01

    Full Text Available Mohammad Reza Amiri-Nikpour,1 Surena Nazarbaghi,1 Babak Ahmadi-Salmasi,1 Tayebeh Mokari,2 Urya Tahamtan,2 Yousef Rezaei3 1Department of Neurology, Imam Khomeini Hospital, 2School of Medicine, 3Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran Background: Cerebrolysin, a brain-derived neuropeptide, has been shown to improve the neurological outcomes of stroke, but no study has demonstrated its effect on cerebral blood flow. This study aimed to determine the cerebrolysin impact on the neurological outcomes and cerebral blood flow. Methods: In a randomized, double-blinded, placebo-controlled trial, 46 patients who had acute focal ischemic stroke were randomly assigned into two groups to receive intravenously either 30 mL of cerebrolysin diluted in normal saline daily for 10 days (n=23 or normal saline alone (n=23 adjunct to 100 mg of aspirin daily. All patients were examined using the National Institutes of Health Stroke Scale and transcranial Doppler to measure the mean flow velocity and pulsatility index (PI of their cerebral arteries at baseline as well as on days 30, 60, and 90. Results: The patients’ mean age was 60±9.7 years, and 51.2% of patients were male. The National Institutes of Health Stroke Scale was significantly lower in the cerebrolysin group compared with the placebo group on day 60 (median 10, interquartile range 9–11, P=0.008 and day 90 (median 11, interquartile range 10–13.5, P=0.001. The median of PI in the right middle cerebral artery was significantly lower in the cerebrolysin group compared with the placebo group on days 30, 60, and 90 (P<0.05. One patient in the cerebrolysin group and two patients in the placebo group died before day 30 (4.3% versus 8.7%. Conclusion: Cerebrolysin can be useful to improve the neurological outcomes and the PI of middle cerebral artery in patients with acute focal ischemic stroke. Keywords: ischemic stroke, cerebrolysin, neuroprotection, NIHSS, mean

  3. Impaired cerebral autoregulation is associated with brain atrophy and worse functional status in chronic ischemic stroke.

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    Mikio C Aoi

    Full Text Available Dynamic cerebral autoregulation (dCA is impaired following stroke. However, the relationship between dCA, brain atrophy, and functional outcomes following stroke remains unclear. In this study, we aimed to determine whether impairment of dCA is associated with atrophy in specific regions or globally, thereby affecting daily functions in stroke patients.We performed a retrospective analysis of 33 subjects with chronic infarctions in the middle cerebral artery territory, and 109 age-matched non-stroke subjects. dCA was assessed via the phase relationship between arterial blood pressure and cerebral blood flow velocity. Brain tissue volumes were quantified from MRI. Functional status was assessed by gait speed, instrumental activities of daily living (IADL, modified Rankin Scale, and NIH Stroke Score.Compared to the non-stroke group, stroke subjects showed degraded dCA bilaterally, and showed gray matter atrophy in the frontal, parietal and temporal lobes ipsilateral to infarct. In stroke subjects, better dCA was associated with less temporal lobe gray matter atrophy on the infracted side ([Formula: see text] = 0.029, faster gait speed ([Formula: see text] = 0.018 and lower IADL score ([Formula: see text]0.002. Our results indicate that better dynamic cerebral perfusion regulation is associated with less atrophy and better long-term functional status in older adults with chronic ischemic infarctions.

  4. Effects of NG-nitro-L-arginine on focal cerebral ischemic injury in rats

    Institute of Scientific and Technical Information of China (English)

    Jianxin Zhang; Huixin Zhang; Lanfang Li; Yonghui Li

    2006-01-01

    BACKGROUND: Previous researches have proved that aminoguanidin can cure cerebral ischemic injury remarkably as a selective induced nitricoxide synthase (iNOS) inhibitor. However, whether nonselective NOS inhibitor could protect cerebral ischemic injury or not is unclear.OBJECTIVE: To investigate the effects of NG-nitro-L-arginine (L-NA), a nonselective nitricoxide synthase (NOS) inhibitor, on cerebral ischemic injury of rats and the possible mechanism.DESIGN: Randomized controlled study.SETTING: Pharmacological Department of Medical Academy of Science of Hebei Province.MATERIALS: A total of 56 male healthy SD rats, of grade II, weighting 250-290 g, were provided by the Experimental Animal Center of Hebei Province (certification: 04036).METHODS: The experiment was completed in the Pharmacological Department of Medical Academy of Science of Hebei Province from March 2005 to January 2006. ① Grouping: Rats were randomly divided into 3 groups: sham operation group (n=8), model group (n=24) and L-NA group (n=24). ② Modeling:Middle cerebral artery (MCA) was established on rats in model group and L-NA group with intraluminal line occlusion methods, and rats in sham operation group were separated their external carotid arteries without occlusion of internal carotid artery. ③ Intervention study: Rats in model group and L-NA group were injected intraperitoneally with 10 mL/kg and 20 mg/kg L-NA at 2, 6 and 12 hours respectively after ischemia twice a day for 3 consecutive days. ④ Rats were sacrificed on the third day for measuring volume of cerebral infarction with image analysis and swelling degrees and activities of mitochondria with electron microscope. Effect of L-NA on ultrastructural changes of neurons in cortex was observed after ischemia.MAIN OUTCOME MEASURES: ① Volume of cerebral infarction; ② Swelling degrees, contents of nitric oxide (NO) and malondialdehyde (MDA) and activities of adenosine triphosphatase (ATPase), superoxide dismutase (SOD) and

  5. Neuroprotective effect of osthole against acute ischemic stroke on middle cerebral ischemia occlusion in rats.

    Science.gov (United States)

    Chao, Xiaodong; Zhou, Jun; Chen, Tao; Liu, Wenbo; Dong, Wenpeng; Qu, Yan; Jiang, Xiaofan; Ji, Xituan; Zhen, Haining; Fei, Zhou

    2010-12-01

    Osthole, a natural coumarin derivative, has taken considerable attention because of its diverse pharmacological functions. It has been reported to be useful in the treatment of chronic cerebral hypoperfusion and neuronal damage. In the present study, we examined the neuroprotective effect of osthole and its potential mechanisms against acute ischemic stroke induced by middle cerebral artery occlusion (MCAO) in rats. The rats were pretreated with osthole 10, 20 and 40 mg/kg 30 min before MCAO. The neuroprotective effect of osthole against acute ischemic stroke was evaluated by neurological deficit score (NDS), dry-wet weight and 2,3,5-triphenyltetrazolium chloride (TTC) staining. The contents of malondialdehyde (MDA) and glutathione (GSH), activity of myeloperoxidase (MPO) and the level of interleukin (IL)-1β and IL-8 after 2h of MCAO in rats were detected to investigate its anti-oxidative action and anti-inflammatory property. Pretreatment with osthole significantly increased in GSH, and decreased the volume of infarction, NDS, edema, MDA, MPO, IL-1β and IL-8 compared with rats in the MCAO group at 24h after MCAO. The study suggests the neuroprotective effect of osthole in the MCAO model of rats. The anti-oxidative action and anti-inflammatory property of osthole may contribute to a beneficial effect against stroke. PMID:20869955

  6. MRI of acute post-ischemic cerebral hemorrhage in stroke patients: diagnosis with T2*-weighted gradient-echo sequences

    International Nuclear Information System (INIS)

    The use of T2*-weighted sequences has been advocated for early differentiation between hematoma and ischemia in patients with acute stroke. Early hemorrhagic transformation of ischemic stroke is an adverse event which may occur under treatment and may impair the prognosis: our aim is to evaluate the ability of T2*-weighted gradient-echo sequence (T2* GRE) to detect post-ischemic cerebral hemorrhage. The imaging procedure included: (1) baseline CT scan at admission. (2) MRI performed within 24 h of therapy onset including: (a) dual fast spin echo T2 sequence, (b) axial isotropic echoplanar diffusion-weighted imaging sequence, (c) conventional T2* GRE, and (d) 3D TOF turbo MRA. Post-ischemic cerebral hemorrhage was diagnosed if T2* GRE detected a focal intraparenchymal area of signal loss. The diameter of this lesion had to be more than 5 mm in order to eliminate past microbleeds. (3) Patients who showed an early suspicion of bleeding on MRI promptly had a second CT scan, and, if this one was negative for bleeding, another CT scan was performed 1 day later. All the other patients had a control CT scan during the first week. Forty-five consecutive patients have been included. T2* GRE showed intracranial bleeding in seven. The diagnosis of post-ischemic cerebral bleeding was confirmed by CT in all patients. Control CT scans did not reveal any post-ischemic cerebral hemorrhage in patients with negative MRI. In one case, hemorrhage was seen earlier on MRI than on CT scan. In conclusion, T2* GRE appeared to be at least as efficient as CT scan in the detection of early post-ischemic cerebral hemorrhage. (orig.)

  7. Neuroprotection Offered by Majun Khadar, a Traditional Unani Medicine, during Cerebral Ischemic Damage in Rats

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    Seema Yousuf

    2011-01-01

    Full Text Available Stroke results in damages to many biochemical, molecular and behavioral deficits. Present study provides evidence of the protective efficacy of a Unani herbal medicine, Majun Khadar (MK, against cerebral ischemia-induced behavioral dysfunctions and neurochemical alterations in the hippocampus (HIP. Transient focal cerebral ischemia was induced for 2 h followed by reperfusion for 22 h in a rat model. Rats were divided into four groups: sham, middle cerebral artery occluded (MCAO, drug sham (MK; 0.816 g kg−1 orally for 15 days and MK pre-treated ischemic group (MK + MCAO. Levels of enzymatic and non-enzymatic antioxidants were estimated in HIP along with behavioral testing. MK pre-treatment significantly (P < .05–.001 restored the activities of glutathione peroxidase (GP×, glutathione reductase (GR, glutathione S-transferase (GST and decreased the level of lipid peroxidation (LPO and H2O2 content in HIP in the MK + MCAO group which were severely altered in the MCAO group. The content of glutathione (GSH, total thiols (TT and ascorbic acid (AsA was significantly depleted in the MCAO group; pretreatment with MK was able to restore its levels. Also in the MK + MCAO group, significant (P < .5–.001 recovery in behavioral testing by rota rod and open-field activities was seen as compared with the MCAO group. MK alone did not show any change neither in the status of various antioxidants nor behavioral functions over sham values. Although detailed studies are required for the evaluation of exact neuroprotective mechanism of MK against cerebral ischemia these preliminary experimental findings conclude that MK exhibits neuroprotective effect in cerebral ischemia by potentiating the antioxidant defense system of the brain.

  8. Effect of delta opioid receptor activation on spatial cognition and neurogenesis in cerebral ischemic rats.

    Science.gov (United States)

    Wang, Shu-Yan; Duan, Ya-Le; Zhao, Bing; Wang, Xiang-Rui; Zhao, Zheng; Zhang, Guang-Ming

    2016-05-01

    This study aimed to investigate whether a selective delta opioid receptor agonist, [D-Ala2, D-Leu5]-Enkephalin (DADLE), regulates neurogenesis in the hippocampus of ischemic rats. Using an intracerebral cannula, rats were subjected to cerebral ischemia using the standard four-vessel occlusion. DADLE (2.5nmol), DADLE (2.5nmol) with naltrindole (NAL) (2.5nmol), or vehicle was administered at the onset of reperfusion. Bromodeoxyuridine (BrdU, 100mg/kg, intraperitoneal) was used to label newly formed cells from days 1 to 7 after ischemia. Immunohistochemistry was used to evaluate cell proliferation and apoptosis and differentiation 7days 28 days, respectively, after ischemia. Morris water maze test was conducted to test spatial learning and memory 23-27 days after ischemia. We found that DADLE treatment improved performance in the Morris water maze test, promoted proliferation and differentiation of newly formed neurons, and inhibited differentiation into astrocytes in a rat model of cerebral ischemia. Furthermore, the protective effects of DADLE were significantly reversed by co-administration of NAL (Pstrategy for cerebral ischemia. PMID:27016387

  9. The experimental study of CT-guided hepatocyte growth factor gene therapy for cerebral ischemic diseases

    International Nuclear Information System (INIS)

    Objectives: To investigate the feasibility of CT guided hepatocyte growth factor (HGF) gene therapy for cerebral ischemic diseases. Methods: Human HGF cDNA was ligated to pIRES2-EGFP vector. The recombinant plasmid was transfected into the penumbra tissue with liposome, guided by CT perfusion images. After seven days of transfer with recombinant plasmid, the cut sections of rat brain tissues of the treated and control groups were analyzed including immunohistochemistry, vessel count, cerebral blood flow and infarct volume etc. in order to investigate HGF gene expression and biological effect. Results: Enzymatic digestion and electrophoresis confirmed that HGF fragments had been correctly cloned into the space between the BamH I and Sal I sites of pIRES2-EGFP. After 7 days of HGF gene transfection, expression of HGF in transfected neurocytes of treated group was observed with immunohistochemistry. The number of vessels in penumbra tissues transfected with HGF vectors and the CBF measured by perfusion CT all were significantly increased than those of the controls (P2-EGFP-HGF complexes can transfect the penumbra tissues and definitely express HGF protein. The HGF gene products can stimulate angiogenesis, promote collateral circulation formation and reduce infarct volume in vivo and therefore is beneficial to the treatment of cerebral ischemia. (authors)

  10. RNA interference-mediated downregulation of Beclin1 attenuates cerebral ischemic injury in rats

    Institute of Scientific and Technical Information of China (English)

    Yong-qiu ZHENG; Jian-xun LIU; Xin-zhi LI; Li XU; Yong-gang XU

    2009-01-01

    Aim:To test the role of the Beclin 1-dependent autophagy pathway in brain damage during cerebral ischemia.Methods:Focal cerebral ischemia was established in rats using a middle cerebral artery occlusion (MCAO) model.A lentiviral vectorassociated RNA interference (RNAi) system was stereotaxically injected into the ipsilateral lateral ventricle to reduce Beclinl expression.We measured the ipsilateral infarct volume,autophagosome formation,neurogenesis and apoptosis,all of which could be modulated by Beclinl RNAi.Results:On the 14th day after MCAO,Beclin1 downregulation by RNAi increased the population of neural progenitor cells (BrdU+-DCX+),newborn immature cells (BrdU+-Tuj-1+) and mature neurons (BrdU+-MAP-2+),and reduced the apoptosis of immature neurons (caspase3+-DCX+ and caspase-3+-Tuj-1+) surrounding the ischemic core of the ipsilateral hemisphere.Furthermore,RNAi-mediated downregulation of Beclin1 decreased infarct volume and inhibited histological injury and neurological deficits.Conclusion:RNAi-mediated downregulation of Beclinl improves outcomes after transient MCAO.

  11. Expression of bone morphogenetic protein 7 in the cerebral cortex of rats after ischemic-hypoxic injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Some researches demonstrate that exogenous bone morphogenetic protein 7 (BMP-7) can protect ischemic cerebral nerve tissue and promote recovery of motor energy function; however, there is lack of direct evidences of endogenous BMP-7 effect.OBJECTIVE: To observe the expression of endogenous BMP-7 in nerve tissue with ischemic-hypoxic injury and investigate the possible effects on damaged nerve tissue.DESIGN: Observational contrast animal study.SETTING: Department of Anatomy and Histoembryology, Peking University Health Science Center.MATERIALS: The experiment was carried out in the Nerve Researching Laboratory of Anatomy Department, Peking University Health Science Center from October 2006 to March 2007. A total of 25 adult male SD rats weighing 250 - 300 g and several newborn SD rats were selected from Experimental Animal Center, Peking University Health Science Center. Rabbit-anti-BMP-7 polyclonal antibody was provided by Wuhan Boster Company.METHODS: ① Adult rats were randomly divided into ischemia group (n =10), sham operation group (n =10) and normal group (n =5). Right external-internal carotid artery occlusion was used to infarct middle cerebral artery of adult rats in the ischemia group so as to copy focal cerebral infarction models. Line cork was inserted in crotch of internal and external carotid artery of adult rats in the sham operation group, while adult rats in the normal group were not given any treatments. ② Cerebral cortex of newborn rats was separated to obtain cell suspension. Cells which were cultured for 10 days were divided into control group and hypoxia/reoxygenation group. And then, cells in the hypoxia/reoxygenation group were cultured in hypoxic incubator for 4 hours and given reoxygenation for 24 hours.MAIN OUTCOME MEASURES: Immunohistochemical method was used to measure expression of BMP-7 in cerebral cortex at 24 hours after ischemia/reperfusion culture and in primary hypoxic culture.RESULTS: ① At 24 hours after

  12. Small white matter lesion detection in cerebral small vessel disease

    Science.gov (United States)

    Ghafoorian, Mohsen; Karssemeijer, Nico; van Uden, Inge; de Leeuw, Frank E.; Heskes, Tom; Marchiori, Elena; Platel, Bram

    2015-03-01

    Cerebral small vessel disease (SVD) is a common finding on magnetic resonance images of elderly people. White matter lesions (WML) are important markers for not only the small vessel disease, but also neuro-degenerative diseases including multiple sclerosis, Alzheimer's disease and vascular dementia. Volumetric measurements such as the "total lesion load", have been studied and related to these diseases. With respect to SVD we conjecture that small lesions are important, as they have been observed to grow over time and they form the majority of lesions in number. To study these small lesions they need to be annotated, which is a complex and time-consuming task. Existing (semi) automatic methods have been aimed at volumetric measurements and large lesions, and are not suitable for the detection of small lesions. In this research we established a supervised voxel classification CAD system, optimized and trained to exclusively detect small WMLs. To achieve this, several preprocessing steps were taken, which included a robust standardization of subject intensities to reduce inter-subject intensity variability as much as possible. A number of features that were found to be well identifying small lesions were calculated including multimodal intensities, tissue probabilities, several features for accurate location description, a number of second order derivative features as well as multi-scale annular filter for blobness detection. Only small lesions were used to learn the target concept via Adaboost using random forests as its basic classifiers. Finally the results were evaluated using Free-response receiver operating characteristic.

  13. Multi-parametric imaging of cerebral hemodynamic and metabolic response followed by ischemic injury

    Science.gov (United States)

    Qin, Jia; Shi, Lei; Dziennis, Suzan; Wang, Ruikang K.

    2014-02-01

    We use rodent parietal cortex as a model system and utilize a synchronized dual wavelength laser speckle imaging (SDW-LSCI) technique to explore the hemodynamic response of infarct and penumbra to a brain injury (middle cerebral artery occlusion (MCAO) model). The SDW-LSCI system is able to take snapshots rapidly (maximum 500 Hz) over the entire brain surface, providing key information about the hemodynamic response, in terms of which it may be used to elucidate evolution of penumbra region from onsite to 90 min of MCAO. Changes in flow are quantified as to the flow experiencing physical occlusions of the MCA normalized to that of baseline. Furthermore, the system is capable of providing information as to the changes of the concentration of oxygenated, (HbO) deoxygenated (Hb), and total hemoglobin (HbT) in the cortex based on the spectral characteristics of HbO and Hb. We observe that the oxygenation variations in the four regions are detectable and distinct. Combining the useful information, four regions of interest (ROI), infarct, penumbra, reduced flow and contralateral portions in the brain upon ischemic injury may be differentiated. Implications of our results are discussed with respect to current understanding of the mechanisms underlying MCAO. We anticipate that SDW-LSCI holds promise for rapid and large field of view localization of ischemic injury.

  14. Asymptomatic ischemic cerebral lesions; MRI study on a high risk group

    Energy Technology Data Exchange (ETDEWEB)

    Udaka, Fukashi; Fushimi, Hisako; Kishino, Bunichiro; Kameyama, Masakuni (Sumitomo Hospital, Osaka (Japan))

    1988-11-01

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T{sub 2} weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author).

  15. Simvastatin Reduces Lipopolysaccharides-Accelerated Cerebral Ischemic Injury via Inhibition of Nuclear Factor-kappa B Activity.

    Science.gov (United States)

    Anthony Jalin, Angela M A; Lee, Jae-Chul; Cho, Geum-Sil; Kim, Chunsook; Ju, Chung; Pahk, Kisoo; Song, Hwa Young; Kim, Won-Ki

    2015-11-01

    Preceding infection or inflammation such as bacterial meningitis has been associated with poor outcomes after stroke. Previously, we reported that intracorpus callosum microinjection of lipopolysaccharides (LPS) strongly accelerated the ischemia/reperfusion-evoked brain tissue damage via recruiting inflammatory cells into the ischemic lesion. Simvastatin, 3-hydroxy-3-methylgultaryl (HMG)-CoA reductase inhibitor, has been shown to reduce inflammatory responses in vascular diseases. Thus, we investigated whether simvastatin could reduce the LPS-accelerated ischemic injury. Simvastatin (20 mg/kg) was orally administered to rats prior to cerebral ischemic insults (4 times at 72, 48, 25, and 1-h pre-ischemia). LPS was microinjected into rat corpus callosum 1 day before the ischemic injury. Treatment of simvastatin reduced the LPS-accelerated infarct size by 73%, and decreased the ischemia/reperfusion-induced expressions of pro-inflammatory mediators such as iNOS, COX-2 and IL-1β in LPS-injected rat brains. However, simvastatin did not reduce the infiltration of microglial/macrophageal cells into the LPS-pretreated brain lesion. In vitro migration assay also showed that simvastatin did not inhibit the monocyte chemoattractant protein-1-evoked migration of microglial/macrophageal cells. Instead, simvastatin inhibited the nuclear translocation of NF-κB, a key signaling event in expressions of various proinflammatory mediators, by decreasing the degradation of IκB. The present results indicate that simvastatin may be beneficial particularly to the accelerated cerebral ischemic injury under inflammatory or infectious conditions. PMID:26535078

  16. Inter-arterial thrombolysis using rt-PA for acute cerebral ischemic stroke

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of intra-arterial thrombolysis in patients with acute cerebral ischemic stroke. Methods: Twenty-one patients with acute internal carotid circulation infraction (internal carotid 3, MCA 12, ACA 5, lenticulostriate in 1)were treated with intra-arterial thrombolysis of recombinant tissue plasminogen activator (rt-PA)which was performed within 2-6 hours of symptom onset. Recanalization was observed during the operation. Intracerebral hemorrhage (ICH)was monitored immediately and 24 h after the treatment by CT or MRI scanning. Chinese stroke scale was used to evaluate the recovery of neurological functions pre-operatively and 30 d after the treatment. Results: All the 21 patients were 100% success in receiving intra-arterial thrombolysis technique and revealed 16 having the degree of recanalization of 2 to 3 grade as regards to TMI, 16 patients degree of recanalization reached 2 to 3 grade according to TMI; 5 patients showed 1 to 2 grade. Symptomatic ICH was observed in 3 patients, with two dead. Arterial dissection was found in one patient. Thirty days after the operation, 17 patients' cerebral function reduced over 50 percent; 2 less than 50 percent; and 2 died. The patients achieved 2 to 3 grade of recanalization were obviously getting better than those achieving 0 to 1 grade. Conclusions: It is adapt to have intra-arterial thrombolysis with six hours from onset; but still have the danger of severe ICH. The treatment should be started as early as possible. (authors)

  17. Regional cerebral blood flow before and after vascular surgery in patients with transient ischemic attacks with 133-xenon inhalation tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Hemmingsen, Ralf; Lindewald, H; Lassen, Niels Alexander

    Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF...... with no abnormality on the CT-scan. The abnormal blood flow pattern was found to be unchanged after clinically successful reconstructive vascular surgery. This suggests the presence of irreversible ischemic tissue damage without gross emollition (incomplete infarction). It is concluded, that TIAs are...

  18. Regional cerebral blood flow in patients with transient ischemic attacks studied by Xenon-133 inhalation and emission tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Hemmingsen, R; Henriksen, L; Lindewald, H; Engell, Hans; Lassen, N A

    1983-01-01

    Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF...... with no abnormality on the CT-scan. The abnormal blood flow pattern was found to be unchanged after clinically successful reconstructive vascular surgery. This suggests the presence of irreversible ischemic tissue damage without gross emollition (incomplete infarction). It is concluded, that TIAs are...

  19. PET Quantification of Cerebral Oxygen Metabolism in Small Animals

    OpenAIRE

    Takashi Temma; Kazuhiro Koshino; Tetsuaki Moriguchi; Jun-ichiro Enmi; Hidehiro Iida

    2014-01-01

    Understanding cerebral oxygen metabolism is of great importance in both clinical diagnosis and animal experiments because oxygen is a fundamental source of brain energy and supports brain functional activities. Since small animals such as rats are widely used to study various diseases including cerebral ischemia, cerebrovascular diseases, and neurodegenerative diseases, the development of a noninvasive in vivo measurement method of cerebral oxygen metabolic parameters such as oxygen extractio...

  20. Lysine and arginine reduce the effects of cerebral ischemic insults and inhibit glutamate-induced neuronal activity in rats

    Directory of Open Access Journals (Sweden)

    Takashi Kondoh

    2010-06-01

    Full Text Available Intravenous administration of arginine was shown to be protective against cerebral ischemic insults via nitric oxide production and possibly via additional mechanisms. The present study aimed at evaluating the neuroprotective effects of oral administration of lysine (a basic amino acid, arginine, and their combination on ischemic insults (cerebral edema and infarction and hemispheric brain swelling induced by transient middle cerebral artery occlusion/reperfusion in rats. Magnetic resonance imaging and 2,3,5-triphenyltetrazolium chloride staining were performed two days after ischemia induction. In control animals, the major edematous areas were observed in the cerebral cortex and striatum. The volumes associated with cortical edema were significantly reduced by lysine (2.0 g/kg, arginine (0.6 g/kg, or their combined administration (0.6 g/kg each. Protective effects of these amino acids on infarction were comparable to the inhibitory effects on edema formation. Interestingly, these amino acids, even at low dose (0.6 g/kg, were effective to reduce hemispheric brain swelling. Additionally, the effects of in vivo microiontophoretic (juxtaneuronal applications of these amino acids on glutamate-evoked neuronal activity in the ventromedial hypothalamus were investigated in awake rats. Glutamate-induced neuronal activity was robustly inhibited by microiontophoretic applications of lysine or arginine onto neuronal membranes. Taken together, our results demonstrate the neuroprotective effects of oral ingestion of lysine and arginine against ischemic insults (cerebral edema and infarction, especially in the cerebral cortex, and suggest that suppression of glutamate-induced neuronal activity might be the primary mechanism associated with these neuroprotective effects.

  1. Demethylation of Circulating Estrogen Receptor Alpha Gene in Cerebral Ischemic Stroke.

    Directory of Open Access Journals (Sweden)

    Hsiu-Fen Lin

    Full Text Available Estrogen is involved in neuron plasticity and can promote neuronal survival in stroke. Its actions are mostly exerted via estrogen receptor alpha (ERα. Previous animal studies have shown that ERα is upregulated by DNA demethylation following ischemic injury. This study investigated the methylation levels in the ERα promoter in the peripheral blood of ischemic stroke patients.The study included 201 ischemic stroke patients, and 217 age- and sex-comparable healthy controls. The quantitative methylation level in the 14 CpG sites of the ERα promoter was measured by pyrosequencing in each participant. Multivariate regression model was used to adjust for stroke traditional risk factors. Stroke subtypes and sex-specific analysis were also conducted.The results demonstrated that the stroke cases had a lower ERα methylation level than controls in all 14 CpG sites, and site 13 and site 14 had significant adjusted p-values of 0.035 and 0.026, respectively. Stroke subtypes analysis showed that large-artery atherosclerosis and cardio-embolic subtypes had significantly lower methylation levels than the healthy controls at CpG site 5, site 9, site 12, site 13 and site 14 with adjusted p = 0.039, 0.009, 0.025, 0.046 and 0.027 respectively. However, the methylation level for the patients with small vessel subtype was not significant. We combined the methylation data from the above five sites for further sex-specific analysis. The results showed that the significant association only existed in women (adjusted p = 0.011, but not in men (adjusted p = 0.300.Female stroke cases have lower ERα methylation levels than those in the controls, especially in large-artery and cardio-embolic stroke subtypes. The study implies that women suffering from ischemic stroke of specific subtype may undergo different protective mechanisms to reduce the brain injury.

  2. Ischemic Postconditioning Alleviates Neuronal Injury Caused by Relief of Carotid Stenosis in a Rat Model of Cerebral Hypoperfusion

    Directory of Open Access Journals (Sweden)

    Pengfei Ge

    2012-10-01

    Full Text Available The effects of early relief of heavy bilateral carotid stenosis and ischemic postconditioning on hippocampus CA1 neurons are still unclear. In this study, we used a rat model to imitate severe bilateral carotid stenosis in humans. The rats were divided into sham group, carotid stenosis group, stenosis relief group and ischemic postconditioning group. Ischemic postconditioning consisted of three cycles of 30 s ischemia and 30 s reperfusion. The cerebral blood flow was measured with a laser Doppler flowmeter. Neuronal death in the CA1 region was observed by hematoxylin-eosin staining, and the number of live neurons was assessed by cell counting under a light microscope. The levels of oxidative products MDA and 8-iso-PGF2α, inflammatory factors IL-1β and TNF-α, and the activities of anti-oxidative enzymes SOD and CAT were assayed by specific enzyme-linked immunosorbent assay (ELISA kits, respectively. We found that relief of carotid stenosis and ischemic postconditioning could increase cerebral blood flow. When stenosis was relieved, the percentage of live neurons was 66.6% ± 6.2% on day 3 and 62.3% ± 9.8% on day 27, which was significantly higher than 55.5% ± 4.8% in stenosis group. Ischemic postconditioning markedly improved the live neurons to 92.5% ± 6.7% on day 3 and 88.6% ± 9.1% on day 27. Further study showed that, neuronal death caused by relief of stenosis is associated with increased oxidative stress and enhanced inflammatory response, and the protection of ischemic postconditioning is related to inhibition of oxidative stress and suppression of inflammatory response.

  3. Transcriptomics and proteomics analyses of the PACAP38 influenced ischemic brain in permanent middle cerebral artery occlusion model mice

    Directory of Open Access Journals (Sweden)

    Hori Motohide

    2012-11-01

    Full Text Available Abstract Introduction The neuropeptide pituitary adenylate cyclase-activating polypeptide (PACAP is considered to be a potential therapeutic agent for prevention of cerebral ischemia. Ischemia is a most common cause of death after heart attack and cancer causing major negative social and economic consequences. This study was designed to investigate the effect of PACAP38 injection intracerebroventrically in a mouse model of permanent middle cerebral artery occlusion (PMCAO along with corresponding SHAM control that used 0.9% saline injection. Methods Ischemic and non-ischemic brain tissues were sampled at 6 and 24 hours post-treatment. Following behavioral analyses to confirm whether the ischemia has occurred, we investigated the genome-wide changes in gene and protein expression using DNA microarray chip (4x44K, Agilent and two-dimensional gel electrophoresis (2-DGE coupled with matrix assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS, respectively. Western blotting and immunofluorescent staining were also used to further examine the identified protein factor. Results Our results revealed numerous changes in the transcriptome of ischemic hemisphere (ipsilateral treated with PACAP38 compared to the saline-injected SHAM control hemisphere (contralateral. Previously known (such as the interleukin family and novel (Gabra6, Crtam genes were identified under PACAP influence. In parallel, 2-DGE analysis revealed a highly expressed protein spot in the ischemic hemisphere that was identified as dihydropyrimidinase-related protein 2 (DPYL2. The DPYL2, also known as Crmp2, is a marker for the axonal growth and nerve development. Interestingly, PACAP treatment slightly increased its abundance (by 2-DGE and immunostaining at 6 h but not at 24 h in the ischemic hemisphere, suggesting PACAP activates neuronal defense mechanism early on. Conclusions This study provides a detailed inventory of PACAP influenced gene expressions

  4. Value of ABCD2-F in Predicting Cerebral Ischemic Attacks: Three Months Follow-Up after the Primary Attack.

    Science.gov (United States)

    Chardoli, Mojtaba; Firoozabadi, Nader H; Nouri, Mohsen; Rahimi-Movaghar, Vafa

    2016-06-01

    Cerebrovascular attack (CVA) and transient ischemic attack (TIA) are major causes of emergency department visits around the globe. A significant number of these patients may experience repeat attacks if left untreated. Several risk stratifying scoring systems have been developed in recent years to point out the high risk patients. ABCD2 is based on age, blood pressure, clinical status, diabetes mellitus, and duration of symptoms and is used commonly for this purpose. In this study, we were to enhance its sensitivity and specificity with the addition of another criterion namely atrial fibrillation and making ABCD2-F. A prospective study in two hospitals was performed and 138 patients diagnosed with TIA/CVA were enrolled. Demographic, clinical, and paraclinical data of all patients were registered. All patients were followed for three months for any sign or symptom of a recurrent ischemic attack. Recurrent ischemic attacks happened in 9.4% of the patients. None of the criteria of ABCD2-F was associated with higher chance of ischemic attacks. Similarly, ABCD2-F was not different between patients with or without repeat cerebral ischemia. The addition of atrial fibrillation to ABCD2 did not enhance the accuracy of this scoring system to detect patients high risk for repeat cerebral ischemia. More studies in the future to improve sensitivity and specificity of this test are warranted. PMID:27306346

  5. Brief cognitive assessment for patients with cerebral small vessel disease

    OpenAIRE

    O'Sullivan, M.; Morris, R; Markus, H

    2005-01-01

    Background: Cerebral small vessel disease is a common cause of cognitive impairment and vascular dementia. The cognitive deficit differs from that in Alzheimer's disease, with greater executive/attentional dysfunction and relatively intact episodic memory.

  6. STUDY ON INVOLVEMENT OF L-ARG-NO IN THE PROTECTIVE ACTION OF ELECTROACUPUNCTURE ON CEREBRAL ISCHEMIC INJURY IN THE RAT

    Institute of Scientific and Technical Information of China (English)

    MaYang; XuNenggui; XuGuansun; ZhuShunli; SunYong; ZhangDaoqin; MaQinyun

    2000-01-01

    In the present study, the involvement of L-arginine(L-Arg) NO on ihe protective action of electroacupuncture(EA) on cerebral ischemic injury was observed in acute ischemia-reperfusion(IR) rat model by taking regional cerebral blood flow(r-CBF), cerebral water content(CWC), and blood nitric oxide(NO) contents as indexes. Results showed that 1) EA could cause r-CBF and serum NO content to increase and CWC to lower, suggesting an protective action of EA on IR cerebral injury; 2) intravenous injection of L-Arg also had an protective effect on cerebral IR cerebral injury, while L-NNA had no this effect; and 3) pre-treatment with L-Arg might strengthen the effect of EA further, while pretreatment with L-NNA could weaken its effect. It indicates that L-Arg-NO may be involved in the effect of EA in protecting the brain from ischemic injury.

  7. STUDY ON INVOLVEMENT OF L-ARG-NO IN THE PROTECTIVE ACTION OF ELECTROACUPUNCTURE ON CEREBRAL ISCHEMIC INJURY IN THE RAT

    Institute of Scientific and Technical Information of China (English)

    马扬; 许能贵; 许冠荪; 朱舜丽; 孙勇; 张道芹; 马勤耘

    2000-01-01

    In the present study, the involvement of L-arginine(L-Arg) NO on he protective action of electroacupuncture(EA) on cerebral ischemic injury was observed in acute ischemia-reperfusion(IR)rat model by taking regional cerebral blood flow(r-CBF), cerebral water content(CWC), and blood nitric oxide(NO) contents as indexes. Results showed that 1) EA could cause r-CBF and serum NO content to increase and CWC to lower, suggesting an protective action of EA on IR cerebral injury; 2) intravenous injection of L-Arg also had an protective effect on cerebral IR cerebral injury, while L-NNA had no this effect; and 3) pre-treatment with L-Arg might strengthen the effect of EA further, while pretreatment with L-NNA could weaken its effect. It indicates that L-Arg-NO may be involved in the effect of EA in protecting the brain from ischemic injury.

  8. Cerebroprotective Effect of Moringa oleifera against Focal Ischemic Stroke Induced by Middle Cerebral Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Woranan Kirisattayakul

    2013-01-01

    Full Text Available The protection against ischemic stroke is still required due to the limitation of therapeutic efficacy. Based on the role of oxidative stress in stroke pathophysiology, we determined whether Moringa oleifera, a plant possessing potent antioxidant activity, protected against brain damage and oxidative stress in animal model of focal stroke. M. oleifera leaves extract at doses of 100, 200 and 400 mg·kg−1 was orally given to male Wistar rats (300–350 g once daily at a period of 2 weeks before the occlusion of right middle cerebral artery (Rt.MCAO and 3 weeks after Rt.MCAO. The determinations of neurological score and temperature sensation were performed every 7 days throughout the study period, while the determinations of brain infarction volume, MDA level, and the activities of SOD, CAT, and GSH-Px were performed 24 hr after Rt.MCAO. The results showed that all doses of extract decreased infarction volume in both cortex and subcortex. The protective effect of medium and low doses of extract in all areas occurred mainly via the decreased oxidative stress. The protective effect of the high dose extract in striatum and hippocampus occurred via the same mechanism, whereas other mechanisms might play a crucial role in cortex. The detailed mechanism required further exploration.

  9. Small Vessel Ischemic Disease of the Brain and Brain Metastases in Lung Cancer Patients

    OpenAIRE

    Mazzone, Peter J.; Marchi, Nicola; Fazio, Vince; Taylor, J. Michael; Masaryk, Thomas; Bury, Luke; Mekhail, Tarek; Janigro, Damir

    2009-01-01

    Background Brain metastases occur commonly in patients with lung cancer. Small vessel ischemic disease is frequently found when imaging the brain to detect metastases. We aimed to determine if the presence of small vessel ischemic disease (SVID) of the brain is protective against the development of brain metastases in lung cancer patients. Methodology/Principal Findings A retrospective cohort of 523 patients with biopsy confirmed lung cancer who had received magnetic resonance imaging of the ...

  10. Electrical stimulation of the vagus nerve protects against cerebral ischemic injury through an anti-infammatory mechanism

    Directory of Open Access Journals (Sweden)

    Yao-xian Xiang

    2015-01-01

    Full Text Available Vagus nerve stimulation exerts protective effects against ischemic brain injury; however, the underlying mechanisms remain unclear. In this study, a rat model of focal cerebral ischemia was established using the occlusion method, and the right vagus nerve was given electrical stimulation (constant current of 0.5 mA; pulse width, 0.5 ms; frequency, 20 Hz; duration, 30 seconds; every 5 minutes for a total of 60 minutes 30 minutes, 12 hours, and 1, 2, 3, 7 and 14 days after surgery. Electrical stimulation of the vagus nerve substantially reduced infarct volume, improved neurological function, and decreased the expression levels of tumor necrosis factor-and interleukin- 6 in rats with focal cerebral ischemia. The experimental findings indicate that the neuroprotective effect of vagus nerve stimulation following cerebral ischemia may be associated with the inhibition of tumor necrosis factor- and interleukin-6 expression.

  11. Comparative evaluation of cerebral blood volume and cerebral blood flow in acute ischemic stroke by using perfusion-weighted MR imaging and SPECT

    International Nuclear Information System (INIS)

    Purpose: To investigate the relationship between relative cerebral blood volume (CBV) measured with perfusion-weighted (PW) MR imaging and relative cerebral blood flow (CBF) measured with SPECT in acute ischemic stroke. Material and Methods: Fifteen patients who had acute unilateral middle cerebral artery occlusion underwent both PW MR imaging and 99mTc-HMPAO SPECT with an interval less than 20 minutes between the two examinations within 6 hours after stroke onset. Lesion-to-contralateral relative CBV and CBF ratios measured in multiple regions of interest were compared to evaluate the relationship of the two parameters. Results: An overall linear relationship was found between relative CBV and relative CBF ratios (R2=0.54, p0.05). Regions with evolving infarction had more severe hypoperfusion (mean relative CBF ratio, 0.38±0.22) than regions without (mean relative CBF ratio, 0.70±0.13) (p<0.0001). Conclusion: A significant linear relationship existed between relative CBV and relative CBF in acute ischemic stroke, although relative CBV did not change linearly to relative CBF in mild hypoperfusion. Relative CBV can be used as an alternative to relative CBF within 6 hours after stroke onset, particularly in regions with severe hypoperfusion proceeding to infarction

  12. Electroacupuncture stimulation of the brachial plexus trunk on the healthy side promotes brain-derived neurotrophic factor mRNA expression in the ischemic cerebral cortex of a rat model of cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Zongjun Guo; Lumin Wang

    2012-01-01

    A rat model of cerebral ischemia/reperfusion was established by suture occlusion of the left middle cerebral artery. In situ hybridization results showed that the number of brain-derived neurotrophic factor mRNA-positive cells in the ischemic rat cerebral cortex increased after cerebral ischemia/ reperfusion injury. Low frequency continuous wave electroacupuncture (frequency 2-6 Hz, current intensity 2 mA) stimulation of the brachial plexus trunk on the healthy (right) side increased the number of brain-derived neurotrophic factor mRNA-positive cells in the ischemic cerebral cortex 14 days after cerebral ischemia/reperfusion injury. At the same time, electroacupuncture stimulation of the healthy brachial plexus truck significantly decreased neurological function scores and alleviated neurological function deficits. These findings suggest that electroacupuncture stimulation of the brachial plexus trunk on the healthy (right) side can greatly increase brain-derived neurotrophic factor mRNA expression and improve neurological function.

  13. Thrombolytic treatment for acute ischemic cerebral stroke: intraarterial urokinase infusion vs. intravenous heparin and urokinase infusion

    International Nuclear Information System (INIS)

    To evaluate the efficacy and limitation of intra-arterial urokinase (IAUK) infusion for treatment of acute cerebral stroke. Twenty-seven acute cerebral stroke patients treated with IAUK infusion within six hours of stroke onset were reviewed. All patients showed normal initial brain findings on CT. In 21 patients, urokinase(5-15 x 105IU) was administered through a microcatheter placed into or proximal to occluded segment. Mechanical disruption of thrombus by guidewire was performed in 17 patients. Angiographic and clinical responses and complications after IAUK infusion, were evaluated and the results were compared with those of intravenous heparin(N=19) and urokinase infusion(N=19). Complete or partial angiographic recanalization of occluded segment was found in 18 patients (67%), and neurologic improvement was followed in 14 patients(52%). The degree of improvement on the stroke scale score after IAUK infusion was statistically more significant(p<0.05) than that shown after intravenous heparin and urokinase infusion. Complications after IAUK infusion were large(15%) and small amount intracerebral hemorrhage(15%), contrast leakage into brain parenchyma(11%), and gastrointestinal bleeding(4%). Between the IAVK and the intravenous urokinase infusion group, differences in extent and types of complications were statistically insignificant, but were significantly higher in those two groups than in the intravenous heparin infusion group. IAUK infusion may be effective for the treatment of acute cerebral stroke

  14. The Significance of Small Cerebral Bleeds in Neurodegenerative Dementia Syndromes

    OpenAIRE

    De Reuck, Jacques L.

    2012-01-01

    Small cerebral bleeds are frequently observed in brains of patients with Alzheimer disease (AD) and cerebral amyloid angiopathy (CAA). However, they are also observed in patients with other neurodegenerative dementias and in persons without cognitive impairment. The aim of this survey is to compare the bleeding load in brains with different dementia syndromes and in age-matched controls. Hundred sixty-five brains were examined. The prevalence and the severity of the different cerebrovascular ...

  15. Enlarged perivascular spaces and cerebral small vessel disease

    OpenAIRE

    Potter, Gillian M; Doubal, Fergus N; Jackson, Caroline A; Chappell, Francesca M; Sudlow, Cathie L; Dennis, Martin S; Wardlaw, Joanna M.

    2013-01-01

    Background and aims Enlarged perivascular spaces (also known as Virchow–Robin spaces) on T2-weighted brain magnetic resonance imaging are common, but their etiology, and specificity to small vessel as opposed to general cerebrovascular disease or ageing, is unclear. We tested the association between enlarged perivascular spaces and ischemic stroke subtype, other markers of small vessel disease, and common vascular risk factors. Methods We prospectively recruited patients with acute stroke, di...

  16. Ischemia preconditioning is neuroprotective in a rat cerebral ischemic injury model through autophagy activation and apoptosis inhibition

    Directory of Open Access Journals (Sweden)

    D.Y. Xia

    2013-08-01

    Full Text Available Sublethal ischemic preconditioning (IPC is a powerful inducer of ischemic brain tolerance. However, its underlying mechanisms are still not well understood. In this study, we chose four different IPC paradigms, namely 5 min (5 min duration, 5×5 min (5 min duration, 2 episodes, 15-min interval, 5×5×5 min (5 min duration, 3 episodes, 15-min intervals, and 15 min (15 min duration, and demonstrated that three episodes of 5 min IPC activated autophagy to the greatest extent 24 h after IPC, as evidenced by Beclin expression and LC3-I/II conversion. Autophagic activation was mediated by the tuberous sclerosis type 1 (TSC1-mTor signal pathway as IPC increased TSC1 but decreased mTor phosphorylation. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL and hematoxylin and eosin staining confirmed that IPC protected against cerebral ischemic/reperfusion (I/R injury. Critically, 3-methyladenine, an inhibitor of autophagy, abolished the neuroprotection of IPC and, by contrast, rapamycin, an autophagy inducer, potentiated it. Cleaved caspase-3 expression, neurological scores, and infarct volume in different groups further confirmed the protection of IPC against I/R injury. Taken together, our data indicate that autophagy activation might underlie the protection of IPC against ischemic injury by inhibiting apoptosis.

  17. Ischemia preconditioning is neuroprotective in a rat cerebral ischemic injury model through autophagy activation and apoptosis inhibition

    Energy Technology Data Exchange (ETDEWEB)

    Xia, D.Y. [Department of Neurology, Navy General Hospital of PLA, Beijing (China); Li, W. [General Hospital of Shenyang Military Command, Department of Neurology, Shenyang, China, Department of Neurology, General Hospital of Shenyang Military Command, Shenyang (China); Qian, H.R.; Yao, S.; Liu, J.G.; Qi, X.K. [Department of Neurology, Navy General Hospital of PLA, Beijing (China)

    2013-08-10

    Sublethal ischemic preconditioning (IPC) is a powerful inducer of ischemic brain tolerance. However, its underlying mechanisms are still not well understood. In this study, we chose four different IPC paradigms, namely 5 min (5 min duration), 5×5 min (5 min duration, 2 episodes, 15-min interval), 5×5×5 min (5 min duration, 3 episodes, 15-min intervals), and 15 min (15 min duration), and demonstrated that three episodes of 5 min IPC activated autophagy to the greatest extent 24 h after IPC, as evidenced by Beclin expression and LC3-I/II conversion. Autophagic activation was mediated by the tuberous sclerosis type 1 (TSC1)-mTor signal pathway as IPC increased TSC1 but decreased mTor phosphorylation. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and hematoxylin and eosin staining confirmed that IPC protected against cerebral ischemic/reperfusion (I/R) injury. Critically, 3-methyladenine, an inhibitor of autophagy, abolished the neuroprotection of IPC and, by contrast, rapamycin, an autophagy inducer, potentiated it. Cleaved caspase-3 expression, neurological scores, and infarct volume in different groups further confirmed the protection of IPC against I/R injury. Taken together, our data indicate that autophagy activation might underlie the protection of IPC against ischemic injury by inhibiting apoptosis.

  18. Ischemia preconditioning is neuroprotective in a rat cerebral ischemic injury model through autophagy activation and apoptosis inhibition

    International Nuclear Information System (INIS)

    Sublethal ischemic preconditioning (IPC) is a powerful inducer of ischemic brain tolerance. However, its underlying mechanisms are still not well understood. In this study, we chose four different IPC paradigms, namely 5 min (5 min duration), 5×5 min (5 min duration, 2 episodes, 15-min interval), 5×5×5 min (5 min duration, 3 episodes, 15-min intervals), and 15 min (15 min duration), and demonstrated that three episodes of 5 min IPC activated autophagy to the greatest extent 24 h after IPC, as evidenced by Beclin expression and LC3-I/II conversion. Autophagic activation was mediated by the tuberous sclerosis type 1 (TSC1)-mTor signal pathway as IPC increased TSC1 but decreased mTor phosphorylation. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and hematoxylin and eosin staining confirmed that IPC protected against cerebral ischemic/reperfusion (I/R) injury. Critically, 3-methyladenine, an inhibitor of autophagy, abolished the neuroprotection of IPC and, by contrast, rapamycin, an autophagy inducer, potentiated it. Cleaved caspase-3 expression, neurological scores, and infarct volume in different groups further confirmed the protection of IPC against I/R injury. Taken together, our data indicate that autophagy activation might underlie the protection of IPC against ischemic injury by inhibiting apoptosis

  19. Indication of recanalization therapy in acute ischemic stroke determined by quantitative evaluation of cerebral blood flow by SPECT

    International Nuclear Information System (INIS)

    Recanalization of occluded vessels has been attempted for the treatment of acute hemispheric ischemic stroke, but increases the risk of hemorrhage. The purpose of this study is to determine the indications for recanalization therapy in acute ischemic stroke by quantitative evaluation of cerebral blood flow by SPECT. We studied retrospectively the relationship between regional cerebral blood flow (rCBF) measured by 99mTc-HM-PAO SPECT before treatment and the radiological final outcome in 9 patients, who had hemispheric ishemic strokes and underwent successful recanalization of the occluded artery by endovascular technique within 6 hours after onset. A noninvasive method described by Matsuda et al (Patlak plot) was used for the quantitative measurement of rCBF with SPECT. The results showed that the low value of rCBF before treatment correlated with the development of infarction after recanalization. When recanalization was achieved between 2 and 6 hours after onset, the critical level of rCBF to develop infarction was 25-30 ml/100 g/min. Despite early recanalization, one patient with a significant rCBF defect suffered from hemorrhagic transformation after recanalization. The measurement of rCBF by 99mTc-HM-PAO SPECT is available for emergent cases and is very useful to determine the extent and the degree of ischemic insult in acute ischemic strokes. Our data indicate that if the residual rCBF, measured by SPECT, is over 25 ml/100 g/min, emergent recanalization therapy should be considered, while on the other hand, if the residual rCBF is severely reduced (below 20 ml/100 g/min), acute recanalization is contraindicated to avoid fatal hemorrhagic transformation. A prospective study to enhance our preliminary results is needed. (author)

  20. Indication of recanalization therapy in acute ischemic stroke determined by quantitative evaluation of cerebral blood flow by SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Umemura, Atsushi; Suzuka, Tomonao; Nakamura, Akihiro [Hamamatsu Social Insurance Hospital, Shizuoka (Japan)

    1999-03-01

    Recanalization of occluded vessels has been attempted for the treatment of acute hemispheric ischemic stroke, but increases the risk of hemorrhage. The purpose of this study is to determine the indications for recanalization therapy in acute ischemic stroke by quantitative evaluation of cerebral blood flow by SPECT. We studied retrospectively the relationship between regional cerebral blood flow (rCBF) measured by {sup 99m}Tc-HM-PAO SPECT before treatment and the radiological final outcome in 9 patients, who had hemispheric ishemic strokes and underwent successful recanalization of the occluded artery by endovascular technique within 6 hours after onset. A noninvasive method described by Matsuda et al (Patlak plot) was used for the quantitative measurement of rCBF with SPECT. The results showed that the low value of rCBF before treatment correlated with the development of infarction after recanalization. When recanalization was achieved between 2 and 6 hours after onset, the critical level of rCBF to develop infarction was 25-30 ml/100 g/min. Despite early recanalization, one patient with a significant rCBF defect suffered from hemorrhagic transformation after recanalization. The measurement of rCBF by {sup 99m}Tc-HM-PAO SPECT is available for emergent cases and is very useful to determine the extent and the degree of ischemic insult in acute ischemic strokes. Our data indicate that if the residual rCBF, measured by SPECT, is over 25 ml/100 g/min, emergent recanalization therapy should be considered, while on the other hand, if the residual rCBF is severely reduced (below 20 ml/100 g/min), acute recanalization is contraindicated to avoid fatal hemorrhagic transformation. A prospective study to enhance our preliminary results is needed. (author)

  1. Anti-Neuroinflammatory Effects of Uncaria sinensis in LPS-Stimulated BV2 Microglia Cells and Focal Cerebral Ischemic Mice.

    Science.gov (United States)

    Kang, Bo Kyung; Kim, Mi Kyoung; Kim, So Young; Lee, Seung Jin; Choi, Young Whan; Choi, Byung Tae; Shin, Hwa Kyoung

    2015-01-01

    Uncaria sinensis (US) has long been used as a traditional Korean medicine to treat cardiovascular and central nervous system diseases, including hypertension and cerebral ischemia. Several recent studies have indicated that US has neuroprotective and cerebrovascular protective effects in ischemic brain injury; however, little is known about the anti-inflammatory effects of US. Therefore, the present study was designed to validate the anti-inflammatory effects of US. The anti-neuroinflammatory properties of US on pro-inflammatory mediators were investigated in lipopolysaccharide (LPS)-stimulated murine BV2 microglia and injured brains induced by photothrombotic cortical ischemia. Hexane extracts of US (HEUS) significantly suppressed the production of nitric oxide (NO) and prostaglandin E2 (PGE2) in LPS-stimulated BV2 microglia and inhibited LPS-induced expression of iNOS and COX-2 in a dose-dependent manner without causing cytotoxicity in BV2 cells. In addition, HEUS significantly reduced the generation of pro-inflammatory cytokines, including TNF-α, IL-1β, and IL-6. Moreover, HEUS treatment inhibited the transcriptional activity and nuclear translocation of NF-κB in LPS-stimulated BV2 cells. In an in vivo study, treatment of HEUS resulted in significantly reduced infarct volume and improved neurological function 48 h after ischemic brain injury, possibly through the inhibition of the production of pro-inflammatory cytokines. HEUS inhibits LPS-stimulated production of pro-inflammatory mediators and prevents cerebral ischemic damage, suggesting that US may have therapeutic potential for the prevention and treatment of ischemic stroke accompanied by microglia activation. PMID:26364663

  2. Contraceptives and cerebral thrombosis: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Kreiner, Svend

    2002-01-01

    Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis......Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis...

  3. The Relationship of the Abdominal Aortic Calcification Index to Carotid Intima Media Thickness for Early Diagnosis of Ischemic Cerebral Disease

    International Nuclear Information System (INIS)

    To evaluate abdominal aortic calcifications as a predictive factor for acute ischemic cerebral disease by performing a comparative analysis of intima-media thickness (IMT) of carotid artery and abdominal aortic calcifications. We prospectively studied 47 consecutive patients (33 men and 14 women; mean age, 63.6 years) who were suspected of having lower-extremity peripheral arterial disease by performing lower-extremity peripheral CT angiogram. Abdominal aortic calcifications were measured from the diaphragm to the iliac bifurcation. Calcification was defined as more than 130 Hounsfield units on CT. The IMT was measured in the right and left carotid arteries within 1 cm from the carotid bulb on three different occasions. The mean volume of abdominal aortic calcification was 2422.2 mm3. The mean IMT was 0.80 mm. Abdominal aortic calcification and IMT increased with age. The correlation coefficient for abdominal aortic calcification and IMT was 0.354 (p 0.80 mm) than in the group with a relatively thin IMT (≤ 0.80 mm) (p < 0.05). Abdominal aortic calcification was a common but an easily-ignored finding on abdominal CT scanning. Quantitative analysis showed that abdominal aortic calcification was well-correlated with IMT. Therefore, investigating for the presence of abdominal aortic calcification can be helpful in predicting acute ischemic cerebral disease in a patient.

  4. The Relationship of the Abdominal Aortic Calcification Index to Carotid Intima Media Thickness for Early Diagnosis of Ischemic Cerebral Disease

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jeong Hyeon; Kim, Min Ji; Park, Chul Hi; Whang, Ho Gyung [Dept. of Radiology,Seoul Medical Center, Seoul (Korea, Republic of); Kim, Hyuk Jung [Dept. of Radiology, Bundang Jesaeng Hospital, Soeul (Korea, Republic of)

    2012-04-15

    To evaluate abdominal aortic calcifications as a predictive factor for acute ischemic cerebral disease by performing a comparative analysis of intima-media thickness (IMT) of carotid artery and abdominal aortic calcifications. We prospectively studied 47 consecutive patients (33 men and 14 women; mean age, 63.6 years) who were suspected of having lower-extremity peripheral arterial disease by performing lower-extremity peripheral CT angiogram. Abdominal aortic calcifications were measured from the diaphragm to the iliac bifurcation. Calcification was defined as more than 130 Hounsfield units on CT. The IMT was measured in the right and left carotid arteries within 1 cm from the carotid bulb on three different occasions. The mean volume of abdominal aortic calcification was 2422.2 mm{sup 3}. The mean IMT was 0.80 mm. Abdominal aortic calcification and IMT increased with age. The correlation coefficient for abdominal aortic calcification and IMT was 0.354 (p < 0.05). Also, abdominal aortic calcification was significantly higher in the group that had a relatively thick IMT (> 0.80 mm) than in the group with a relatively thin IMT ({<=} 0.80 mm) (p < 0.05). Abdominal aortic calcification was a common but an easily-ignored finding on abdominal CT scanning. Quantitative analysis showed that abdominal aortic calcification was well-correlated with IMT. Therefore, investigating for the presence of abdominal aortic calcification can be helpful in predicting acute ischemic cerebral disease in a patient.

  5. Intravenous Administration of Cilostazol Nanoparticles Ameliorates Acute Ischemic Stroke in a Cerebral Ischemia/Reperfusion-Induced Injury Model

    Directory of Open Access Journals (Sweden)

    Noriaki Nagai

    2015-12-01

    Full Text Available It was reported that cilostazol (CLZ suppressed disruption of the microvasculature in ischemic areas. In this study, we have designed novel injection formulations containing CLZ nanoparticles using 0.5% methylcellulose, 0.2% docusate sodium salt, and mill methods (CLZnano dispersion; particle size 81 ± 59 nm, mean ± S.D., and investigated their toxicity and usefulness in a cerebral ischemia/reperfusion-induced injury model (MCAO/reperfusion mice. The pharmacokinetics of injections of CLZnano dispersions is similar to that of CLZ solutions prepared with 2-hydroxypropyl-β-cyclodextrin, and no changes in the rate of hemolysis of rabbit red blood cells, a model of cell injury, were observed with CLZnano dispersions. In addition, the intravenous injection of 0.6 mg/kg CLZnano dispersions does not affect the blood pressure and blood flow, and the 0.6 mg/kg CLZnano dispersions ameliorate neurological deficits and ischemic stroke in MCAO/reperfusion mice. It is possible that the CLZnano dispersions will provide effective therapy for ischemic stroke patients, and that injection preparations of lipophilic drugs containing drug nanoparticles expand their therapeutic usage.

  6. Regional cerebral blood flow in patients with transient ischemic attacks studied by Xenon-133 inhalation and emission tomography

    International Nuclear Information System (INIS)

    Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF with a spatial resolution of 1.7 cm. Based primarily on the clinical evidence and on the angiographical findings embolism was considered the pathogenetic factor in 10 cases, whereas chronic hemodynamic insufficiency rendered symptomatic by postural factors probably accounted for the symptoms in 4 patients. Of the 14 patients, all studied days to weeks after the most recent TIA, four showed hypoperfused areas on the CBF-tomograms and with roughly the same location hypodense areas on CT-scanning, i.e. areas of complete infarction. However, an additional five patients showed reduction of CBF in areas with no abnormality on the CT-scan. The abnormal blood flow pattern was found to be unchanged after clinically successful reconstructive vascular surgery. This suggests the presence of irreversible ischemic tissue damage without gross emollition (incomplete infarction). It is concluded, that TIAs are often harmful events, as no less than 9 of the 14 patients studied had evidence of complete and/or incomplete infarction. Thorough examination and rational therapy should be instituted as soon as possible to prevent further ischemic lesions

  7. Protective and super-imposing effects of Estradiol , Breviscapini, Lumbrokinase In focal cerebral ischemic-reperfusion injury on rats

    Institute of Scientific and Technical Information of China (English)

    Shang huiFang; Luo ZuMing

    2000-01-01

    Baekgrouad: Postmenopausal estrogen replacement therapy is always associated with a decrease in risk of stroke incidence and mortality. The breviscapini and lumbrokinase can protect brain from ischemic injury..Experiments in animal models suggest estradiol can protect brain from ischemic injury. But we know little about the mechanism of brain protection role of estradiol. Espectically we don't know if estrodiol plus other brain protective drugs such as breviscapini and lumbrokinase have superimposing protection. Objective: To study protective function and its mechanism of estradio breviscapini and lumbrokinase after cerebral ischemic reperfusion tn overiectimiaed rat. Methods: We made the local ischemic repenfusion model with thread emgolism of right middle cerebral artery (MCA) of young female SD rars which werc bilaterally ovariectomized two weeks ago were used. These rats were randomized into sham-operated group, control group, estrodiol group, brevisacapini group, 10 SD rats each group. We admistrated each group with reseponsed treatment when rats were subjected to half an hour of MCAO. MCA were oecluded 2 hours and followed by 70 hours of reperfusion. Sham-poerated group were exposed cervical common artery and weren't occluded MCA. The rats were killed at 72 hours. The observed patameters each group listed: 1) The neurological deficit scores were made after MCAO 2 hours and bcforc killed. 2) Each group excluded sham operaated group were caculaled cerebral infarct volume ratio and edema volume with stereological microscoppe. 3) The level of Nitrc oxide (NO) in serum were determined with nitrate redutase method. 4) The level of Interlukin-I (IL-1) and tumor necrosis factot (TNF) were determined by biological activity method. 5) Ultrastructure of neuron were observed with electron microscope. All the rcsults from different groups were compared with each other. The drugs identified effictive in formcr study plus estradiot wcre admistratcd to rats to obscrvcd

  8. Computer-aided diagnosis of acute ischemic stroke based on cerebral hypoperfusion using 4D CT angiography

    Science.gov (United States)

    Charbonnier, Jean-Paul; Smit, Ewoud J.; Viergever, Max A.; Velthuis, Birgitta K.; Vos, Pieter C.

    2013-02-01

    The presence of collateral blood flow is found to be a strong predictor of patient outcome after acute ischemic stroke. Collateral blood flow is defined as an alternative way to provide oxygenated blood to ischemic cerebral tissue. Assessment of collateral blood supply is currently performed by visual inspection of a Computed Tomography Angiogram (CTA) which introduces inter-observer variability and depends on the grading scale. Furthermore, variations in the arterial contrast arrival time may lead to underestimation of collateral blood supply in a CTA which exerts a negative influence on the prediction of patient outcome. In this study, the feasibility of a Computer-aided Diagnosis system is investigated capable of objectively predicting patient outcome. We present a novel automatic method for quantitative assessment of cerebral hypoperfusion in timing-invariant (i.e. delay insensitive) CTA (TI-CTA). The proposed Vessel Density Symmetry algorithm automatically generates descriptive maps based on hemispheric asymmetry of blood vessels. Intensity and symmetry based features are extracted from these descriptive maps and subjected to a best-first-search feature selection. Linear Discriminant Analysis is performed to combine selected features into a likelihood of good patient outcome. Receiver operating characteristic (ROC) analysis is conducted to evaluate the diagnostic performance of the CAD by leave-one- patient-out cross validation. A Positive Predicting Value of 1 was obtained at a sensitivity of 25% with an area under the ROC-curve of 0.86. The results show that the CAD is feasible to objectively predict patient outcome. The presented CAD could make an important contribution to acute ischemic stroke diagnosis and treatment.

  9. MRI of acute post-ischemic cerebral hemorrhage in stroke patients: diagnosis with T2{sup *}-weighted gradient-echo sequences

    Energy Technology Data Exchange (ETDEWEB)

    Hermier, M. [Dept. of Radiology, Univ. Claude-Bernard Lyon-I (France); Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France); Service de Radiologie, Hopital Neurologique, Lyon (France); Nighoghossian, N. [Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France); Cerebrovascular Disease and Ataxia Research Center, Univ. Claude-Bernard Lyon-I, Lyon (France); Derex, L.; Blanc-Lasserre, K.; Trouillas, P. [Cerebrovascular Disease and Ataxia Research Center, Univ. Claude-Bernard Lyon-I, Lyon (France); Berthezene, Y. [Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France); Dept. of Radiology, Univ. Claude-Bernard Lyon-I, Lyon (France); Froment, J.C. [Dept. of Radiology, Univ. Claude-Bernard Lyon-I (France); Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France)

    2001-10-01

    The use of T2{sup *}-weighted sequences has been advocated for early differentiation between hematoma and ischemia in patients with acute stroke. Early hemorrhagic transformation of ischemic stroke is an adverse event which may occur under treatment and may impair the prognosis: our aim is to evaluate the ability of T2*-weighted gradient-echo sequence (T2{sup *} GRE) to detect post-ischemic cerebral hemorrhage. The imaging procedure included: (1) baseline CT scan at admission. (2) MRI performed within 24 h of therapy onset including: (a) dual fast spin echo T2 sequence, (b) axial isotropic echoplanar diffusion-weighted imaging sequence, (c) conventional T2* GRE, and (d) 3D TOF turbo MRA. Post-ischemic cerebral hemorrhage was diagnosed if T2{sup *} GRE detected a focal intraparenchymal area of signal loss. The diameter of this lesion had to be more than 5 mm in order to eliminate past microbleeds. (3) Patients who showed an early suspicion of bleeding on MRI promptly had a second CT scan, and, if this one was negative for bleeding, another CT scan was performed 1 day later. All the other patients had a control CT scan during the first week. Forty-five consecutive patients have been included. T2* GRE showed intracranial bleeding in seven. The diagnosis of post-ischemic cerebral bleeding was confirmed by CT in all patients. Control CT scans did not reveal any post-ischemic cerebral hemorrhage in patients with negative MRI. In one case, hemorrhage was seen earlier on MRI than on CT scan. In conclusion, T2{sup *} GRE appeared to be at least as efficient as CT scan in the detection of early post-ischemic cerebral hemorrhage. (orig.)

  10. A cohort study of relationship between serum calcium levels and cerebral microbleeds (CMBs) in ischemic stroke patients with AF and/or RHD.

    Science.gov (United States)

    Liu, Junfeng; Wang, Deren; Xiong, Yao; Liu, Bian; Wei, Chenchen; Ma, Zhenxing; Wu, Bo; Yuan, Ruozhen; Tang, Hehan; Liu, Ming

    2016-06-01

    Calcium is an essential element for life and has cerebroprotective property in stroke patients. Low serum calcium levels were found to be related to large hematoma volumes in intracerebral hemorrhagic patients and hemorrhagic transformation in ischemic stroke patients after thrombolysis. However, their impact on hemorrhage-prone small vessel disease represented by cerebral microbleeds (CMBs) is uncertain. We aim to investigate whether low serum calcium levels are associated with presence and location of CMBs.Ischemic stroke patients with atrial fibrillation (AF) and/or rheumatic heart disease admitted to our hospital were consecutively and prospectively enrolled. Demographic and clinical information were collected and analyzed according to the occurrence and location of CMBs, and levels of serum calcium. We used logistic regression analysis to estimate the multivariable adjusted relationship between serum calcium levels and the presence or location of CMBs.Among the 67 patients (28 males; mean age, 67.3 years) in the final analysis, 39 (58.2%) were found to have CMBs. After adjustment for age, sex, smoking habits, drinking habits, and renal impairment, the presence of CMBs and deep CMBs was, respectively, 4.96- and 4.83-fold higher in patients with lower serum calcium levels (≤2.15 mmol/L) than in patients with higher serum calcium levels.Lower serum calcium levels (≤2.15 mmol/L) are independently associated with the presence of CMBs and deep CMBs in ischemic stroke patients with AF and/or rheumatic heart disease, which should be verified and extended in large cohorts, with other types of stroke patients and the general population. PMID:27368027

  11. Cerebral blood flow distribution and reactivity during the symptom-free stages of transient ischemic attacks; A [sup 99m]Tc-HMPAO SPECT study

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Yoshinari; Iiji, Osamu; Imaizumi, Masatoshi; Ashida, Keiichi (Osaka National Hospital (Japan))

    1992-08-01

    Even during the symptom-free stages, patients with transient ischemic attacks (TIA) often show cerebral blood flow (CBF) disturbances. For evaluating the factors which cause these abnormalities, we studied CBF and CBF reactivity to acetazolamide (diamox) using a [sup 99m]Tc-hexamethylpropyleneamine oxime (HMPAO) SPECT. The results from CBF-SPECT were compared with X-ray computed tomography (CT), cerebral arteriogram, clinical characteristics of TIA and cerebrovascular risk factors. The overall sensitivity rates in detecting the lesion were 68% in CBF-SPECT and 9% in CT. The size of the hypoperfused area tended to be wide in patients who had intracranial, severe stenotic or multiple arterial lesions on the ipsilateral side. No such relations were found between CBF and other examinations. Brain hypoperfusion was located in the subcortical region in eight patients; two patients showed a small hypodense lesion on CT which corresponded to the hypoperfusion on SPECT, and three patients showed no arteriographic abnormality. Hypoperfusion in the cortex was seen in seven patients; all patients showed arteriographic abnormality, but no CT abnormality. The severity rating of the vascular stenosis and hypoperfusion, and the incidence of the intracranial lesions were higher in this group than the group with subcortical hypoperfusion. Seven patients showed fixed normoperfusion before and after diamox injection. Two patients with a subcortical small infarction showed fixed hypoperfusion even after diamox injection. Twelve patients showed focal hypoperfusion before diamox with a new filling-in after diamox. Only one patient showed resting hypoperfusion and decreased CBF reactivity to diamox. The results suggest that most of the patients with a brain hypoperfusion in the symptom-free stages of TIAs have preserved cerebrovascular reactivity although a few patients show hypoperfusion having cerebral infarction or hemodynamically compromised tissue. (author).

  12. Baicalin attenuates focal cerebral ischemic reperfusion injury through inhibition of nuclear factor {kappa}B p65 activation

    Energy Technology Data Exchange (ETDEWEB)

    Xue, Xia [Department of Pharmacology, School of Pharmaceutical Sciences, Shandong University, Jinan 250012 (China); Center for New Drugs Evaluation, Shandong University, Jinan 250012 (China); Qu, Xian-Jun [Department of Pharmacology, School of Pharmaceutical Sciences, Shandong University, Jinan 250012 (China); Yang, Ying [School of Pharmaceutical Sciences, Shandong University of Traditional Chinese Medicine, Jinan 250355 (China); Sheng, Xie-Huang; Cheng, Fang; Jiang, E-Nang; Wang, Jian-hua; Bu, Wen [Center for New Drugs Evaluation, Shandong University, Jinan 250012 (China); Liu, Zhao-Ping, E-mail: liuzhaoping@sdu.edu.cn [Center for New Drugs Evaluation, Shandong University, Jinan 250012 (China)

    2010-12-17

    Research highlights: {yields} Permanent NF-{kappa}B p65 activation contributes to the infarction after ischemia-reperfusion injury in rats. {yields} Baicalin can markedly inhibit the nuclear NF-{kappa}B p65 expression and m RNA levels after ischemia-reperfusion injury in rats. {yields} Baicalin decreased the cerebral infarction area via inhibiting the activation of nuclear NF-{kappa}B p65. -- Abstract: Baicalin is a flavonoid compound purified from plant Scutellaria baicalensis Georgi. We aimed to evaluate the neuroprotective effects of baicalin against cerebral ischemic reperfusion injury. Male Wistar rats were subjected to middle cerebral artery occlusion (MCAO) for 2 h followed by reperfusion for 24 h. Baicalin at doses of 50, 100 and 200 mg/kg was intravenously injected after ischemia onset. Twenty-four hours after reperfusion, the neurological deficit was scored and infarct volume was measured. Hematoxylin and eosin (HE) staining was performed to analyze the histopathological changes of cortex and hippocampus neurons. We examined the levels of NF-{kappa}B p65 in ischemic cortexes by Western blot analysis and RT-PCR assay. The results showed that the neurological deficit scores were significantly decreased from 2.0 {+-} 0.7 to 1.2 {+-} 0.4 and the volume of infarction was reduced by 25% after baicalin injection. Histopathological examination showed that the increase of neurons with pycnotic shape and condensed nuclear in cortex and hippocampus were not observed in baicalin treated animals. Further examination showed that NF-{kappa}B p65 in cortex was increased after ischemia reperfusion injury, indicating the molecular mechanism of ischemia reperfusion injury. The level of NF-{kappa}B p65 was decreased by 73% after baicalin treatment. These results suggest that baicalin might be useful as a potential neuroprotective agent in stroke therapy. The neuroprotective effects of baicalin may relate to inhibition of NF-{kappa}B p65.

  13. The Traditional Herbal Medicine, Dangkwisoo-San, Prevents Cerebral Ischemic Injury through Nitric Oxide-Dependent Mechanisms

    Directory of Open Access Journals (Sweden)

    Ji Hyun Kim

    2011-01-01

    Full Text Available Dangkwisoo-San (DS is an herbal extract that is widely used in traditional Korean medicine to treat traumatic ecchymosis and pain by promoting blood circulation and relieving blood stasis. However, the effect of DS in cerebrovascular disease has not been examined experimentally. The protective effects of DS on focal ischemic brain were investigated in a mouse model. DS stimulated nitric oxide (NO production in human brain microvascular endothelial cells (HBMECs. DS (10–300 μg/mL produced a concentration-dependent relaxation in mouse aorta, which was significantly attenuated by the nitric oxide synthase (NOS inhibitor L-NAME, suggesting that DS causes vasodilation via a NO-dependent mechanism. DS increased resting cerebral blood flow (CBF, although it caused mild hypotension. To investigate the effect of DS on the acute cerebral injury, C57/BL6J mice received 90 min of middle cerebral artery occlusion followed by 22.5 h of reperfusion. DS administered 3 days before arterial occlusion significantly reduced cerebral infarct size by 53.7% compared with vehicle treatment. However, DS did not reduce brain infarction in mice treated with the relatively specific endothelial NOS (eNOS inhibitor, N5-(1-iminoethyl-L-ornithine, suggesting that the neuroprotective effect of DS is primarily endothelium-dependent. This correlated with increased phosphorylation of eNOS in the brains of DS-treated mice. DS acutely improves CBF in eNOS-dependent vasodilation and reduces infarct size in focal cerebral ischemia. These data provide causal evidence that DS is cerebroprotective via the eNOS-dependent production of NO, which ameliorates blood circulation.

  14. Recombinant human erythropoietin increases cerebral cortical width index and neurogenesis following ischemic stroke☆

    OpenAIRE

    Wen, Zhongmin; Wang, Peiji

    2012-01-01

    The cerebral cortical expansion index refers to the ratio between left and right cortex width and is recognized as an indicator for cortical hyperplasia. Cerebral ischemia was established in CB-17 mice in the present study, and the mice were subsequently treated with recombinant human erythropoietin via subcutaneous injection. Results demonstrated that cerebral cortical width index significantly increased. Immunofluorescence detection showed that the number of nuclear antigen antibody/5-bromo...

  15. Neuroprotection Offered by Majun Khadar, a Traditional Unani Medicine, during Cerebral Ischemic Damage in Rats

    OpenAIRE

    Seema Yousuf; Fahim Atif; Muzamil Ahmad; Tauheed Ishrat; Badruzzaman Khan; Fakhrul Islam

    2011-01-01

    Stroke results in damages to many biochemical, molecular and behavioral deficits. Present study provides evidence of the protective efficacy of a Unani herbal medicine, Majun Khadar (MK), against cerebral ischemia-induced behavioral dysfunctions and neurochemical alterations in the hippocampus (HIP). Transient focal cerebral ischemia was induced for 2 h followed by reperfusion for 22 h in a rat model. Rats were divided into four groups: sham, middle cerebral artery occluded (MCAO), drug sham ...

  16. Ischemic Postconditioning Protects Neuronal Death Caused by Cerebral Ischemia and Reperfusion via Attenuating Protein Aggregation

    Directory of Open Access Journals (Sweden)

    Jianmin Liang, Jihang Yao, Guangming Wang, Ying Wang, Boyu Wang, Pengfei Ge

    2012-01-01

    Full Text Available Objective: To investigate the effect of ischemic postconditioning on protein aggregation caused by transient ischemia and reperfusion and to clarify its underlying mechanism.Methods: Two-vessel-occluded transient global ischemia rat model was used. The rats in ischemic postconditioning group were subjected to three cycles of 30-s/30-s reperfusion/clamping after 15min of ischemia. Neuronal death in the CA1 region was observed by hematoxylin-eosin staining, and number of live neurons was assessed by cell counting under a light microscope. Succinyl-LLVY-AMC was used as substrate to assay proteasome activity in vitro. Protein carbonyl content was spectrophotometrically measured to analyze protein oxidization. Immunochemistry and laser scanning confocal microscopy were used to observe the distribution of ubiquitin in the CA1 neurons. Western blotting was used to analyze the quantitative alterations of protein aggregates, proteasome, hsp70 and hsp40 in cellular fractions under different ischemic conditions.Results: Histological examination showed that the percentage of live neurons in the CA1 region was elevated from 5.21%±1.21% to 55.32%±5.34% after administration of ischemic postconditioning (P=0.0087. Western blotting analysis showed that the protein aggregates in the ischemia group was 32.12±4.87, 41.86±4.71 and 34.51±5.18 times higher than that in the sham group at reperfusion 12h, 24h and 48h, respectively. However, protein aggregates were alleviated significantly by ischemic postconditioning to 2.84±0.97, 13.72±2.13 and 14.37±2.42 times at each indicated time point (P=0.000032, 0.0000051 and 0.0000082. Laser scanning confocal images showed ubiquitin labeled protein aggregates could not be discerned in the ischemic postconditioning group. Further study showed that ischemic postconditioning suppressed the production of carbonyl derivatives, elevated proteasome activity that was damaged by ischemia and reperfusion, increased the expression

  17. Transstomal Small Bowel Evisceration after Colonic Perforation Secondary to Ischemic Colitis

    Directory of Open Access Journals (Sweden)

    Ali Guner

    2012-01-01

    Full Text Available Intestinal stomas are commonly used in a temporary or permanent fashion in gastrointestinal surgeries. The complication rate of stomas has been reported to vary between 23 and 50%. There is only one case in the literature involving transstomal small bowel evisceration following colonic perforation. In this paper, we aimed to present a patient with a perforated colon secondary to ischemic colitis, which resulted in small bowel evisceration through this perforation site.

  18. Transstomal Small Bowel Evisceration after Colonic Perforation Secondary to Ischemic Colitis

    OpenAIRE

    Ali Guner; Izzettin Kahraman; Omer Faruk Ozkan; Adem Aktas; Can Kece

    2012-01-01

    Intestinal stomas are commonly used in a temporary or permanent fashion in gastrointestinal surgeries. The complication rate of stomas has been reported to vary between 23 and 50%. There is only one case in the literature involving transstomal small bowel evisceration following colonic perforation. In this paper, we aimed to present a patient with a perforated colon secondary to ischemic colitis, which resulted in small bowel evisceration through this perforation site.

  19. Validation of Intraluminal and Intraperitoneal microdialysis in ischemic small intestine

    DEFF Research Database (Denmark)

    Pynnönen, Lauri; Minkkinen, Minna; Perner, Anders; Räty, Sari; Nordback, Isto; Sand, Juhani; Tenhunen, Jyrki

    2013-01-01

    We sought to define the sensitivity and specificity of intraperitoneal (IP) and intraluminal (IL) microdialysate metabolites in depicting ex vivo small intestinal total ischemia during GI-tract surgery. We hypothesized that IL as opposed to IP microdialysis detects small intestinal ischemia with...

  20. Intranasal administration of aTf protects and repairs the neonatal white matter after a cerebral hypoxic-ischemic event.

    Science.gov (United States)

    Guardia Clausi, Mariano; Paez, Pablo M; Campagnoni, Anthony T; Pasquini, Laura A; Pasquini, Juana M

    2012-10-01

    Our previous studies showed that the intracerebral injection of apotransferrin (aTf) attenuates white matter damage and accelerates the remyelination process in a neonatal rat model of cerebral hypoxia-ischemia (HI) injury. However, the intracerebral injection of aTf might not be practical for clinical treatments. Therefore, the development of less invasive techniques capable of delivering aTf to the central nervous system would clearly aid in its effective clinical use. In this work, we have determined whether intranasal (iN) administration of human aTf provides neuroprotection to the neonatal mouse brain following a cerebral hypoxic-ischemic event. Apotransferrin was infused into the naris of neonatal mice and the HI insult was induced by right common carotid artery ligation followed by exposure to low oxygen concentration. Our results showed that aTf was successfully delivered into the neonatal HI brain and detected in the olfactory bulb, forebrain and posterior brain 30 min after inhalation. This treatment successfully reduced white matter damage, neuronal loss and astrogliosis in different brain regions and enhanced the proliferation and survival of oligodendroglial progenitor cells (OPCs) in the subventricular zone and corpus callosum (CC). Additionally, using an in vitro hypoxic model, we demonstrated that aTf prevents oligodendrocyte progenitor cell death by promoting their differentiation. In summary, these data suggest that iN administration of aTf has the potential to be used for clinical treatment to protect myelin and to induce remyelination in demyelinating hypoxic-ischemic events in the neonatal brain. PMID:22736466

  1. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients

    Energy Technology Data Exchange (ETDEWEB)

    De Ciuceis, Carolina; Porteri, Enzo; Rizzoni, Damiano; Boari, Gianluca E.M.; Rosei, Enrico Agabiti [University of Brescia, Clinica Medica, Department of Clinical and Experimental Sciences, Brescia (Italy); Cornali, Claudio; Mardighian, Dikran; Fontanella, Marco M. [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Pinardi, Chiara [Spedali Civili, Medical Physics Unit, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Rodella, Luigi F.; Rezzani, Rita [University of Brescia, Section of Anatomy, Department of Clinical and Experimental Sciences, Brescia (Italy); Gasparotti, Roberto [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy)

    2014-12-15

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences. (orig.)

  2. Angiogenesis and stem cell transplantation as potential treatments of cerebral ischemic stroke.

    Science.gov (United States)

    Wei, Ling; Keogh, Christine L; Whitaker, Vivian Riley; Theus, Michelle Hedrick; Yu, Shan Ping

    2005-07-01

    Ischemic stroke is a leading cause of human death and disability. Although stroke survivors may gain spontaneous partial functional recovery, they often suffer from sensory-motor dysfunctions, behavioral/neurological alterations, and various degrees of paralysis. Currently, limited clinical intervention is available to prevent ischemic damage and restore lost function in stroke victims. In addition to the extensive research on protective maneuvers against ischemia-induced cell death, increasing attention has been focused on potential strategies of promoting tissue repair and functional recovery in the damaged post-ischemic brain. Angiogenesis, or the growth of new blood vessels, may contribute to cell survival and functional recovery of the area of insult. The study of angiogenesis will increase the understanding of the mechanism underlying post-ischemia neurovascular plasticity and regeneration. Additionally, stem cell transplantation has emerged in the last few years as a potential therapy for ischemic stroke, because of their capability to differentiate into multiple cell types and the possibility that they may provide trophic support for cell survival, tissue repair, and functional recovery. PMID:15927824

  3. Preliminary experience on early mechanical recanalization of middle cerebral artery for acute ischemic stroke and literature review

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility,efficacy and complication of early middle cerebral artery (MCA) mechanical recanalization (MER) for treatment of acute ischemic stroke. Methods: Seven cases undergone MER of MCA for the treatment of acute cerebral infarct were retrospectively reviewed and analyzed, including the etiology, mechanism, Qureshi grading scale, location and size of infarcts, NIHSS score of pre and post procedure, endovascular technique and complications. Referring to the literature, the indications of MCA recanalization were further identified. Results: A total of 7 cases with mean age of 48 yrs were reviewed, which included 3 cases of atherosclerotic thrombosis and 4 embolic cases with pre NIHSS score ranging from 3 to 22. Mechanical recanalization succeeded in 6 cases, but 2 cases of cardiogenic embolism died of intracranial hemorrhage postoperatively. Favorable clinical outcomes were achieved in 4 cases whereas 1 deteriorated. Overall complications seemed to be consistent with literatures reviewed. Conclusions: Early MER of MCA may benefit to a certain subset of acute ischemia stroke patients, however, embolic cases, elder patients and those with severe neurologic deficits are often accompanied by higher complications and unfavorable outcome. (authors)

  4. Three-Dimensional Time-of-Flight Magnetic Resonance Angiography of Intracranial Vessels in a Canine Model of Ischemic Stroke with Permanent Occlusion of the Middle Cerebral Artery

    OpenAIRE

    KANG, Byeong-Teck; Jang, Dong-Pyo; Gu, Su-Hyun; Kim, Young-Bo; Lim, Chae-Young; Lee, Jong-Hwan; Woo, Eung-Je; Cho, Zang-Hee; Park, Hee-Myung

    2009-01-01

    The purpose of this study was to evaluate the potential efficacy of 3-dimensional time-of-flight magnetic resonance angiography (TOF-MRA) to validate a canine ischemic stroke model. Ischemic stroke was induced through permanent middle cerebral artery occlusion (MCAO) in 5 healthy Beagle dogs. T2-turbo spin echo images and TOF-MRA were obtained with a 1.5-T magnetic resonance system before and 3 and 10 d after MCAO. In 3 dogs, angiograms of the brain obtained at 3 d after MCAO showed complete ...

  5. Zingiber officinale Mitigates Brain Damage and Improves Memory Impairment in Focal Cerebral Ischemic Rat

    Directory of Open Access Journals (Sweden)

    Jintanaporn Wattanathorn

    2011-01-01

    Full Text Available Cerebral ischemia is known to produce brain damage and related behavioral deficits including memory. Recently, accumulating lines of evidence showed that dietary enrichment with nutritional antioxidants could reduce brain damage and improve cognitive function. In this study, possible protective effect of Zingiber officinale, a medicinal plant reputed for neuroprotective effect against oxidative stress-related brain damage, on brain damage and memory deficit induced by focal cerebral ischemia was elucidated. Male adult Wistar rats were administrated an alcoholic extract of ginger rhizome orally 14 days before and 21 days after the permanent occlusion of right middle cerebral artery (MCAO. Cognitive function assessment was performed at 7, 14, and 21 days after MCAO using the Morris water maze test. The brain infarct volume and density of neurons in hippocampus were also determined. Furthermore, the level of malondialdehyde (MDA, superoxide dismutase (SOD, catalase (CAT, and glutathione peroxidase (GSH-Px in cerebral cortex, striatum, and hippocampus was also quantified at the end of experiment. The results showed that cognitive function and neurons density in hippocampus of rats receiving ginger rhizome extract were improved while the brain infarct volume was decreased. The cognitive enhancing effect and neuroprotective effect occurred partly via the antioxidant activity of the extract. In conclusion, our study demonstrated the beneficial effect of ginger rhizome to protect against focal cerebral ischemia.

  6. Vulnerability of the Developing Brain to Hypoxic-Ischemic Damage: Contribution of the Cerebral Vasculature to Injury and Repair?

    Directory of Open Access Journals (Sweden)

    Ana eBaburamani

    2012-11-01

    Full Text Available As clinicians attempt to understand the underlying reasons for the vulnerability of different regions of the developing brain to injury, it is apparent that little is known as to how hypoxia-ischemia may affect the cerebrovasculature in the developing infant. Most of the research investigating the pathogenesis of perinatal brain injury following hypoxia-ischemia has focussed on excitotoxicity, oxidative stress and inflammatory response, with the response of the developing cerebrovasculature receiving less attention. This is surprising as the presentation of devastating and permanent injury such as germinal matrix-intraventricular haemorrhage (GM-IVH and perinatal stroke are of vascular origin, and the origin of periventricular leukomalacia (PVL may also arise from poor perfusion of the white matter. This highlights that cerebrovasculature injury following hypoxia could primarily be responsible for the injury seen in the brain of many infants diagnosed with hypoxic-ischemic encephalopathy (HIE.Interestingly the highly dynamic nature of the cerebral blood vessels in the fetus, and the fluctuations of cerebral blood flow and metabolic demand that occur following hypoxia suggest that the response of blood vessels could explain both regional protection and vulnerability in the developing brain. However research into how blood vessels respond following hypoxia-ischemia have mostly been conducted in adult models of ischemia or stroke, further highlighting the need to investigate how the developing cerebrovasculature responds and the possible contribution to perinatal brain injury following hypoxia. This review discusses the current concepts on the pathogenesis of perinatal brain injury, the development of the fetal cerebrovasculature and the blood brain barrier (BBB, and key mediators involved with the response of cerebral blood vessels to hypoxia.

  7. Andrographolide stimulates p38 mitogen-activated protein kinase-nuclear factor erythroid-2-related factor 2-heme oxygenase 1 signaling in primary cerebral endothelial cells for definite protection against ischemic stroke in rats.

    Science.gov (United States)

    Yen, Ting-Lin; Chen, Ray-Jade; Jayakumar, Thanasekaran; Lu, Wan-Jung; Hsieh, Cheng-Ying; Hsu, Ming-Jen; Yang, Chih-Hao; Chang, Chao-Chien; Lin, Yen-Kuang; Lin, Kuan-Hung; Sheu, Joen-Rong

    2016-04-01

    Stroke pathogenesis involves complex oxidative stress-related pathways. The nuclear factor erythroid-2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) pathways have been considered molecular targets in pharmacologic intervention for ischemic diseases. Andrographolide, a labdane diterpene, has received increasing attention in recent years because of its various pharmacologic activities. We determined that andrographolide modulates the mitogen-activated protein kinase (MAPK)-Nrf2-HO-1 signaling cascade in primary cerebral endothelial cells (CECs) to provide positive protection against middle cerebral artery occlusion (MCAO)-induced ischemic stroke in rats. In the present study, andrographolide (10 μM) increased HO-1 protein and messenger RNA expressions, Nrf2 phosphorylation, and nuclear translocation in CECs, and these activities were disrupted by a p38 MAPK inhibitor, SB203580, but not by the extracellular signal-regulated kinase inhibitor PD98059 or c-Jun amino-terminal kinase inhibitor SP600125. Similar results were observed in confocal microscopy analysis. Moreover, andrographolide-induced Nrf2 and HO-1 protein expressions were significantly inhibited by Nrf2 small interfering RNA. Moreover, HO-1 knockdown attenuated the protective effect of andrographolide against oxygen-glucose deprivation-induced CEC death. Andrographolide (0.1 mg/kg) significantly suppressed free radical formation, blood-brain barrier disruption, and brain infarction in MCAO-insulted rats, and these effects were reversed by the HO-1 inhibitor zinc protoporphyrin IX. The mechanism is attributable to HO-1 activation, as directly evidenced by andrographolide-induced pronounced HO-1 expression in brain tissues, which was highly localized in the cerebral capillary. In conclusion, andrographolide increased Nrf2-HO-1 expression through p38 MAPK regulation, confirming that it provides protection against MCAO-induced brain injury. These findings provide strong evidence that andrographolide could

  8. Effect of Pre-nutrion of Flax Seed Oil (Linum Usitatissimum on the amount of Cerebral ischemic lesion and motor nerve disorders in animal model rat.

    Directory of Open Access Journals (Sweden)

    SV Hosseini

    2015-10-01

    Full Text Available Background & aim: Stroke is the third death agent (factor in industrial countries after cardiovascular disease and cancer. With regard to high content of antioxidant materials in flax seed oil like &alpha-linolenic acid, lignan as well as phenolic combinations like secoisolarisirsinol (SDG, this study performed for studding relationship between of cerebral ischemic lesion and motor-nerve disorders in model of stroke in rat. Methods: in the study, 35 male mice from strain Wistar divided to 5 groups. The groups included control, sham and 3 experimental groups. They received doses 0.25, 0.5 and 0.75 ml/kg from flax seed oil orally. By gavage for 30 days two control and sham groups received aqua distillate (distil water. Two hours after the last gavaged dose, overly group with 7 pieces operated for measurement of the amount of cerebral lesion and motor-nerve disorders. (Middle Cerebral Artery Occlusion Model. Middle cerebral Artery Occlusion by the model resulted in local ischemic stroke in animal. Data analyzed by software SPSS, test ANOVA and disorders by test mann-Whitney. Findings: Average of records of motor-nerve disorders decreased significantly in group with dose 0.5 and 0.75 using flax seed oil (P<0.05. The amount of cerebral ischemic lesion in doses 0.5 and 0.75 than to control group is indicated meaning full different, but percent of the total cerebral lesion in control group in compared group with dose 0.25 is not indicated meaningful different. Percent of the amount of ischemic lesion in region penumbra in group 0.75 and 0.5 than to control group is indicated meaningful different, but percent of the amount of lesion in region penumbra in control group in compared region penumbra in group with dose 0.25 is not indicated meaning full different. Results: Findings of the study indicated that flax seed oil, particular in doses 0.5 and 0.75 resulted to decrease of the amount of cerebral ischemic lesion and decrease of motor-nerve disorders in

  9. Neuroimmunomodulatory effects of transcranial laser therapy combined with intravenous tPA administration for acute cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    Philip V. Peplow

    2015-01-01

    At present, the only FDA approved treatment for ischemic strokes is intravenous administration of tissue plasminogen activator within 4.5 hours of stroke onset. Owing to this brief window only a small percentage of patients receive tissue plasminogen activator. Transcranial laser therapy has been shown to be effective in animal models of acute ischemic stroke, resulting in signiifcant improvement in neurological score and function. NEST-1 and NEST-2 clinical trials in human patients have demonstrated the safety and positive trends in efifcacy of transcranial laser therapy for the treatment of ischemic stroke when initiated close to the time of stroke onset. Combining intravenous tissue plasminogen activator treatment with transcranial laser therapy may provide better functional outcomes. Statins given within 4 weeks of stroke onset improve stroke out-comes at 90 days compared to patients not given statins, and giving statins following transcranial laser therapy may provide an effective treatment for patients not able to be given tissue plasmin-ogen activator due to time constraints.

  10. Altered ischemic cerebral injury in mice lacking αIE subunit of the voltage-dependent Ca2+ channel

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective ①To set up a stable and reproducible focal cerebral infarct modelin mice; (②To examine theinvolvement of αIE subunit of voltage-dependent Ca2 + channel in cerebral ischemic injury. Methods Male C57BL/6J Jclmice 8 ~ 12w and F4 ~ F6αIE subunit of Ca2+ channel mutant mice were both used in this study. All animals were allowedto freely access to food and water before and after operation. Animals were anesthetized with pentobarbital sodium 60mg/kg,ip. Rectal temperature was continuously monitored before, during and after operation, and maintained at (36.6 +0.1 )°C by a autoregulating pad. To produce pilot models, the middle cerebral artery (MCA) was occluded either by sur-gical ligation or electrical coagulation and in some models the common carotid artery (CCA) was surgically ligated in tan-dem. In our latter work the MCA was cut off soon after it was ligated or coagulated in order to make sure that the bloodflow was occluded completely. The MCA was coagulated or ligated with a bipolar coagulator or microsurgery suture at thesite just superior to the rhinal fissure. Twenty~four hours after the operation, the mice were anesthetized and decapitated,then their brains were dissected from the skull and put into cold artificial brain spinal fluid as soon as possible. Lmm thickcoronal sections were cut by vibratome and stained with 2% 2,3,5-triphenyltetrazolium chloride (TTC) at 37°C for30min. Every section was photographed positively and the whole infarction volume was calculated by summing up the in-farction volumes of all sections by NIH Image System. Infarction ratio ( % ) was also calculated by the following fommula:(contralateral volume-ipsilateral undamaged volume)/contralateral volume × 100% to eliminate the influence of edema.In brief, the mutant mice were produced with gene targeting technique. F4 ~ F6 mice were used in this experiment. Alloffsprings were genotyped by the polymerase chain reaction (PCR) and the genotypes remained umknown

  11. Protection by the gross saponins of Tribulus terrestris against cerebral ischemic injury in rats involves the NF-κB pathway

    Directory of Open Access Journals (Sweden)

    En-ping Jiang

    2011-06-01

    Full Text Available The aim of this study was to investigate whether the gross saponins of Tribulus terrestris (GSTT, a traditional Chinese herbal medicine, have neuroprotective effects on rats subjected to middle cerebral artery occlusion (MCAO, through nuclear factor-κB (NF-κB pathway and inflammatory mediators. Cerebral ischemia was produced by MCAO in either untreated (control or GSTT-pretreated rats, and the animals were examined for infarct volume, cerebral edema, neuro-behavioral abnormality and pathological changes. Meanwhile, the expression of NF-κB protein in brain tissue was analyzed on Western blots and the serum levels of TNF-α and IL-1 were determined by ELISA. The experimental results demonstrated that, compared with the control MCAO group, GSTT-pretreated MCAO group had significantly reduced infarct volume, brain edema and neuro-behavioral abnormality, and lesser degree of pathologic changes in the brain, as well as had lower levels of serum TNF-α and IL-1β, and higher levels of brain NF-κB (P<0.05. Furthermore, treatment with an NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC abolished the protective effects of GSTT against MCAO-induced cerebral ischemic injury. These results indicated that GSTT's ability to protect against cerebral ischemic injury was mediated through the NF-κB signaling pathway, and that GSTT may act through inhibition of the production of inflammatory mediators.

  12. Cerebroprotective Effect of Moringa oleifera against Focal Ischemic Stroke Induced by Middle Cerebral Artery Occlusion

    OpenAIRE

    Woranan Kirisattayakul; Jintanaporn Wattanathorn; Terdthai Tong-Un; Supaporn Muchimapura; Panakaporn Wannanon; Jinatta Jittiwat

    2013-01-01

    The protection against ischemic stroke is still required due to the limitation of therapeutic efficacy. Based on the role of oxidative stress in stroke pathophysiology, we determined whether Moringa oleifera, a plant possessing potent antioxidant activity, protected against brain damage and oxidative stress in animal model of focal stroke. M. oleifera leaves extract at doses of 100, 200 and 400 mg·kg−1 was orally given to male Wistar rats (300–350 g) once daily at a period of 2 weeks before t...

  13. Predictive factors for spasticity among ischemic stroke patients Fatores preditivos para espasticidade após acidente vascular cerebral

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    Rita de Cássia dos Reis Moura

    2009-12-01

    Full Text Available Spasticity is a determining for functional loss following ischemic stroke. OBJECTIVE: To detect possible predictive factors for its occurrence. METHOD: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. RESULTS: Spasticity was noted more frequently among patients who underwent physiotherapy (pA espasticidade é fator determinante para perda funcional após o acidente vascular cerebral isquêmico (AVCI. OBJETIVO: Detectar possíveis fatores preditivos para a ocorrência da espasticidade. MÉTODO: Foram analisados dados demográficos, clínicos e tomográficos de 146 pacientes pós-AVCI. RESULTADOS: Na análise univariada a espasticidade foi notada com maior freqüência em pacientes que realizaram fisioterapia (p<0,0001; OR=19,4; 95% CI: 4,4-84,5, com maior tempo de duração desse tratamento (p=0,028; OR=4,80; 95% CI: 1,1-8,3 e que realizavam trabalho braçal (p=0,041; OR=2,2; 95% CI: 1,02-4,6, renda menor (p=0,038, referência de dor (p<0,0001; OR=107,0; 95% CI: 13,5-847,3 e seu aparecimento simultâneo à espasticidade (p<0,0001, acidente vascular cerebral (AVC pregresso (p=0,001; OR=4,2; 95% CI: 1,7-10,3, fraqueza muscular (p<0,0001; OR=91,9; 95% CI: 12,0-699,4, lesão tomográfica extensa (p=0,01 e lesão afetando mais de um lobo cerebral (p=0,018. Na análise de regressão multivariada a atividade braçal apresentou risco relativo de 2,9; acidente vascular cerebral prévio com risco relativo de 3,9 e lesão tomográfica extensa risco relativo de 3,6. CONCLUSÃO: A espasticidade afetou um quarto da população estudada e esteve associada ao trabalho braçal, AVC pregresso, lesões tomográficas extensas, diminuição da renda individual, realização de fisioterapia, realização de fisioterapia por um período maior, presença de dor, surgimento da dor simultânea à espasticidade e alteração da força.

  14. EEG patterns from acute to chronic stroke phases in focal cerebral ischemic rats: correlations with functional recovery

    International Nuclear Information System (INIS)

    Monitoring the neural activities from the ischemic penumbra provides critical information on neurological recovery after stroke. The purpose of this study is to evaluate the temporal alterations of neural activities using electroencephalography (EEG) from the acute phase to the chronic phase, and to compare EEG with the degree of post-stroke motor function recovery in a rat model of focal ischemic stroke. Male Sprague–Dawley rats were subjected to 90 min transient middle cerebral artery occlusion surgery followed by reperfusion for seven days (n = 58). The EEG signals were recorded at the pre-stroke phase (0 h), acute phase (3, 6 h), subacute phase (12, 24, 48, 72 h) and chronic phase (96, 120, 144, 168 h) (n = 8). This study analyzed post-stroke seizures and polymorphic delta activities (PDAs) and calculated quantitative EEG parameters such as the alpha-to-delta ratio (ADR). The ADR represented the ratio between alpha power and delta power, which indicated how fast the EEG activities were. Forelimb and hindlimb motor functions were measured by De Ryck's test and the beam walking test, respectively. In the acute phase, delta power increased fourfold with the occurrence of PDAs, and the histological staining showed that the infarct was limited to the striatum and secondary sensory cortex. In the subacute phase, the alpha power reduced to 50% of the baseline, and the infarct progressed to the forelimb cortical region. ADRs reduced from 0.23 ± 0.09 to 0.04 ± 0.01 at 3 h in the acute phase and gradually recovered to 0.22 ± 0.08 at 168 h in the chronic phase. In the comparison of correlations between the EEG parameters and the limb motor function from the acute phase to the chronic phase, ADRs were found to have the highest correlation coefficients with the beam walking test (r = 0.9524, p < 0.05) and De Ryck's test (r = 0.8077, p < 0.05). This study measured EEG activities after focal cerebral ischemia and showed that functional recovery was closely

  15. Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

    OpenAIRE

    Amiri-Nikpour MR; Nazarbaghi S; Ahmadi-Salmasi B; Mokari. T.; Tahamtan U; Rezaei Y

    2014-01-01

    Mohammad Reza Amiri-Nikpour,1 Surena Nazarbaghi,1 Babak Ahmadi-Salmasi,1 Tayebeh Mokari,2 Urya Tahamtan,2 Yousef Rezaei3 1Department of Neurology, Imam Khomeini Hospital, 2School of Medicine, 3Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran Background: Cerebrolysin, a brain-derived neuropeptide, has been shown to improve the neurological outcomes of stroke, but no study has demonstrated its effect on cerebral blood flow. This study aimed to determine the ce...

  16. Experimental animal models and inflammatory cellular changes in cerebral ischemic and hemorrhagic stroke

    OpenAIRE

    Yan, Tao; Chopp, Michael; Chen, Jieli

    2015-01-01

    Stroke, including cerebral ischemia, intracerebral hemorrhage, and subarachnoid hemorrhage, is the leading cause of long-term disability and death worldwide. Animal models have greatly contributed to our understanding of the risk factors and the pathophysiology of stroke, as well as the development of therapeutic strategies for its treatment. Further development and investigation of experimental models, however, are needed to elucidate the pathogenesis of stroke and to enhance and expand nove...

  17. Clinical significance of regional cerebral blood volume and flow-to-volume ratio in ischemic cerebrovascular disease measeured by SPECT

    International Nuclear Information System (INIS)

    Regional cerebral blood volume (rCBV) and flow-to-volume ratio (rCBF/rCBV) were evaluated for clinical significance in comparison to rCBF and findings in X-ray CT (XCT) and radionuclide (RNA) and contrast angiography (CAG). A total of 109 cases were studied within 90 days after cerebrovascular ischemic attack. CBV SPECT was performed following CBF SPECT with I-123-IMP and RNA with Tc-99m-RBC, and processed for subtraction of I-123 contamination fraction. CBF/CBV images was obtained as the count ratio of CBF to CBV image at the same slice-level. Parametric rCBV and rCBF/rCBV were estimated as the count ratio of the focus to the contralateral normal region of interest. Image findings were scored by visual judgement. Student's t-test was applied for statistical analysis with a significance level of p=0.01. The rCBV-ratio was inversely proportional to rCBF/rCBV-ratio, and was different between the two groups with high and low score on flip-flop perfusion in RNA and among three groups with different postictal neurological course. The ratio was the highest for the group of improved course. The rCBF/rCBV-ratio was possibly correlated to rCBF-ratio, and was different between the two groups with high and low score on low density area in XCT, early perfusion in RNA and arterial stenosis in CAG. In the group of improved course, the ratio was different between the second and the third postictal week's duraiton. These results, therefore, suggest that rCBV-ratio reflects collateral perfusion, and is valuable for assessing postictal prognosis in cerebrovascular disease, and that rCBF/rCBV-ratio may reflect regional oxygen extraction fraction, and is valuable for speculating cerebral perfusion reserve. (author)

  18. Changes of cerebral contents of neuropeptides in rat models of multiple ischemic dementia (MID)

    International Nuclear Information System (INIS)

    Objective: To investigate the significance of changes of cerebral contents of the neuropeptides somatostatin (SS), arginine vasopressin (AVP) and substance P in rat models of MID. Methods: The rat models consisted of 15 rats undergoing intracarotid injection of autogenous thrombus powder. Another group of 15 rats undergoing sham operation served as controls. Learning and memory ability in these rats was assessed with daily passive avoidance task testing for 10 consecutive days. The animals were sacrificed on 30d and contents of the neuropeptides in tissue homogenate from different areas of brain (frontal cortex, temporal cortex, hippocampus, thalamus and corpus striatum) were measured with (RIA). Results: On the first day of passive avoidance task testing, the frequency of errors in the MID group and the control group was about the same. From the third day on, the frequency of errors in the MID group was significantly higher than that in the control group (P<0.05). The neuropeptides contents of all these cerebral areas in the MID group were significantly higher than those in the control group (P<0.05 or P<0.01) with the only exception of the contents of substance P in thalamus (no significant difference between the contents in the two groups). Conclusion: The impairment of learning and memory in rat models with MID was possibly related to the lowered contents of SS, AVP and substance P in the brain tissue. (authors)

  19. Effect of restraint stress on depression-like behaviors in rats after transient focal cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Restraint stress is a typical psychophysiological stressor. Simulating the early passion and difficulty in walking of patients after attack of stroke meets onset features.OBJECTIVE: To evaluate the effect of restraint stress on depression-like behaviors in rats after transient focal cerebral ischemic injury, and to investigate the feasibility for its being as modeling method of depression model after stroke.DESIGN: A randomized controlled animal experiment.SETTING: Department of Clinical Medicine, Faculty of Aerospace Medicine of the Fourth Military Medical University of Chinese PLA.MATERIALS: Forty-eight male Sprague-Dawley rats, weighing 240 - 270 g, provided by the Experimental Animal Center of the Fourth Military Medical University of Chinese PLA were used in the current study.METHODS: The experiments were carried out in the Faculty of Aerospace Medicine of the Fourth Military Medical University of Chinese PLA between August 2005 and August 2006. ①Experiment intervention: The rats were randomized into middle cerebral artery occlusion-reperfusion (MCAO) +stress group, simple MCAO group, sham-operation + stress group and simple sham-operation group, with 12 rats in each group.Rats in the first two groups were developed into cerebral ischemia/reperfusion models by suture-occluded method. Rats in the MCAO+stress group were modeled and restraint stress scheme was performed. At week 5 after modeling, the rats were placed in self-made restraining tubes, 2 hours/time, once a day, for 2 successive weeks. The common carotid artery, external and internal carotid arteries of rats in the latter two groups were exposed. The stress way of sham-operation+ stress group was the same as that of MCAO+ stress group. ②The neurological status grading and motor performance evaluation (screen test, rota-rod test and balance beam test) were conducted in rats with simple sham-operation group and MCAO group before, 1st and 28th days after modeling. Depression-like behavior

  20. Treatment for cerebral small vessel disease: effect of relaxin on the function and structure of cerebral parenchymal arterioles during hypertension

    OpenAIRE

    Chan, Siu-Lung; Sweet, Julie G.; Cipolla, Marilyn J.

    2013-01-01

    We investigated the effect of hypertension on the function and structure of cerebral parenchymal arterioles (PAs), a major target of cerebral small vessel disease (SVD), and determined whether relaxin is a treatment for SVD during hypertension. PAs were isolated from 18-wk-old female normotensive Wistar-Kyoto (WKY) rats, spontaneous hypertensive rats (SHRs), and SHRs treated with human relaxin 2 for 14 d (4 μg/h; n=8/group) and studied using a pressurized arteriograph system. Hypertension red...

  1. Studies on cerebral protection of digoxin against hypoxic-ischemic brain damage in neonatal rats.

    Science.gov (United States)

    Peng, Kaiwei; Tan, Danfeng; He, Miao; Guo, Dandan; Huang, Juan; Wang, Xia; Liu, Chentao; Zheng, Xiangrong

    2016-08-17

    Hypoxic-ischemic brain damage (HIBD) is a major cause of neonatal acute deaths and chronic nervous system damage. Our present study was designed to investigate the possible neuroprotective effect of digoxin-induced pharmacological preconditioning after hypoxia-ischemia and underlying mechanisms. Neonatal rats were assigned randomly to control, HIBD, or HIBD+digoxin groups. Pharmacological preconditioning was induced by administration of digoxin 72 h before inducing HIBD by carotid occlusion+hypoxia. Behavioral assays, and neuropathological and apoptotic assessments were performed to examine the effects; the expression of Na/K ATPase was also assessed. Rats in the HIBD group showed deficiencies on the T-maze, radial water maze, and postural reflex tests, whereas the HIBD+digoxin group showed significant improvements on all behavioral tests. The rats treated with digoxin showed recovery of pathological conditions, increased number of neural cells and proliferative cells, and decreased number of apoptotic cells. Meanwhile, an increased expression level of Na/K ATPase was observed after digoxin preconditioning treatment. The preconditioning treatment of digoxin contributed toward an improved functional recovery and exerted a marked neuroprotective effect including promotion of cell proliferation and reduction of apoptosis after HIBD, and the neuroprotective action was likely associated with increased expression of Na/K ATPase. PMID:27362436

  2. The evolution of the cerebral blood volume abnormality in patients with ischemic stroke: a CT perfusion study

    Energy Technology Data Exchange (ETDEWEB)

    D' Esterre, Christopher D.; Lee, Ting Yim (Lawson Health Research Inst., London (Canada); Robarts Research Inst., London (Canada)), email: tlee@robarts.ca; Aviv, Richard I. (Sunnybrook Health Sciences Centre, Toronto (Canada))

    2012-05-15

    Background: Accurate identification of the acute infarct core abnormality is important for guiding acute stroke treatment. Abnormality volumes from diffusion-weighted MRI (DWI) and CT perfusion (CTP)-cerebral blood volume (CBV) are highly correlated. DWI lesions have been shown to be reversible at 24 h. Purpose: To examine the temporal profile of the CT perfusion (CTP)-derived CBV abnormality out to 7 days post ischemic stroke. Material and Methods: Twenty-six patients were included. Group A (n = 13) underwent a noncontrast CT (NCCT), CTP/CT angiography (CTA) within 6 h of stroke onset, CTP/CTA at 24 h, and CTP/NCCT at 5-7 days post stroke. Group B (n = 13) underwent a NCCT, CTP/CTA within 6 h of stroke onset, and NCCT at 5-7 days. Recanalization status was established in all patients. For both groups, infarct volumes were traced on 5-7 day NCCT images and superimposed onto all CTP-CBV functional maps to determine CBV. Group B (n = 13) admission images were used to define CBV infarct thresholds for gray and white matter. CBV-lesion overestimation was determined for Group A using the thresholds from Group B. Results: CBV (ml x 100g- 1; mean +- stdev) for gray/white matter, within confirmed infarcted regions (CBVI) at admission, 24 h, and 5-7 days were 1.82 +- 0.56, 1.56 +- 0.42, 1.75 +- 0.31, and 1.38 +- 0.65, 1.13 +- 0.31, 1.32 +- 0.44, respectively, when averaged over all patients (P > 0.05). Four patients had tissue time-density curves from ischemic lesions (TDCi) with an incomplete contrast medium wash-out phase (truncation) at admission and/or 24 h. Compared to admission, gray matter CBVI was higher at 5-7 days for patients with TDCi truncation (P < 0.05). There were no significant CBVI increases for the eight patients without truncation (P > 0.05). Over-estimation of acute CBV lesion was present in 3/4 (75%) and 1/9 (11%) of patients with/without TDCi truncation, respectively. Conclusion: CTP-derived CBV lesion reversal is associated with TDCi truncation

  3. Regional cerebral blood flow and oxygen metabolism in patients with ischemic stroke studied with high resolution pet and the O-15 labelled gas steady-state method

    International Nuclear Information System (INIS)

    Although regional cerebral blood flow (rCBF) studies have considerably increased pathophysiological knowledge in ischemic cerebrovascular disease, sometimes the results of such studies do not correlate with neurological abnormalities observed in the subjects being examined. Because regional neuronal activities always couple to the regional energy metabolism of brain tissue, simultaneous observation of rCBF and regional energy metabolism, such as regional oxygen consumption (rCMRO/sub 2/) and regional glucose consumption (rCMRG1), will provide greater understanding of the pathophysiology of the disease than rCBF study alone. Positron emission tomography (PET) using the 0-15 labelled gas steady-state method offers simultaneous measurement of rCBF and rCMRO/sub 2/ in vivo, and demonstrates imbalance between rCBF and rCMRO/sub 2/ in an ischemic lesion in a human brain. However, clinical PET studies in ischemic cerebrovascular disease reported previously, have been carried out using low resolution (more than 15 mm in the full width at half maximum; FWHM) PET. This report presents preliminary results using a high resolution tomograph; Headtome III and 0-15 labelled gas steady state method to investigate ischemic cerebrovascular disease

  4. Cerebral changes and cognitive impairment after an ischemic heart disease: a multimodal MRI study.

    Science.gov (United States)

    Bernard, Charlotte; Catheline, Gwénaëlle; Dilharreguy, Bixente; Couffinhal, Thierry; Ledure, Sylvain; Lassalle-Lagadec, Saioa; Callaert, Dorothée; Allard, Michèle; Sibon, Igor

    2016-09-01

    Three to 6 months after an acute coronary syndrome (ACS), cognitive impairment is observed in more than 30 % of the patients, mainly in executive functioning. The aim of this study was to investigate, using multimodal MRI, cerebral anatomo-functional substratum of executive dysfunction. Thirty-three patients were recruited 4 ± 1 months after a first ACS. Executive functions were evaluated with the Trail-Making-Test-B (TMTB) at baseline (ie 4 ± 1 months after ACS) and 6 months later (ie 10 ± 1 months after ACS). Using both time-points, we identified 3 groups of patients according to normative data based on age, gender and education level: 15 'cognitively normal' patients without impairment at each follow-up, 10 'transient impaired' patients with an impairment only at baseline and 8 'impairing' patients with an impairment only at follow-up. We explored, in the whole-brain, the structural integrity using Voxel-Based Morphometry and Tract-Based Spatial Statistics and the resting-state functional connectivity using Network-Based Statistics. No structural difference was observed between impaired and cognitively normal patients. At the functional level, compared to the 'cognitively normal' group, the 'transient impaired' patients presented an increased functional connectivity in a network centered on middle-orbito-frontal regions, whereas the 'impairing' patients presented only a non-significant decrease of functional connectivity. Executive dysfunction in ACS patients is associated to functional but no structural characteristics, particularly to an increased functional connectivity in cognitive networks in transient impaired patients. Further studies with larger sample size are needed to confirm these results and to determine if these patients could be at higher risk for developing permanent cognitive disorders. PMID:26589710

  5. Atrial myxoma causing cerebral embolic ischemic stroke as the first presentation in an apparently asymptomatic young male with birth asphyxial injury: a case report

    OpenAIRE

    Akash Mathur; Dinesh Gurjar; Arvind Lakesar; Ramkrishna Sai; Arun Agrawal; Hemant Malhotra

    2016-01-01

    A myxoma is the most common primary tumor of the heart. It has been reported as the source of a cardiogenic embolism. Therefore, it is important for clinicians to detect the myxoma early to prevent complications like cerebral embolic stroke. This report presents the case of a 40-year-old male with birth asphyxial injury whose first clinical manifestation of atrial myxoma was an ischemic stroke. Atrial myxoma was later confirmed as the cause of his symptoms by echocardiography and cardiac CT s...

  6. Cerebrovascular ischemic changes associated with fetal posterior cerebral artery- descriptive retrospective study with magnetic resonance imaging and angiography of brain

    OpenAIRE

    Venkatraman Indiran; Prabakaran Maduraimuthu

    2016-01-01

    Objectives: Circle of Willis, the main collateral pathway for cerebral circulation, is complete in only a portion of the population. There are many variations in the Circle of Willis. Fetal posterior cerebral artery, which is defined as posterior cerebral artery arising from internal carotid artery, is a common variant of the Circle of Willis. Though association between the fetal posterior cerebral artery and ischemia have been studied, no specific study has been conducted in the Indian popul...

  7. Small vessel ischemic disease of the brain and brain metastases in lung cancer patients.

    Directory of Open Access Journals (Sweden)

    Peter J Mazzone

    Full Text Available BACKGROUND: Brain metastases occur commonly in patients with lung cancer. Small vessel ischemic disease is frequently found when imaging the brain to detect metastases. We aimed to determine if the presence of small vessel ischemic disease (SVID of the brain is protective against the development of brain metastases in lung cancer patients. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cohort of 523 patients with biopsy confirmed lung cancer who had received magnetic resonance imaging of the brain as part of their standard initial staging evaluation was reviewed. Information collected included demographics, comorbidities, details of the lung cancer, and the presence of SVID of the brain. A portion of the cohort had the degree of SVID graded. The primary outcome measure was the portion of study subjects with and without SVID of the brain who had evidence of brain metastases at the time of initial staging of their lung cancer.109 patients (20.8% had evidence of brain metastases at presentation and 345 (66.0% had evidence of SVID. 13.9% of those with SVID and 34.3% of those without SVID presented with brain metastases (p<0.0001. In a model including age, diabetes mellitus, hypertension, hyperlipidemia, and tobacco use, SVID of the brain was found to be the only protective factor against the development of brain metastases, with an OR of 0.31 (0.20, 0.48; p<0.001. The grade of SVID was higher in those without brain metastases. CONCLUSIONS/SIGNIFICANCE: These findings suggest that vascular changes in the brain are protective against the development of brain metastases in lung cancer patients.

  8. Effects of movement training on synaptic interface structure in the sensorimotor cortex and hippocampal CA3 area of the ischemic hemisphere in cerebral infarction rats

    Institute of Scientific and Technical Information of China (English)

    Min Yang; Jiyan Cheng

    2008-01-01

    BACKGROUND: Movement is an effective way to provide sensory, movement and reflectivity afferent stimulation to the central nervous system. Movement plays an important role in functional recombination and compensation in the brain. OBJECTIVE: To observe movement training effects on texture parameters of synaptic interfaces in the sensorimotor cortex and hippocampal CA3 area of the ischemic hemisphere and on motor function in cerebral infarction rats. DESIGN, TIME AND SETTING: This neural morphology and pathology randomized controlled animal experiment was performed at the Center Laboratory, Affiliated Hospital of Luzhou Medical College, China from November 2004 to April 2005. MATERIALS: A total of 32 healthy male Wistar rats aged 8 weeks were equally and randomly assigned into model and movement training groups. METHODS: Rat models of right middle cerebral artery occlusion were established using the suture occlusion method in both groups. Rats in the movement training group underwent balance training, screen training, and rotating rod training starting on day 5 after surgery, for 40 minutes every day, 6 days per week, for 4 weeks. MAIN OUTCOME MEASURES: Texture parameters of synaptic interfaces were determined using a transmission electron microscope and image analyzer during week 5 following model induction. The following parameters were measured: synaptic cleft width; postsynaptic density thickness; synaptic interface curvature; and active zone length. Motor function was assessed using balance training, screen training, and rotating rod training. The lower score indicated a better motor function. RESULTS: The postsynaptic density thickness, synaptic interface curvature, and active zone length were significantly increased in the sensorimotor cortex and hippocampal CA3 area of the ischemic hemisphere of rats from the movement training group compared with the model group (P < 0.05 or 0.01). Curved synapses and perforated synapses were seen in the sensorimotor cortex

  9. Visual field damage in normal-tension glaucoma patients with or without ischemic changes in cerebral magnetic resonance imaging

    International Nuclear Information System (INIS)

    The purpose of this study was to compare the pattern of visual field damage between normal-tension glaucoma (NTG) patients with signs indicative of ischemic changes and those NTG patients without signs of ischemic changes, using brain magnetic resonance imaging (MRI), in a single center, cross-sectional study. In 94 consecutive NTG patients who were younger than 61 years old, brain MRI images were obtained using fluid-attenuated inversion recovery pulse sequences. The presence of signs indicative of ischemic changes in brain MRI images was decided separately by two neuroradiologists masked to the diagnosis and stage of glaucoma. Visual field testing was performed using the 30-2 program of the Humphrey Visual Field Analyzer. Between the patients with signs indicative of ischemic changes in brain MRI (ischemic group) and those without MRI signs (nonischemic group), total deviation (TD) at each test point less the average of TDs of the 30-2 program ([TD-TDmean]) was compared at each test point. Signs indicative of ischemic changes in brain MRI were found in 32 of the 94 patients (34.0%). Age, blood pressure, refraction, intraocular pressure, the average of TDs, mean deviation, and corrected pattern standard deviation were not significantly different between the ischemic (N=32) and nonischemic (N=62) groups (P>0.2). [TD-TDmean] in the ischemic group was significantly smaller than that in the nonischemic group at 6 nonedge contiguous test points in the inferior pericentral to nasal field (P=0.005-0.047). NTG patients with signs indicative of ischemic changes in brain MRI had a relatively deeper depression in the inferior pericentral visual field. (author)

  10. Involvement of δ-and μ-opioid receptors in the delayed cerebral ischemic tolerance induced by repeated electroacupuncture preconditioning in rats

    Institute of Scientific and Technical Information of China (English)

    XIONG Li-ze; YANG Jing; WANG Qiang; LU Zhi-hong

    2007-01-01

    Background Preconditioning with repeated electroacupuncture (EA) could mimic ischemic preconditioning to induce cerebral ischemic tolerance in rats. The present study was designed to investigate whether mu(μ)-, delta(δ)- or kappa(κ)-opioid receptors are involved in the neuroprotection induced by repeated EA preconditioning.Methods The rats were pretreated with naltrindole (NTI), nor-binaltorphimine (nor-BNI) or D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (CTOP), which is a highly selective δ-, κ- or μ-opioid receptor antagonist respectively, before each EA preconditioning (30 minutes per day, 5 days). Twenty-four hours after the last EA treatment, the middle cerebral artery occlusion (MCAO) was induced for 120 minutes. The brain infarct volume was determined with 2,3,5-triphenyltetrazolium chloride staining at 24 hours after MCAO and compared with that in rats which only received EA preconditioning. In another experiment, the met-enkephalin-like immunoreactivity in rat brain was investigated by immunohistochemistry in both EA preconditioning and control rats.Results The EA preconditioning reduced brain infarct volume compared with the control rats (P=0.000). Administration of both NTI and CTOP attenuated the brain infarct volume reduction induced by EA preconditioning, presenting with larger infarct volume than that in the EA preconditioning rats (P<0.001). But nor-BNI administration did not block the infarct volume reduction induced by EA preconditioning, presenting with smaller infarct volume than the control group rats(P=0.000). The number of met-enkephalin-like immunoreactivity positive neurons in the EA preconditioning rats was more than that of the control rats (P=0.000).Conclusion Repeated EA preconditioning stimulates the release of enkephalins, which may bind δ- and μ-opioid receptors to induce the tolerance against focal cerebral ischemia.

  11. Prediction of clinical outcome with baseline and 24-hour perfusion CT in acute middle cerebral artery territory ischemic stroke treated with intravenous recanalization therapy

    International Nuclear Information System (INIS)

    We sought to determine whether Alberta Stroke Program Early CT Scores (ASPECTS) derived from baseline noncontrast CT (NCCT) and perfusion CT (CTP) imaging maps can predict clinical outcome after recanalization therapy in acute ischemic stroke of the middle cerebral artery (MCA) territory and whether changes in the ASPECTS from baseline to 24 h after recanalization therapy can help predict clinical outcome. We retrospectively studied consecutive patients with acute ischemic stroke of the MCA territory treated with intravenous tissue plasminogen activator (t-PA) or abciximab within 6 h of symptom onset. We performed NCCT and CTP before and 24 h after intravenous t-PA or abciximab treatment and determined the ASPECTS and the changes in the ASPECTS from baseline to 24 h. A favorable outcome was defined as a modified Rankin scale score of 0 or 1 at 3 months. During the 18-month study period 44 patients were studied. In multivariate logistic regression analysis, the cerebral blood volume (CBV) ASPECTS (OR 1.80, 95% CI 1.10 to 2.93) at baseline and the increase in cerebral blood flow (CBF) ASPECTS (OR 1.68, 95% CI 1.13 to 2.50) from baseline to 24 h were associated with a favorable outcome. The cutoff values for a favorable outcome using receiver operating characteristic curves were 8 and 1, respectively. When the CBV ASPECTS at baseline was 8 or more, its positive predictive value was only 58.1%. When the CBV ASPECTS at baseline was 8 or more and the increase in CBF ASPECTS from baseline to 24 h was 1 or more, the positive predictive value was 100% and the negative predictive value was 74.2%. The CBV ASPECTS derived from baseline CTP maps was found to be predictive of a favorable outcome, but its positive predictive value was suboptimal. The change in the CBF ASPECTS from baseline to 24 h after treatment was helpful in predicting outcome. (orig.)

  12. Cerebrolysin adjuvant treatment in Broca's aphasics following first acute ischemic stroke of the left middle cerebral artery

    OpenAIRE

    Jianu, DC; Muresanu, DF; Bajenaru, O; Popescu, BO; Deme, SM; Moessler, H; Meinzingen, SZ; Petrica, L; Serpe, M; Ursoniu, S.

    2010-01-01

    Background: The aim of our study was to assess the efficacy of Cerebrolysin administration in Broca's aphasics with acute ischemic stroke. Methods: We registered 2,212 consecutive Broca's aphasics following an acute ischemic stroke admitted in four departments of neurology in Romania, between September 2005 and September 2009. Language was evaluated with the Romanian version of the Western Aphasia Battery (WAB). The following inclusion criteria were used for this study: age 20%75 years, admis...

  13. Autophagy protects human brain microvascular endothelial cells against methylglyoxal-induced injuries, reproducible in a cerebral ischemic model in diabetic rats.

    Science.gov (United States)

    Fang, Lili; Li, Xue; Zhong, Yinbo; Yu, Jing; Yu, Lina; Dai, Haibin; Yan, Min

    2015-10-01

    Cerebral microvascular endothelial cells (ECs) are crucial for brain vascular repair and maintenance, but their physiological function may be impaired during ischemic stroke and diabetes. Methylglyoxal (MGO), a reactive dicarbonyl produced during glucose metabolism, could exacerbate ischemia-induced EC injury and dysfunction. We investigated the protective effect of autophagy on cultured human brain microvascular endothelial cells (HBMEC) that underwent MGO treatment. A further study was conducted to explore the underlying mechanisms of the protective effect. Autophagic activity was assessed by evaluating protein levels, using western blot. 3-methyladenine (3-MA), bafilomycin A1, ammonium chloride (AC), Beclin 1 siRNA, and chloroquine (CQ) were used to cause autophagy inhibition. Alarmar blue assay and lactate dehydrogenase release assay were used to evaluate cell viability. Streptozotocin was administered to induce type I diabetes in rats and post-permanent middle cerebral artery occlusion was performed to elicit cerebral ischemia. Blood-brain barrier permeability was also assessed. Our study found that MGO reduced HBMEC cell viability in a concentration- and time-dependent manner, and triggered the responsive autophagy activation. Autophagy inhibitors bafilomycin A1, AC, 3-MA, and BECN1 siRNA exacerbated MGO-induced HBMEC injury. FAK phosphorylation inhibitor PF573228 inhibited MGO-triggered autophagy and enhanced lactate dehydrogenase release. Meanwhile, similar autophagy activation in brain vascular ECs was observed during permanent middle cerebral artery occlusion-induced cerebral ischemia in diabetic rats, while chloroquine-induced autophagy inhibition enhanced blood-brain barrier permeability. Taken together, our study indicates that autophagy triggered by MGO defends HBMEC against injuries. PMID:26251121

  14. Effect of electroacupuncture on synaptic transmission in dentate gyrus of the hippocampus in cerebral ischemic injured rats

    Institute of Scientific and Technical Information of China (English)

    Haibo Yu; Zhuoxin Yang; Ling Wang; Min Pi; Jiawei Zhang

    2006-01-01

    BACKGROUND: Some studies suggest that the long-term potentiation (LTP) of synaptic transmission may be the basis for the neural synaptic plasticity of hippocampus, but can be evoked by various factors including electroacupuncture.OBJECTIVE: To observe the effect of electroacupuncture on the activities of basic synaptic transmission in dentate gyrus of hippocampus and the changes of high frequency stimulation (HFS) induced activity of synaptic transmission in cerebral ischemic injured rats.DESIGN: A randomized control trial.SETTING: Shenzhen Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine.MATERIALS: Sixty healthy male Wistar rats, weighing 150-250 g, were provided by the Experimental Animal Center of Guangzhou University of Traditional Chinese Medicine. The experiment began after adaptation of environment for 1 week under standard experimental environment. The main experimental instruments included the programming electrical acupuncture apparatus (PCEA, product of the Institute of Acupuncture and Meridians, Anhui College of Traditional Chinese Medicine) and multichannel physiologic recorder (RM-86, Nihon Konden).METHODS: The experiment was carried out in Guangzhou University of Traditional Chinese Medicine between July 2003 and July 2004. ① Embedding of brain electrodes: In reference of the Pellegrino's rat brain atlas, the bipolar electrode stimulator was embedded into the perforant path (PP) anterior to the entorhinal area with location coordinates of AP 7.5 mm, L 4.2 mm and H 3.0 mm, that is, 7.5 mm posterior to the anterior fontanelle, 4.2 mm laterally on the right side and 3.0 mm under the subcortex. The subcortex recorder electrode coordinates are AP 3.8 mm, L 2.5 mm and H 3.5 mm, located in the granular cell layer of the unilateral dentate gyrus (DG) of hippocampus, at the site of which an opening with the diameter of 1.5 mm was drilled for the purpose of embedding of the stimulating and recording

  15. Local cerebral blood flow (1CBF) and oxygen consumption (1CMRO2) in evolving irreversible ischemic infarction: a study with positron tomography and oxygen-15

    International Nuclear Information System (INIS)

    In 25 patients suffering from cerebral ischemia set up in the area of the internal carotid artery the local cerebral blood flow (lCBF) and local cerebral oxygen consumption (lCMRO2) were measured by the method of continuous inhalation of oxygen 15-labelled gas combined with positron emission tomography. These two local parameters and their ratio, the local oxygen extraction rate (lO2E), were studied inside the brain region tending spontaneously towards ischemic necrosis, a zone defined by means of repeated tomodensitometric examinations. The essential facts observed are the variability of the lCBF and the lO2E values, from extremely low to extremely high, whereas the collapse of the lCMRO2 is constant. Consequently this last parameter alone would be a good prognostic index, an lCMRO2 decrease to a level below about 70% of the controlateral value indicating that the necrosis is spontaneously irreparable. These results are discussed in the light of published data

  16. NADPH Oxidase Activity in Cerebral Arterioles Is a Key Mediator of Cerebral Small Vessel Disease—Implications for Prevention

    Directory of Open Access Journals (Sweden)

    Mark F. McCarty

    2015-04-01

    Full Text Available Cerebral small vessel disease (SVD, a common feature of brain aging, is characterized by lacunar infarcts, microbleeds, leukoaraiosis, and a leaky blood-brain barrier. Functionally, it is associated with cognitive decline, dementia, depression, gait abnormalities, and increased risk for stroke. Cerebral arterioles in this syndrome tend to hypertrophy and lose their capacity for adaptive vasodilation. Rodent studies strongly suggest that activation of Nox2-dependent NADPH oxidase activity is a crucial driver of these structural and functional derangements of cerebral arterioles, in part owing to impairment of endothelial nitric oxide synthase (eNOS activity. This oxidative stress may also contribute to the breakdown of the blood-brain barrier seen in SVD. Hypertension, aging, metabolic syndrome, smoking, hyperglycemia, and elevated homocysteine may promote activation of NADPH oxidase in cerebral arterioles. Inhibition of NADPH oxidase with phycocyanobilin from spirulina, as well as high-dose statin therapy, may have potential for prevention and control of SVD, and high-potassium diets merit study in this regard. Measures which support effective eNOS activity in other ways—exercise training, supplemental citrulline, certain dietary flavonoids (as in cocoa and green tea, and capsaicin, may also improve the function of cerebral arterioles. Asian epidemiology suggests that increased protein intakes may decrease risk for SVD; conceivably, arginine and/or cysteine—which boosts tissue glutathione synthesis, and can be administered as N-acetylcysteine—mediate this benefit. Ameliorating the risk factors for SVD—including hypertension, metabolic syndrome, hyperglycemia, smoking, and elevated homocysteine—also may help to prevent and control this syndrome, although few clinical trials have addressed this issue to date.

  17. Effect of the antibody of brain-derived neurotrophic factor on the rat with ischemic injury from obstruction of middle cerebral artery%脑源性神经营养因子抗体对大脑中动脉阻塞大鼠缺血损伤的影响

    Institute of Scientific and Technical Information of China (English)

    陈英辉; 王根发; 陈兴华; 姚革; 陈伟; 周永炜

    2003-01-01

    AIM:To observe the effect of the antibody of brain derived neurotrophic factor(BDNF) by cortical microinjection on hippocampal ischemic injury rats.METHODS:Preparation of local cerebral ischemic reperfusion injury model: cortical stereostaxic approach, microinjection of BDNF antibody. Applied immunohistochemical method to observe distribution of BDNF in cortex after injection of the antibody,to observe the alteration of ischemic injury between control group and BDNF antibody group.RESULT: The volume of cerebral infarction in BDNF antibody group was larger than control group.CONCLUSION: BDNF has protection function for cerebral ischemia.

  18. Delayed hippocampal neuronal death in young gerbil following transient global cerebral ischemia is related to higher and longer-term expression of p63 in the ischemic hippocampus

    Directory of Open Access Journals (Sweden)

    Eun Joo Bae

    2015-01-01

    Full Text Available The tumor suppressor p63 is one of p53 family members and plays a vital role as a regulator of neuronal apoptosis in the development of the nervous system. However, the role of p63 in mature neuronal death has not been addressed yet. In this study, we first compared ischemia-induced effects on p63 expression in the hippocampal regions (CA1- 3 between the young and adult gerbils subjected to 5 minutes of transient global cerebral ischemia. Neuronal death in the hippocampal CA1 region of young gerbils was significantly slow compared with that in the adult gerbils after transient global cerebral ischemia. p63 immunoreactivity in the hippocampal CA1 pyramidal neurons in the sham-operated young group was significantly low compared with that in the sham-operated adult group. p63 immunoreactivity was apparently changed in ischemic hippocampal CA1 pyramidal neurons in both ischemia-operated young and adult groups. In the ischemia-operated adult groups, p63 immunoreactivity in the hippocampal CA1 pyramidal neurons was significantly decreased at 4 days post-ischemia; however, p63 immunoreactivity in the ischemia-operated young group was significantly higher than that in the ischemia-operated adult group. At 7 days post-ischemia, p63 immunoreactivity was decreased in the hippocampal CA1 pyramidal neurons in both ischemia-operated young and adult groups. Change patterns of p63 level in the hippocampal CA1 region of adult and young gerbils after ischemic damage were similar to those observed in the immunohistochemical results. These findings indicate that higher and longer-term expression of p63 in the hippocampal CA1 region of the young gerbils after ischemia/reperfusion may be related to more delayed neuronal death compared to that in the adults.

  19. A Pilot Study for the Neuroprotective Effect of Gongjin-dan on Transient Middle Cerebral Artery Occlusion-Induced Ischemic Rat Brain

    Directory of Open Access Journals (Sweden)

    Yun-Young Sunwoo

    2012-01-01

    Full Text Available In this study, we investigated whether gongjin-dan improves functional recovery and has neuroprotective effects on reducing the infarct volume after transient middle cerebral artery occlusion (MCAo. Infarct volume was measured using TTC staining and glucose utilization by F-18 FDG PET. Functional improvement was evaluated with the Rota-rod, treadmill, Garcia score test, and adhesive removal test. At 14 days after MCAo, neuronal cell survival, astrocytes expansion, and apoptosis were assessed by immunohistofluorescence staining in the peri-infarct region. Also, the expression of neurotrophic factors and inflammatory cytokines such as VEGF, BDNF, Cox-2, TNF-α, IL-1β, and IL-1α was measured in ischemic hemisphere regions. The gongjin-dan-treated group showed both reduced infarct volume and increased glucose utilization. Behavior tests demonstrated a significant improvement compared to the control. Also in the gongjin-dan treated group, NeuN-positive cells were increased and number of astrocytes, microglia, and apoptotic cells was significantly decreased compared with the control group in the ischemic peri-infarct area. Furthermore, the expression of VEGF and BDNF was increased and level of Cox-2, TNF-α, IL-1β, and IL-1α was decreased. These results suggest that gongjin-dan may improve functional outcome through the rapid restoration of metabolism and can be considered as a potential neuroprotective agent.

  20. Treatment for cerebral small vessel disease: effect of relaxin on the function and structure of cerebral parenchymal arterioles during hypertension.

    Science.gov (United States)

    Chan, Siu-Lung; Sweet, Julie G; Cipolla, Marilyn J

    2013-10-01

    We investigated the effect of hypertension on the function and structure of cerebral parenchymal arterioles (PAs), a major target of cerebral small vessel disease (SVD), and determined whether relaxin is a treatment for SVD during hypertension. PAs were isolated from 18-wk-old female normotensive Wistar-Kyoto (WKY) rats, spontaneous hypertensive rats (SHRs), and SHRs treated with human relaxin 2 for 14 d (4 μg/h; n=8/group) and studied using a pressurized arteriograph system. Hypertension reduced PA inner diameter (58±3 vs. 49±3 μm at 60 mmHg in WKY rats, Prelaxin (56±4 μm, PRelaxin also increased PA distensibility in SHRs (34±2 vs. 10±2% in SHRs, PRelaxin was detected in cerebrospinal fluid (110±30 pg/ml) after systemic administration, suggesting that it crosses the blood-brain barrier (BBB). Relaxin receptors (RXFP1/2) were not detected in cerebral vasculature, but relaxin increased vascular endothelial growth factor (VEGF) and matrix metalloproteinase 2 (MMP-2) expression in brain cortex. Inhibition of VEGF receptor tyrosine kinase (axitinib, 4 mg/kg/d, 14 d) had no effect on increased distensibility with relaxin, but caused outward hypertrophic remodeling of PAs from SHRs. These results suggest that relaxin crosses the BBB and activates MMP-2 in brain cortex, which may interact with PAs to increase distensibility. VEGF appears to be involved in remodeling of PAs, but not relaxin-induced increased distensibility. PMID:23783073

  1. First Autologous Cord Blood Therapy for Pediatric Ischemic Stroke and Cerebral Palsy Caused by Cephalic Molding during Birth: Individual Treatment with Mononuclear Cells

    Science.gov (United States)

    Hamelmann, E.

    2016-01-01

    Intracranial laceration due to traumatic birth injury is an extremely rare event affecting approximately one newborn per a population of 4.5 million. However, depending on the mode of injury, the resulting brain damage may lead to lifelong sequelae, for example, cerebral palsy for which there is no cure at present. Here we report a rare case of neonatal arterial ischemic stroke and cerebral palsy caused by fetal traumatic molding and parietal depression of the head during delivery caused by functional cephalopelvic disproportion due to a “long pelvis.” This patient was treated by autologous cord blood mononuclear cells (45.8 mL, cryopreserved, TNC 2.53 × 10e8) with a remarkable recovery. Active rehabilitation was provided weekly. Follow-up examinations were at 3, 18, 34, and 57 months. Generous use of neonatal head MRI in case of molding, craniofacial deformity, and a sentinel event during parturition is advocated to enhance diagnosis of neonatal brain damage as a basis for fast and potentially causative treatment modalities including autologous cord blood transplantation in a timely manner. PMID:27239361

  2. Mapping of cerebral metabolic rate of oxygen using dynamic susceptibility contrast and blood oxygen level dependent MR imaging in acute ischemic stroke

    International Nuclear Information System (INIS)

    MR-derived cerebral metabolic rate of oxygen utilization (CMRO2) has been suggested to be analogous to PET-derived CMRO2 and therefore may be used for detection of viable tissue at risk for infarction. The purpose of this study was to evaluate MR-derived CMRO2 mapping in acute ischemic stroke in relation to established diffusion- and perfusion-weighted imaging. In 23 patients (mean age 63 ± 18.7 years, 11 women) with imaging findings for acute ischemic stroke, relative oxygen extraction fraction was calculated from quantitative transverse relaxation times (T2, T2*) and relative cerebral blood volume using a quantitative blood oxygenation level dependent (BOLD) approach in order to detect a local increase of deoxyhemoglobin. Relative CMRO2 (rCMRO2) maps were calculated by multiplying relative oxygen extraction fraction (rOEF) by cerebral blood flow, derived from PWI. After co-registration, rCMRO2 maps were evaluated in comparison with apparent diffusion coefficient (ADC) and time-to-peak (TTP) maps. Mean rCMRO2 values in areas with diffusion-restriction or TTP/ADC mismatch were compared with rCMRO2 values in the contralateral tissue. In tissue with diffusion restriction, mean rCMRO2 values were significantly decreased compared to perfusion-impaired (17.9 [95 % confidence interval 10.3, 25.0] vs. 58.1 [95 % confidence interval 50.1, 70.3]; P < 0.001) and tissue in the contralateral hemisphere (68.2 [95 % confidence interval 61.4, 75.0]; P < 0.001). rCMRO2 in perfusion-impaired tissue showed no significant change compared to tissue in the contralateral hemisphere (58.1 [95 % confidence interval 50.1, 70.3] vs. 66.7 [95 % confidence interval 53.4, 73.4]; P = 0.34). MR-derived CMRO2 was decreased within diffusion-restricted tissue and stable within perfusion-impaired tissue, suggesting that this technique may be adequate to reveal different pathophysiological stages in acute stroke. (orig.)

  3. Mapping of cerebral metabolic rate of oxygen using dynamic susceptibility contrast and blood oxygen level dependent MR imaging in acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Gersing, Alexandra S.; Schwaiger, Benedikt J. [Technical University Munich, Klinikum rechts der Isar, Department of Neuroradiology, Munich (Germany); University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Ankenbrank, Monika; Toth, Vivien; Bauer, Jan S.; Zimmer, Claus [Technical University Munich, Klinikum rechts der Isar, Department of Neuroradiology, Munich (Germany); Janssen, Insa [Technical University Munich, Department of Neurosurgery, Munich (Germany); Kooijman, Hendrik [Philips Healthcare, Hamburg (Germany); Wunderlich, Silke [Technical University Munich, Department of Neurology, Munich (Germany); Preibisch, Christine [Technical University Munich, Klinikum rechts der Isar, Department of Neuroradiology, Munich (Germany); Technical University Munich, Department of Neurology, Munich (Germany)

    2015-12-15

    MR-derived cerebral metabolic rate of oxygen utilization (CMRO{sub 2}) has been suggested to be analogous to PET-derived CMRO{sub 2} and therefore may be used for detection of viable tissue at risk for infarction. The purpose of this study was to evaluate MR-derived CMRO{sub 2} mapping in acute ischemic stroke in relation to established diffusion- and perfusion-weighted imaging. In 23 patients (mean age 63 ± 18.7 years, 11 women) with imaging findings for acute ischemic stroke, relative oxygen extraction fraction was calculated from quantitative transverse relaxation times (T2, T2*) and relative cerebral blood volume using a quantitative blood oxygenation level dependent (BOLD) approach in order to detect a local increase of deoxyhemoglobin. Relative CMRO{sub 2} (rCMRO{sub 2}) maps were calculated by multiplying relative oxygen extraction fraction (rOEF) by cerebral blood flow, derived from PWI. After co-registration, rCMRO{sub 2} maps were evaluated in comparison with apparent diffusion coefficient (ADC) and time-to-peak (TTP) maps. Mean rCMRO{sub 2} values in areas with diffusion-restriction or TTP/ADC mismatch were compared with rCMRO{sub 2} values in the contralateral tissue. In tissue with diffusion restriction, mean rCMRO{sub 2} values were significantly decreased compared to perfusion-impaired (17.9 [95 % confidence interval 10.3, 25.0] vs. 58.1 [95 % confidence interval 50.1, 70.3]; P < 0.001) and tissue in the contralateral hemisphere (68.2 [95 % confidence interval 61.4, 75.0]; P < 0.001). rCMRO{sub 2} in perfusion-impaired tissue showed no significant change compared to tissue in the contralateral hemisphere (58.1 [95 % confidence interval 50.1, 70.3] vs. 66.7 [95 % confidence interval 53.4, 73.4]; P = 0.34). MR-derived CMRO{sub 2} was decreased within diffusion-restricted tissue and stable within perfusion-impaired tissue, suggesting that this technique may be adequate to reveal different pathophysiological stages in acute stroke. (orig.)

  4. Gene interference regulates aquaporin-4 expression in swollen tissue of rats with cerebral ischemic edema Correlation with variation in apparent diffusion coefficient

    Institute of Scientific and Technical Information of China (English)

    Hui Hu; Hong Lu; Zhanping He; Xiangjun Han; Jing Chen; Rong Tu

    2012-01-01

    To investigate the effects of mRNA interference on aquaporin-4 expression in swollen tissue of rats with ischemic cerebral edema, and diagnose the significance of diffusion-weighted MRI, we injected 5 μL shRNA- aquaporin-4 (control group) or siRNA- aquaporin-4 solution (1:800) (RNA interference group) into the rat right basal ganglia immediately before occlusion of the middle cerebral artery. At 0.25 hours after occlusion of the middle cerebral artery, diffusion-weighted MRI displayed a high signal; within 2 hours, the relative apparent diffusion coefficient decreased markedly, aquaporin-4 expression increased rapidly, and intracellular edema was obviously aggravated; at 4 and 6 hours, the relative apparent diffusion coefficient slowly returned to control levels, aquaporin-4 expression slightly increased, and angioedema was observed. In the RNA interference group, during 0.25- 6 hours after injection of siRNA- aquaporin-4 solution, the relative apparent diffusion coefficient slightly fluctuated and aquaporin-4 expression was upregulated; during 0.5-4 hours, the relative apparent diffusion coefficient was significantly higher, while aquaporin-4 expression was significantly lower when compared with the control group, and intracellular edema was markedly reduced; at 0.25 and 6 hours, the relative apparent diffusion coefficient and aquaporin-4 expression were similar when compared with the control group; obvious angioedema remained at 6 hours. Pearson's correlation test results showed that aquaporin-4 expression was negatively correlated with the apparent diffusion coefficient (r = -0.806, P < 0.01). These findings suggest that upregulated aquaporin-4 expression is likely to be the main molecular mechanism of intracellular edema and may be the molecular basis for decreased relative apparent diffusion coefficient. Aquaporin-4 gene interference can effectively inhibit the upregulation of aquaporin-4 expression during the stage of intracellular edema with time

  5. Simvastatin Reduces Lipopolysaccharides-Accelerated Cerebral Ischemic Injury via Inhibition of Nuclear Factor-kappa B Activity

    OpenAIRE

    Anthony Jalin, Angela M. A.; Lee, Jae-Chul; CHO, GEUM-SIL; Kim, Chunsook; Ju, Chung; Pahk, Kisoo; Song, Hwa Young; Kim, Won-Ki

    2015-01-01

    Preceding infection or inflammation such as bacterial meningitis has been associated with poor outcomes after stroke. Previously, we reported that intracorpus callosum microinjection of lipopolysaccharides (LPS) strongly accelerated the ischemia/reperfusion-evoked brain tissue damage via recruiting inflammatory cells into the ischemic lesion. Simvastatin, 3-hydroxy-3-methylgultaryl (HMG)-CoA reductase inhibitor, has been shown to reduce inflammatory responses in vascular diseases. Thus, we in...

  6. Reduction of mitochondrial electron transport complex activity is restricted to the ischemic focus after transient focal cerebral ischemia in rats

    DEFF Research Database (Denmark)

    Christensen, Thomas; Diemer, Nils Henrik

    2003-01-01

    the ipsilateral cortex and caudate putamen were measured by densitometric image analysis. Reductions in complex I, II, and IV activity were restricted to areas in the ischemic foci in cortex and caudate putamen, which microscopically displayed signs of early morphological damage. In cortex, the tissue...... volume with reduced activity did not change significantly during reperfusion but progressively increased in the caudate putamen, possibly reflecting a faster maturation of morphological damage in this region. Treatment with alpha-PBN did not affect the observed reductions in activities. We deduce that...... inhibition of mitochondrial ETC complex activity does not play a critical role for recruitment of the penumbra in the infarction process....

  7. Eye-Movement Training Results in Changes in qEEG and NIH Stroke Scale in Subjects Suffering from Acute Middle Cerebral Artery Ischemic Stroke: A Randomized Control Trial

    OpenAIRE

    Carrick, Frederick Robert; Oggero, Elena; Pagnacco, Guido; Wright, Cameron H. G.; Machado, Calixto; Estrada, Genco; Pando, Alejandro; Cossio, Juan C.; Beltrán, Carlos

    2016-01-01

    Context Eye-movement training (EMT) can induce altered brain activation and change the functionality of saccades with changes of the brain in general. Objective To determine if EMT would result in changes in quantitative electroencephalogram (qEEG) and NIH Stroke Scale (NIHSS) in patients suffering from acute middle cerebral artery (MCA) infarction. Our hypothesis is that there would be positive changes in qEEG and NIHSS after EMT in patients suffering from acute MCA ischemic strok...

  8. Endothelial dysfunction is associated with the severity of cerebral small vessel disease.

    Science.gov (United States)

    Nezu, Tomohisa; Hosomi, Naohisa; Aoki, Shiro; Kubo, Satoshi; Araki, Mutsuko; Mukai, Tomoya; Takahashi, Tetsuya; Maruyama, Hirofumi; Higashi, Yukihito; Matsumoto, Masayasu

    2015-04-01

    The pathogenesis of cerebral small vessel disease, a disease that involves white matter lesions (WMLs) and cerebral microbleeds (CMBs), is thought to be associated with endothelial dysfunction. Flow-mediated dilation (FMD) has been used to measure endothelium-dependent vasodilation. The aim of this study was to investigate the association between endothelial function (as measured by FMD) and cerebral small vessel disease. Patients with a history of cerebrovascular disease and comorbidities were enrolled in this study (n=102; 69 males, 70.1±9.2 years). The patients were divided into two groups according to the severity of WMLs, which were assessed by Fazekas classification; grades 0 to 1 as mild WMLs group and grades 2 to 3 as severe WMLs group. A gradient-echo MRI was performed in 96 patients (94.1%) to evaluate whether CMBs were present. The patients in the severe WMLs group (n=40) were older (P=0.001), more frequently exhibited hypertension (P=0.045) and diabetes mellitus (P=0.026) and possessed lower FMD values (PFMD cutoff values for predicting the presence of severe WMLs and CMBs were 3.9% and 3.7%, respectively. On multivariate logistic analysis, FMD FMD dysfunction as evaluated by FMD may be predictive of the severity of cerebral small vessel disease. PMID:25672660

  9. Role of Centella asiatica on cerebral post-ischemic reperfusion and long-term hypoperfusion in rats

    Directory of Open Access Journals (Sweden)

    Raghavendra M

    2009-01-01

    Full Text Available Centella asiatica (CA, a well known adaptogenic agent in Indian system of Medicine (Ayurveda, is believed to have beneficial effects in improving memory, treating anxiety and eczema. It also possesses antioxidant, cognitive enhancing and antiepileptic properties. Acute ischemia followed by reperfusion is known to bring about biochemical and histopathological alterations. In the present study the effect of Centella asiatica on acute cerebral reperfusion and long-term cerebral hypoperfusion in rats was investigated. Transient cerebral ischemia was induced under Ketamine anaesthesia by blocking bilateral common carotid arteries (BCCAO for 30 min and then reperfusion was allowed for 45 min by releasing the block. Lipid peroxidation, superoxide dismutase (SOD and brain protein were estimated, behavioral and histopathological studies were done for both acute ischemia-reperfusion and chronic hypoperfusion studies. One way ANOVA followed by post hoc Tukey test was used. In the present study, acute ischemia-reperfusion induced increases in lipid peroxidation and superoxide SOD activity. CA pre-treatment (100 mg/kg p.o. for 5 days attenuated the reperfusion induced biochemical alterations. Long-term cerebral hypoperfusion in rats caused a propensity towards anxiety and listlessness (open field paradigm and elevated plus maze test accompanied by deficits in learning and memory (Morris′ water maze testing and tendency towards depression (Porsolts swim test. Additionally, histopathological observations in forebrain revealed changes like gliosis, astrocytosis, cellular edema and inflammatory changes. CA treatment (100 mg/kg p.o. for 28 days alleviated these behavioral, cognitive and histopathological changes. The results suggest that CA may be useful in cerebrovascular insufficiency conditions.

  10. Detection of white matter lesions in cerebral small vessel disease

    Science.gov (United States)

    Riad, Medhat M.; Platel, Bram; de Leeuw, Frank-Erik; Karssemeijer, Nico

    2013-02-01

    White matter lesions (WML) are diffuse white matter abnormalities commonly found in older subjects and are important indicators of stroke, multiple sclerosis, dementia and other disorders. We present an automated WML detection method and evaluate it on a dataset of small vessel disease (SVD) patients. In early SVD, small WMLs are expected to be of importance for the prediction of disease progression. Commonly used WML segmentation methods tend to ignore small WMLs and are mostly validated on the basis of total lesion load or a Dice coefficient for all detected WMLs. Therefore, in this paper, we present a method that is designed to detect individual lesions, large or small, and we validate the detection performance of our system with FROC (free-response ROC) analysis. For the automated detection, we use supervised classification making use of multimodal voxel based features from different magnetic resonance imaging (MRI) sequences, including intensities, tissue probabilities, voxel locations and distances, neighborhood textures and others. After preprocessing, including co-registration, brain extraction, bias correction, intensity normalization, and nonlinear registration, ventricle segmentation is performed and features are calculated for each brain voxel. A gentle-boost classifier is trained using these features from 50 manually annotated subjects to give each voxel a probability of being a lesion voxel. We perform ROC analysis to illustrate the benefits of using additional features to the commonly used voxel intensities; significantly increasing the area under the curve (Az) from 0.81 to 0.96 (p<0.05). We perform the FROC analysis by testing our classifier on 50 previously unseen subjects and compare the results with manual annotations performed by two experts. Using the first annotator results as our reference, the second annotator performs at a sensitivity of 0.90 with an average of 41 false positives per subject while our automated method reached the same

  11. Monitoring stem cell transplantation in rat cerebral ischemic infarction model with 131I-FIAU/TK reporter gene system

    International Nuclear Information System (INIS)

    Objective: To study the biodistribution of 131I-2'-deoxy-1-β-D-arabinofuranosyl-5-iodouracil (FIAU) in the rat middle cerebral artery occlusion model and the expression of thymidine kinase (TK) gene in brain tissue after gene-modified stem cell transplantation, and thus evaluate the possibility of further noninvasive monitoring of stem cell transplantation therapy in cerebral infarction. Methods: Adenovirus recombinant Ad5-TK-internal ribosome entry site-brain derived heterotrophic factor-enhanced green florescent protein(IRES-BDNF-EGFP) carrying TK-IRES-BDNF gene was prepared. Cerebral infarction model was established in rats by intraluminal middle cerebral artery occlusion with nylon monofilament. Gene modified bone marrow mesenchymal stem cells were transplanted via intraparenchymal route, lateral ventricle, carotid artery and tail vein, respectively. The normal rats were used as controls. 131I-FAU was prepared to be the tracer for biodistribution study and the % ID/g was calculated based on measurement of the tissue radioactivity counts. The expression of TK gene was evaluated by quantitative real-time PCR (QR-PCR) and Western blot analysis. Data were analyzed with independent-samples t-test, one-way analysis of variance (ANOVA) test, and Pearson linear correlation test. Results: The % ID/g of infarcted brain tissue in the intraparenchymal group was 0.124 ± 0.013, which was significantly higher than that in lateral ventricle group (0.052 ±0.004), carotid artery group (0.061 ±0.002), tail vein group (0.059 ±0.005) and control group (0.005 ±0.001) (t=2.913-5.652, all P<0.05), while there were no statistically significant differences among the other route transplanted groups (t=0.694-1.448, all P>0.05). The differences of % ID/g between the infarcted and contralateral sides of brain tissue in all transplanted groups were statistically significant (t=9.004-15.734, all P<0.05), while there was no statistically significant difference of this parameter

  12. Clinical Neuroimaging of cerebral ischemia

    International Nuclear Information System (INIS)

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  13. S100B and acute ischemic cerebral injury%S100B与急性缺血性脑损伤

    Institute of Scientific and Technical Information of China (English)

    余周伟; 毕桂南

    2011-01-01

    S100B is a class of acid calcium-binding protein. It mainly exists in neuroglial cells in the central nervous system, and it is one of the signs of astrocyte activation. S100B may reflect the function of neuroglial cells and regulate the complex interactions between the neurons and neuroglial cells. Studies in recent years have demonstrated that S100B protein is involved in the pathological processes of acute ischemic brain injury. Serum S100B protein can be used as an important marker for identifying the severity of cerebral infarction, progress and outcome.%S100B是一类酸性钙结合蛋白,在中枢神经系统中主要存在于胶质细胞,是星形胶质细胞活化的标志之一.S100B可反映胶质细胞的功能,调节神经元与胶质细胞之间复杂的相互作用.近年来的研究显示,S100B蛋白参与了急性缺血性脑损伤的病理学过程,血清S100B蛋白可作为预测脑梗死严重程度、进展以及转归的标记物.

  14. Ischemic strokes and migraine

    International Nuclear Information System (INIS)

    Lasting neurological deficits, though most infrequent, do occur in migrainous subjects and are well documented by clinical angiographic computed tomographic (CT scan) and even pathological studies. However the mechanism of cerebral ischemia in migraine remains widely unknown and the precise role of migraine in the pathogenesis of ischemic strokes is still debated. (orig./MG)

  15. Improved Estimation of Local Cerebral Glucose Metabolic Rate Using Bayes Regression Analysis of PET Scan Data

    OpenAIRE

    Wilson, P D; Huang, S. C.; Links, J M

    1984-01-01

    The current method for measurement of local cerebral metabolic rate of glucose (LCMRG) has relatively small errors when applied to normal healthy tissue. But when applied to ischemic regions in brains of stroke patients, the method gives estimates which average about 50% too low. Here we introduce a modified Bayes Regression (BR) to compute LCMRG, and use computer simulation studies to demonstrate that BR has relatively small errors for either ischemic or normal tissue.

  16. 短暂性脑缺血发作进展为脑梗死相关因素的临床分析%Transient ischemic attack clinical analysis of correlative factors of cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    郎凤东; 任芳

    2013-01-01

      Objective To investigate the effect of transient ischemic attack(TIA) the factors responsible for the development of cerebral infarction. Methods 143 patients with transient cerebral ischemia in our hospital from 2010 March-2013 year in January the attack patients as the object of study, retrospective analysis of the clinical data of their. Results By analyzing the clinical data of 143 cases of patients in the analysis, patient gender, history of coronary heart disease, alcohol and tobacco, hyperlipemia and transient ischemic attack of cerebral infarction and no significant association(P >0.05); patients age, diabetes, hypertension and cerebral artery stenosis in patients with transient cerebral ischemia cerebral infarction has a significant association(P 0.05);高龄、糖尿病、高血压及脑动脉狭窄等有显著性关联(P <0.05);发作频率在3次/d以上、有严重神经功能缺损、发作时间持续高于30min的患者,其TIA进展为脑梗死显著性增高(P <0.05)。结论 TIA进展为脑梗死是由多种因素共同作用的结果,尤其与病患年龄较高,患有糖尿病、高血压、脑动脉狭窄及发作频率过高等有关,值得临床重点关注。

  17. Effects of JPEG data compression on magnetic resonance imaging evaluation of small vessels ischemic lesions of the brain

    International Nuclear Information System (INIS)

    Objective: to establish the maximum achievable JPEG compression ratio without affecting quantitative and qualitative magnetic resonance imaging analysis of ischemic lesion in small vessels of the brain. Material and method: fifteen DICOM images were converted to JPEG with a compression ratio of 1:10 to 1:60 and were assessed together with the original images by three neuro radiologists. The number, morphology and signal intensity of the lesions were analyzed. Results: lesions were properly identified up to a 1:30 ratio. More lesions were identified with a 1:10 ratio then in the original images. Morphology and edges were properly evaluated up toa 1:40 ratio. Compression did not affect signal. Conclusion: small lesions were identified ( < 2 mm ) and in all compression ratios the JPEG algorithm generated image noise that misled observers to identify more lesions in JPEG images then in DICOM images, thus generating false-positive results.(author)

  18. Neuroprotective effects of compound FLZ in an ischemic model mediated by improving cerebral blood flow and enhancing Hsp27 expression.

    Science.gov (United States)

    Ma, Bo; Li, Min; Ma, Tao; Liu, Geng-Tao; Zhang, Jianjun

    2016-08-01

    Compound FLZ is a synthetic novel derivate of natural squamosamide, which has potent neuroprotective effects based on our previous study. We are now aiming to investigate the effects of FLZ on cerebral blood flow (CBF), infarct volume, neurological function, heat shock protein 70 (Hsp70), and Hsp27 expression in transient focal ischemia. For this goal, an animal model of middle cerebral artery occlusion (MCAO) for 2h followed by reperfusion was used, and animals received low or high doses of FLZ (150 or 300mg/kg), orally 10min after MCAO onset. The results show that the infarct volume was 32.7% for the vehicle control group, and reduced to 17.6 and 12.8% for the low and high dose FLZ-treated groups, respectively. FLZ treatment also significantly improved the neurobehavioral score from 2.6 in the vehicle control group to 1.0 and 0.9 in the low and high dose groups, respectively. Further, FLZ significantly induced Hsp27 over-expression and reduced over-expression of HSP70, a sensitive marker of acute ischemia, in ipsilateral cortex by a dose-dependent manner. In addition, CBF was quantified using laser-Doppler flowmetry. During ischemia, regional CBF (rCBF) was improved from approximately 30% to over 50% of the baseline and the reperfusion-induced hyperemia was reduced in both FLZ dosage groups. Particularly, high dose FLZ reduced rCBF during hyperemia by 30%. In conclusion, FLZ (150 and 300mg/kg) can significantly reduce the infarct volume and improve neurobehavioral deficits in a rat MCAO model, most likely through improving CBF in the penumbra and enhancing Hsp27 expression. PMID:24675028

  19. Qualidade do cuidado ao acidente vascular cerebral isquêmico no SUS Quality of care for ischemic stroke in the Brazilian Unified National Health System

    Directory of Open Access Journals (Sweden)

    Cristina Lúcia Rocha Cubas Rolim

    2011-11-01

    Full Text Available A taxa de mortalidade hospitalar é uma medida do resultado do cuidado, utilizada como indicador da qualidade do cuidado para o acidente vascular cerebral (AVC. A tomografia computadorizada é o principal método de imagem utilizado para o diagnóstico e condução terapêutica dessa patologia. O objetivo deste artigo é avaliar a qualidade do cuidado hospitalar ao AVC isquêmico (AVCi agudo no SUS, considerando o perfil de gravidade dos casos e a realização de tomografia computadorizada. Análise multivariada foi empregada para ajustar a mortalidade por risco, avaliar o uso de tomografia e classificar o desempenho dos hospitais no período entre abril de 2006 e dezembro de 2007. 16.879 internações foram analisadas. A realização de, pelo menos, um exame de tomografia computadorizada equivaleu a 28,6% das internações. A taxa de mortalidade bruta foi 34,3%, e a taxa ajustada, 31,2%. A realização de exame de tomografia computadorizada apresentou um efeito protetor: OR ajustado de 0,27 para um exame e de 0,32 para a realização de dois exames. A subutilização da tomografia computadorizada é um dos fatores limitantes para a boa prática médica no tratamento do AVCi no SUS.The hospital mortality rate is an outcome measure of care used as an indicator of quality of care for stroke. Computerized tomography is the main imaging method for diagnosing and managing stroke. This study aimed to assess the quality of hospital care for acute ischemic stroke (AIS in the Brazilian Unified National Health System (SUS, considering the severity of cases and use of computerized tomography. Multivariate analysis was used to adjust the mortality risk, evaluate the use of computerized tomography, and rank the performance of hospitals from April 2006 to December 2007. 16,879 admissions were analyzed, and at least one CT scan was performed in 28.6% of the admissions. The crude mortality rate was 34.3%, and the adjusted rate was 31.2%. Performance of a CT

  20. Long-Term Population-Based Cerebral Ischemic Event and Cognitive Outcomes of Direct Oral Anticoagulants Compared With Warfarin Among Long-term Anticoagulated Patients for Atrial Fibrillation.

    Science.gov (United States)

    Jacobs, Victoria; May, Heidi T; Bair, Tami L; Crandall, Brian G; Cutler, Michael J; Day, John D; Mallender, Charles; Osborn, Jeffrey S; Stevens, Scott M; Weiss, J Peter; Woller, Scott C; Bunch, T Jared

    2016-07-15

    Direct oral anticoagulants (DOACs) have been used in clinical practice in the United States for the last 4 to 6 years. Although DOACs may be an attractive alternative to warfarin in many patients, long-term outcomes of use of these medications are unknown. We performed a propensity-matched analysis to report patient important outcomes of death, stroke/transient ischemic attack (TIA), bleeding, major bleeding, and dementia in patients taking a DOAC or warfarin. Patients receiving long-term anticoagulation from June 2010 to December 2014 for thromboembolism prevention with either warfarin or a DOAC were matched 1:1 by index date and propensity score. Multivariable Cox hazard regression was performed to determine the risk of death, stroke/TIA, major bleed, and dementia by the anticoagulant therapy received. A total of 5,254 patients were studied (2,627 per group). Average age was 72.4 ± 10.9 years, and 59.0% were men. Most patients were receiving long-term anticoagulation for AF management (warfarin: 96.5% vs DOAC: 92.7%, p <0.0001). Rivaroxaban (55.3%) was the most commonly used DOAC, followed by apixaban (22.5%) and dabigatran (22.2%). The use of DOACs compared with warfarin was associated with a reduced risk of long-term adverse outcomes: death (p = 0.09), stroke/TIA (p <0.0001), major bleed (p <0.0001), and bleed (p = 0.14). No significant outcome variance was noted in DOAC-type comparison. In the AF multivariable model patients taking DOAC were 43% less likely to develop stroke/TIA/dementia (hazard ratio 0.57 [CI 0.17, 1.97], p = 0.38) than those taking warfarin. Our community-based results suggest better long-term efficacy and safety of DOACs compared with warfarin. DOAC use was associated with a lower risk of cerebral ischemic events and new-onset dementia. PMID:27236255

  1. Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome.

    LENUS (Irish Health Repository)

    Murray, Deirdre M

    2009-09-01

    Despite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24\\/35 (69%), suspicious in 8\\/35 (23%), and pathological in 3\\/35 (8%). All CTGs developed nonreassuring features prior to delivery. Three patterns of fetal heart rate abnormalities were seen: group 1, abnormal CTGs on admission in 11\\/35 (31%); group 2, normal CTGs on admission with gradual deterioration to pathological in 20\\/35 cases (57%); and group 3, normal CTGs on admission with acute sentinel events in 4\\/35 (11.5%). The median (interquartile range) duration between the development of pathological CTGs and delivery was 145 (81, 221) minutes in group 2 and 22 (12, 28) minutes in group 3. There was no correlation between duration of pathological CTG trace and grade of encephalopathy (R = 0.09, P = 0.63) or neurological outcome (P = 0.75). However, the grade of encephalopathy was significantly worse in group 3 (P = 0.001), with a trend to worse outcomes. The majority of infants with HIE have normal CTG traces on admission but develop pathological CTG patterns within hours of delivery. More severe encephalopathy was associated with normal admission CTG and acute sentinel events shortly before delivery.

  2. Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome.

    LENUS (Irish Health Repository)

    Murray, Deirdre M

    2012-01-31

    Despite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24\\/35 (69%), suspicious in 8\\/35 (23%), and pathological in 3\\/35 (8%). All CTGs developed nonreassuring features prior to delivery. Three patterns of fetal heart rate abnormalities were seen: group 1, abnormal CTGs on admission in 11\\/35 (31%); group 2, normal CTGs on admission with gradual deterioration to pathological in 20\\/35 cases (57%); and group 3, normal CTGs on admission with acute sentinel events in 4\\/35 (11.5%). The median (interquartile range) duration between the development of pathological CTGs and delivery was 145 (81, 221) minutes in group 2 and 22 (12, 28) minutes in group 3. There was no correlation between duration of pathological CTG trace and grade of encephalopathy (R = 0.09, P = 0.63) or neurological outcome (P = 0.75). However, the grade of encephalopathy was significantly worse in group 3 (P = 0.001), with a trend to worse outcomes. The majority of infants with HIE have normal CTG traces on admission but develop pathological CTG patterns within hours of delivery. More severe encephalopathy was associated with normal admission CTG and acute sentinel events shortly before delivery.

  3. Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke

    Directory of Open Access Journals (Sweden)

    Hakimelahi Reza

    2012-11-01

    Full Text Available Abstract Background We tested the hypothesis that in patients with occlusion of the terminal internal carotid artery and/or the proximal middle cerebral artery, a diffusion abnormality of 70 ml or less is accompanied by a diffusion/perfusion mismatch of at least 100%. Methods Sixty-eight consecutive patients with terminal ICA and/or proximal MCA occlusions and who underwent diffusion/perfusion MRI within 24 hours of stroke onset were retrospectively identified. DWI and mean transit time (MTT volumes were measured. Prospectively, 48 consecutive patients were identified with the same inclusion criteria. DWI and time to peak (TTP lesion volumes were measured. A large mismatch volume was defined as an MTT or TTP abnormality at least twice the DWI lesion volume. Results In the retrospective study, 49 of 68 patients had a DWI lesion volume ≤ 70 ml (mean 20.2 ml; SEM 2.9 ml. A DWI/MTT mismatch of > 100% was observed in all 49 patients (P  100% was present in all 35 (P  Conclusions Acute stroke patients with major anterior circulation artery occlusion are exceedingly likely to have a major diffusion/perfusion mismatch if the diffusion lesion volume is 70 ml or less. This suggests that physiology-based patient assessments may be made using only vessel imaging and diffusion MRI as a simple alternative to perfusion imaging.

  4. pH-Responsive biodegradable polymeric micelles with anchors to interface magnetic nanoparticles for MR imaging in detection of cerebral ischemic area.

    Science.gov (United States)

    Yang, Hong Yu; Jang, Moon-Sun; Gao, Guang Hui; Lee, Jung Hee; Lee, Doo Sung

    2016-07-01

    A novel type of pH-responsive biodegradable copolymer was developed based on methyloxy-poly(ethylene glycol)-block-poly[dopamine-2-(dibutylamino) ethylamine-l-glutamate] (mPEG-b-P(DPA-DE)LG) and applied to act as an intelligent nanocarrier system for magnetic resonance imaging (MRI). The mPEG-b-P(DPA-DE)LG copolymer was synthesized by a typical ring opening polymerization of N-carboxyanhydrides (NCAs-ROP) using mPEG-NH2 as a macroinitiator, and two types of amine-terminated dopamine groups and pH-sensitive ligands were grafted onto a side chain by a sequential aminolysis reaction. This design greatly benefits from the addition of the dopamine groups to facilitate self-assembly, as these groups can act as high-affinity anchors for iron oxide nanoparticles, thereby increasing long-term stability at physiological pH. The mPEG moiety in the copolymers helped the nanoparticles to remain well-dispersed in an aqueous solution, and pH-responsive groups could control the release of hydrophobic Fe3O4 nanoparticles in an acidic environment. The particle size of the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles was measured by dynamic light scattering (DLS) and cryo-TEM. The superparamagnetic properties of the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles were confirmed by a superconducting quantum interference device (SQUID). T2-weighted magnetic resonance imaging (MRI) of Fe3O4-loaded mPEG-b-P(DPA-DE)LG phantoms exhibited enhanced negative contrast with an r2 relaxivity of approximately 106.7 mM(-1) s(-1). To assess the ability of the Fe3O4-loaded mPEG-P(DE-DPA)LG micelles to act as MRI probes, we utilized a cerebral ischemia disease rat model with acidic tissue. We found that a gradual change in contrast in the cerebral ischemic area could be visualized by MRI after 1 h, and maximal signal loss was detected after 24 h post-injection. These results demonstrated that the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles can act as pH-triggered MRI probes for diagnostic imaging of acidic

  5. Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic

    Energy Technology Data Exchange (ETDEWEB)

    Fainardi, E. [Arcispedale S. Anna, Neuroradiology Unit, Department of Neurosciences, Ferrara (Italy); Tagliaferri, M.F.; Compagnone, C.; Tanfani, A.; Cocciolo, F.; Targa, L.; Chieregato, A. [Ospedale M. Bufalini, Neurocritical Care Unit, Cesena (Italy); Battaglia, R.; Frattarelli, M. [Ospedale M. Bufalini, Neurosurgery Unit, Cesena (Italy); Pascarella, R. [Ospedale M. Bufalini, Neuroradiology Unit, Cesena (Italy)

    2006-09-15

    The aim of this study was to assess regional cerebral blood flow (rCBV) in areas of CT hypoattenuation appearing in the postoperative period in patients treated for aneurysmal subarachnoid hemorrhage (SAH) using xenon-enhanced CT scanning (Xe-CT). We analyzed 15 patients (5 male and 10 female; mean age 49.7{+-}12.1 years) with SAH on CT performed on admission to hospital and who showed a low-density area within a well-defined vascular territory on CT scans after clipping or coiling of a saccular aneurysm. All zones of hypoattenuation were larger than 1 cm{sup 2} and showed signs of a mass effect suggesting a subacute phase of evolution. Two aneurysms were detected in two patients. Aneurysms were located in the middle cerebral artery (n=7), in the anterior communicating artery (n=6), in the internal carotid artery (n=3), and in the posterior communicating artery (n=1). Treatments were surgical (n=8), endovascular (n=2) or both (n=1). A total of 36 Xe-CT studies were performed and rCBF values were measured in two different regions of interest (ROI): the low-density area, and an area of normal-appearing brain tissue located symmetrically in the contralateral hemisphere. rCBF levels were significantly lower in the low-density area than in the contralateral normal-appearing area (P<0.01). In the low-density areas, irreversible ischemia (CBF <10 ml/100 g per minute) was present in 11/36 lesions (30.6%), ischemic penumbra (CBF 10-20 ml/100 g per minute) and oligemia (CBF 20-34 ml/100 g per minute) in 8/36 lesions (22.2%), relative hyperemia (CBF 34-55 ml/100 g per minute) in 7/36 lesions (19.4%), and absolute hyperemia (CBF >55 ml/100 g per minute) in 2/36 lesions (5.6%). Our study confirmed that rCBF is reduced in new low-density lesions related to specific vascular territories. However, only about one-third of the lesions showed rCBF levels consistent with irreversible ischemia and in a relatively high proportion of lesions, rCBF levels indicated penumbral, oligemic and

  6. Interventional effect of laser acupoint radiation on the expression of Nissl body and brain-derived neurotrophic factor in newborn rat models with ischemic/hypoxic cerebral injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND:Some researches report that He-Ne laser can activate function of erythrocytes and increase content of blood and oxygen via bio-stimulating effect;therefore,it suspects that laser radiation at Baihui and Dazhui can partially increase blood circulation for oxygen-supplying content of brain and improve functional status of neurons.OBJECTIVE:To verify the effects of laser radiation at Baihui and Dazhui on the expression of Nissl body of brain tissue neurons and brain-derived neurotrophic factor (BDNF) in newborn rats with ischemic/hypoxic cerebral injury.DESIGN:Randomized controlled animal study.SETTING:Department of Neurological Histochemistry,Xianning University.MATERIALS:Forty Wistar rats of 7 - 8 days old,weighing 15 - 20 g and of both genders,were selected from Wuhan Experimental Animal Center.All the rats were randomly divided into sham operation group (n =8),model group (n =16) and radiation group (n =16).The experimental animals were disposed according to ethical criteria.BDNF kit was provided by Wuhan Boster Bioengineering Co.,Ltd.METHODS:The experiment was carried out in the Department of Neurological Histochemistry,Xianning University from April 2005 to October 2006.Rats in the radiation group and model group were performed with ligation of left common carotid artery,recovered at room temperature for 1-6 days,maintained in self-made hypoxic cabin under normal pressure and injected mixture gas (0.05 volume fraction of O2 and 0.92 volume fraction of N2) for 2 hours.In addition,rats in the sham operation group were treated with separation of left common carotid artery but not ligation and hypoxia.Rats in the model group were not given any treatment;while,rats in the radiation group were exposed with He-Ne laser of 63.28 nm in the wave length at Baihui and Dazhui acupoints on the second day after ischemia-hypoxia.The radiation was given for 10 minutes per day and once a day.Ten days were regarded as a course and the rats were exposed for 2 courses in

  7. The effects of therapeutic hypothermia on cerebral metabolism in neonates with hypoxic-ischemic encephalopathy: An in vivo 1H-MR spectroscopy study.

    Science.gov (United States)

    Wisnowski, Jessica L; Wu, Tai-Wei; Reitman, Aaron J; McLean, Claire; Friedlich, Philippe; Vanderbilt, Douglas; Ho, Eugenia; Nelson, Marvin D; Panigrahy, Ashok; Blüml, Stefan

    2016-06-01

    Therapeutic hypothermia has emerged as the first empirically supported therapy for neuroprotection in neonates with hypoxic-ischemic encephalopathy (HIE). We used magnetic resonance spectroscopy ((1)H-MRS) to characterize the effects of hypothermia on energy metabolites, neurotransmitters, and antioxidants. Thirty-one neonates with HIE were studied during hypothermia and after rewarming. Metabolite concentrations (mmol/kg) were determined from the thalamus, basal ganglia, cortical grey matter, and cerebral white matter. In the thalamus, phosphocreatine concentrations were increased by 20% during hypothermia when compared to after rewarming (3.49 ± 0.88 vs. 2.90 ± 0.65, p < 0.001) while free creatine concentrations were reduced to a similar degree (3.00 ± 0.50 vs. 3.74 ± 0.85, p < 0.001). Glutamate (5.33 ± 0.82 vs. 6.32 ± 1.12, p < 0.001), aspartate (3.39 ± 0.66 vs. 3.87 ± 1.19, p < 0.05), and GABA (0.92 ± 0.36 vs. 1.19 ± 0.41, p < 0.05) were also reduced, while taurine (1.39 ± 0.52 vs. 0.79 ± 0.61, p < 0.001) and glutathione (2.23 ± 0.41 vs. 2.09 ± 0.33, p < 0.05) were increased. Similar patterns were observed in other brain regions. These findings support that hypothermia improves energy homeostasis by decreasing the availability of excitatory neurotransmitters, and thereby, cellular energy demand. PMID:26661180

  8. Dementia due to cerebral small vessel damage: Current ideas on its pathogenesis and therapy

    Directory of Open Access Journals (Sweden)

    I. V. Damulin

    2014-12-01

    Full Text Available Ever-increasing attention now focusses on dementia caused by small vessel damage when considering cerebrovascular disease leading to cognitive impairments (CIs. Stroke is one of the most important risk factors (RFs of vascular CI, including vascular dementia. Experienced stroke increases thrice the risk of dementia. Diffuse changes in the cerebral white matter (leukoaraiosis due to fluctuating blood pressure (BP and cerebral small vessel damage in most cases play an important role in the genesis of vascular CIs. Executive dysfunctions frequently concurrent with delayed psychomotor speed are the leading clinical manifestations of subcortical vascular dementia. Severe memory impairments are nottypical for subcortical dementia, its early stages in particular. The basis for the pathogenesis of CIs is the dissociation phenomenon that disrupts connections between the frontal lobes and subcortical structures and other cerebral cortical areas. Inadequate hypertension correction at a middle age is responsible for more than one fourth of cases of dementia developing in the elderly. The detection and further elimination of vascular RFs can reduce the risk of developing dementia in elderly and senile patients. Correction of elevated BP in the middle-aged is regarded as an effective method to prevent dementia in the future, but no premium is placed upon antihypertensive therapy in the elderly to lower elevated BP that is an inherent characteristic of this category of patients. Medications affecting RFs and those improving cerebral metabolism and bloodflow, including nicergoline are widely used to treat PD.

  9. Efficacy Observation on Limbs Dysfunction of Ischemic Cerebral Stroke with the Treatment of Acupoint Therapy%点穴疗法治疗缺血性脑卒中后肢体功能障碍疗效观察

    Institute of Scientific and Technical Information of China (English)

    林广华; 陈昌宝; 张杏娥

    2013-01-01

      目的:探讨点穴疗法对缺血性脑卒中后肢体功能障碍患者的运动功能恢复及MBI的影响。方法:将60例缺血性脑卒中患者随机分为治疗组和对照组,两组均采用常规药物治疗,治疗组在此基础上配合点穴治疗,比较两组患者的肢体运动功能和MBI评分。结果:治疗组的总有效率及MBI评分均优于对照组(P<0.05)。结论:点穴治疗对缺血性脑卒中后肢体功能障碍患者的肢体功能恢复、缺血灶修复及MBI的改善均明显优于单纯药物治疗。%Objective:To investigate the effects of MBI and motor functional recovery of limbs dysfunction after ischemic cerebral stroke with the treatment of acupoint therapy. Methods:60 cases of patients with ischemic cerebral stroke were randomly divided into treatment group and control group, two groups both adopted conventional therapy, based on which treatment group added with acupoint therapy, to compare limbs motor function and MBI scores of the two groups. Results:The total efficiency and MBI scores of treatment group were both better than those of control group (P<0.05). Conclusion:With the treatment of acupoint treatment, the limbs functional recovery, focal ischemia repair and improvement of MBI among pa-tients with limbs dysfunction after ischemic cerebral stroke are all significantly superior to those with simple medication.

  10. pH-Responsive biodegradable polymeric micelles with anchors to interface magnetic nanoparticles for MR imaging in detection of cerebral ischemic area

    Science.gov (United States)

    Yang, Hong Yu; Jang, Moon-Sun; Gao, Guang Hui; Lee, Jung Hee; Lee, Doo Sung

    2016-06-01

    A novel type of pH-responsive biodegradable copolymer was developed based on methyloxy-poly(ethylene glycol)-block-poly[dopamine-2-(dibutylamino) ethylamine-l-glutamate] (mPEG-b-P(DPA-DE)LG) and applied to act as an intelligent nanocarrier system for magnetic resonance imaging (MRI). The mPEG-b-P(DPA-DE)LG copolymer was synthesized by a typical ring opening polymerization of N-carboxyanhydrides (NCAs-ROP) using mPEG-NH2 as a macroinitiator, and two types of amine-terminated dopamine groups and pH-sensitive ligands were grafted onto a side chain by a sequential aminolysis reaction. This design greatly benefits from the addition of the dopamine groups to facilitate self-assembly, as these groups can act as high-affinity anchors for iron oxide nanoparticles, thereby increasing long-term stability at physiological pH. The mPEG moiety in the copolymers helped the nanoparticles to remain well-dispersed in an aqueous solution, and pH-responsive groups could control the release of hydrophobic Fe3O4 nanoparticles in an acidic environment. The particle size of the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles was measured by dynamic light scattering (DLS) and cryo-TEM. The superparamagnetic properties of the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles were confirmed by a superconducting quantum interference device (SQUID). T2-weighted magnetic resonance imaging (MRI) of Fe3O4-loaded mPEG-b-P(DPA-DE)LG phantoms exhibited enhanced negative contrast with an r2 relaxivity of approximately 106.7 mM-1 s-1. To assess the ability of the Fe3O4-loaded mPEG-P(DE-DPA)LG micelles to act as MRI probes, we utilized a cerebral ischemia disease rat model with acidic tissue. We found that a gradual change in contrast in the cerebral ischemic area could be visualized by MRI after 1 h, and maximal signal loss was detected after 24 h post-injection. These results demonstrated that the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles can act as pH-triggered MRI probes for diagnostic imaging of acidic

  11. 老年缺血性脑卒中后轻度血管性认知障碍的影响因素%The factors of mild vascular cognitive impairment in elderly patients with ischemic cerebral stroke

    Institute of Scientific and Technical Information of China (English)

    王和平; 黄燕秋

    2016-01-01

    目的:分析老年缺血性脑卒中后轻度血管性认知障碍(VCI)的影响因素。方法对患者一般资料、体格检查、认知评估及影像学资料进行收集与调查,并行单因素分析与Logistic回归分析。结果老年缺血性卒中后轻度VCI的发生与患者年龄、文化程度、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积有关;与性别、BM I、吸烟、饮酒等无明显相关。Logistic回归分析显示,文化程度为老年缺血性脑卒中后轻度VCI发生的保护因素,而年龄、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积是危险因素。结论老年缺血性脑卒中后轻度 VCI发生的危险因素众多,临床上可进行针对性的早期干预。%Objective To analyze the factors of mild vascular cognitive impairment (VCI) in elderly patients with ischemic cerebral stroke. Methods The general information ,physical examination ,cognitive evaluation and imaging data were collected and investigated;single factor analysis and Logistic regression analysis were used. Results The occurrence of mild VCI in eld-erly patients with ischemic cerebral stroke was related with age ,educational level ,coronary heart disease ,diabetes ,hyperten-sion ,stroke frequency ,disease location and area of stroke ,and had non-obvious relation with sex ,BMI ,smoking ,alcohol con-sumption. Logistic regression analysis showed that education was a protective factor for mild VIC in elderly patients with is-chemic cerebral stroke ,and age ,coronary heart disease ,diabetes ,hypertension ,stroke frequency ,disease location and area were the risk factors. Conclusion The risk factors for mild VCI in elderly patients with ischemic cerebral stroke are many ;targeted early intervention can be applied in clinic.

  12. The factors of mild vascular cognitive impairment in elderly patients with ischemic cerebral stroke%老年缺血性脑卒中后轻度血管性认知障碍的影响因素

    Institute of Scientific and Technical Information of China (English)

    王和平; 黄燕秋

    2016-01-01

    Objective To analyze the factors of mild vascular cognitive impairment (VCI) in elderly patients with ischemic cerebral stroke. Methods The general information ,physical examination ,cognitive evaluation and imaging data were collected and investigated;single factor analysis and Logistic regression analysis were used. Results The occurrence of mild VCI in eld-erly patients with ischemic cerebral stroke was related with age ,educational level ,coronary heart disease ,diabetes ,hyperten-sion ,stroke frequency ,disease location and area of stroke ,and had non-obvious relation with sex ,BMI ,smoking ,alcohol con-sumption. Logistic regression analysis showed that education was a protective factor for mild VIC in elderly patients with is-chemic cerebral stroke ,and age ,coronary heart disease ,diabetes ,hypertension ,stroke frequency ,disease location and area were the risk factors. Conclusion The risk factors for mild VCI in elderly patients with ischemic cerebral stroke are many ;targeted early intervention can be applied in clinic.%目的:分析老年缺血性脑卒中后轻度血管性认知障碍(VCI)的影响因素。方法对患者一般资料、体格检查、认知评估及影像学资料进行收集与调查,并行单因素分析与Logistic回归分析。结果老年缺血性卒中后轻度VCI的发生与患者年龄、文化程度、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积有关;与性别、BM I、吸烟、饮酒等无明显相关。Logistic回归分析显示,文化程度为老年缺血性脑卒中后轻度VCI发生的保护因素,而年龄、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积是危险因素。结论老年缺血性脑卒中后轻度 VCI发生的危险因素众多,临床上可进行针对性的早期干预。

  13. EFFECTS OF RAPAMYCIN ON CEREBRAL OXYGEN SUPPLY AND CONSUMPTION DURING REPERFUSION AFTER CEREBRAL ISCHEMIA

    Science.gov (United States)

    CHI, O. Z.; BARSOUM, S.; VEGA-COTTO, N. M.; JACINTO, E.; LIU, X.; MELLENDER, S. J.; WEISS, H. R.

    2016-01-01

    Abstract—Activation of the mammalian target of rapamycin (mTOR) leads to cell growth and survival. We tested the hypothesis that inhibition of mTOR would increase infarct size and decrease microregional O2 supply/consumption balance after cerebral ischemia–reperfusion. This was tested in isoflurane-anesthetized rats with middle cerebral artery blockade for 1 h and reperfusion for 2 h with and without rapamycin (20 mg/kg once daily for two days prior to ischemia). Regional cerebral blood flow was determined using a C14-iodoantipyrine autoradiographic technique. Regional small-vessel arterial and venous oxygen saturations were determined microspectrophotometrically. The control ischemic-reperfused cortex had a similar blood flow and O2 consumption to the contralateral cortex. However, microregional O2 supply/consumption balance was significantly reduced in the ischemic-reperfused cortex. Rapamycin significantly increased cerebral O2 consumption and further reduced O2 supply/consumption balance in the reperfused area. This was associated with an increased cortical infarct size (13.5 ± 0.8% control vs. 21.5 ± 0.9% rapamycin). We also found that ischemia–reperfusion increased AKT and S6K1 phosphorylation, while rapamycin decreased this phosphorylation in both the control and ischemic-reperfused cortex. This suggests that mTOR is important for not only cell survival, but also for the control of oxygen balance after cerebral ischemia–reperfusion. PMID:26742793

  14. Revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo: opinião nacional Clinical and interventional revascularization in the acute ischemic stroke: national opinion

    Directory of Open Access Journals (Sweden)

    Cesar N. Raffin

    2006-06-01

    Full Text Available Este artigo apresenta as conclusões sobre revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo, um dos temas discutidos na reunião "Opinião Nacional sobre o Tratamento do AVC". Tratou-se de reunião promovida e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados em doenças cerebrovasculares, que analisaram e discutiram as evidências e experiências atuais sobre o uso de trombólise e técnicas intervencionistas em pacientes com acidente vascular cerebral isquêmico agudo.The Brazilian Stroke Society constituted a committee composed by specialists from different areas of Brazil that emitted a viewpoint called "National Opinion" , considering the interventional procedures and thrombolysis in the treatment of the acute ischemic stroke. This study presents the conclusions of this committee.

  15. Patent foramen ovale in a cohort of young patients with cryptogenic ischemic stroke Forame oval patente em uma coorte de pacientes jovens com acidente vascular cerebral isquêmico

    Directory of Open Access Journals (Sweden)

    Marcus Tulius T. Silva

    2005-06-01

    Full Text Available OBJECTIVE: Although its role is a matter of debate, some studies described a higher prevalence of patent foramen ovale (PFO and atrial septal aneurysm (ASA in young stroke patients, with higher risk with PFO / ASA association (OR 4.96. The aim of this study was determine the prevalence of PFO and ASA in a cohort of cryptogenic ischemic stroke (IS patients younger than 55 years and to follow-up after surgical or percutaneous endovascular closure (PEC. METHOD: In 21 months we identified all patients less than 55 years old with IS who were admitted to our hospital. Cryptogenic IS was considered if there is not an identifiably cause to cerebral ischemia. Transesophageal echocardiography (TEE was performed in all patients. After interatrial septal abnormalities diagnosis, percutaneous device closure was offered to all. Patients were followed monthly and keeped with oral AAS or Clopidogrel. RESULTS: We identified 189 patients with IS and 32 were less than 55 years old (16.9%. In 29 the IS was cryptogenic. TEE was performed in all patients and some form of interatrial septal abnormality was identified in 12 (12/29 - 41.3%; 5 had a PFO and in 7 there was PFO plus ASA. Ten patients were submitted to PEC and 2 were submitted to surgical closure. In mid-term follow-up (28 months no ischemic events occurred and 2 patients related disappearance of migraine symptoms. CONCLUSION: Our small series description is in accordance with other studies and suggests a possible relation between interatrial septal abnormalities and IS in a cohort of young patient.OBJETIVO: A associação das anormalidades do septo interatrial - forame oval patente (FOP e aneurisma de septo interatrial (ASA - com acidente vascular cerebral isquêmico (AVCI ainda é questão de incerteza para muitos autores. No entanto, vários estudo mostram que em pacientes jovens tais anormalidades podem estar relacionadas à gênese de eventos isquêmicos. Nosso objetivo é descrever a prevalência do

  16. Carotid artery wall stiffness is increased in patients with small vessel disease: A case-control study

    OpenAIRE

    Salihović-Hajdarević Denisa; Pavlović Aleksandra M.; Smajlović Dževdet; Podgorac Ana; Jovanović Zagorka; Švabić-Međedović Tamara; Čovičković-Šternić Nadežda

    2016-01-01

    Introduction. Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk of stroke, dementia and death. Increased arterial stiffness has been associated with ischemic stroke and cerebral SVD independently of common vascular risk factors. Objective. The aim of the study was to analyze arterial stiffness in our pa...

  17. Ischemic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  18. Ischemic Stroke

    Science.gov (United States)

    ... can help you. Learn more What Is Stroke? Hemorrhagic Stroke Ischemic Stroke What is TIA? Stroke Facts Recognizing ... Stroke Survey Faces of Stroke What is stroke? Hemorrhagic stroke Ischemic stroke What is TIA? Stroke facts I ...

  19. Cerebral infarction presenting pure motor mono-paresis. Diagnosis by diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Masaya; Udaka, Fukashi; Nishinaka, Kazuto; Kubori, Tamotsu; Kameyama, Masakuni [Sumitomo Hospital, Osaka (Japan)

    2001-02-01

    We studied 10 patients with acute ischemic cerebrovascular disorders presenting paralysis confined to one limb, unaccompanied by sensory signs (pure motor monoparesis, PMM) on diffusion-weighted MR imaging (DWI). DWI revealed fresh ischemic lesions in all patients, except for 2 cases of transient ischemic attack. On DWI, acute infarction in multiple lesions was identified, and small superficial lesions were clearly described. Superficial lesions were seen in 4 patients, and deep lesions were also seen in 4 patients. DWI is useful for lesion analysis in cerebral infarction with PMM. (author)

  20. Cerebral infarction presenting pure motor mono-paresis. Diagnosis by diffusion-weighted MR imaging

    International Nuclear Information System (INIS)

    We studied 10 patients with acute ischemic cerebrovascular disorders presenting paralysis confined to one limb, unaccompanied by sensory signs (pure motor monoparesis, PMM) on diffusion-weighted MR imaging (DWI). DWI revealed fresh ischemic lesions in all patients, except for 2 cases of transient ischemic attack. On DWI, acute infarction in multiple lesions was identified, and small superficial lesions were clearly described. Superficial lesions were seen in 4 patients, and deep lesions were also seen in 4 patients. DWI is useful for lesion analysis in cerebral infarction with PMM. (author)

  1. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    Focal cerebral ischemia due to occlusion of a major cerebral artery is the cause of ischemic stroke which is a major reason of mortality, morbidity and disability in the populations of the developed countries. In the seven studies summarized in the thesis focal ischemia in rats induced by occlusion...... of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the...... radical scavenger α-PBN on the periinfarct depolarizations and infarct volume was investigated. In study number six, the activity of the mitochondrial electron transport complexes I, II and IV was evaluated histochemically during reperfusion after MCAO in order to assess the possible role of mitochondrial...

  2. Protection by the gross saponins of Tribulus terrestris against cerebral ischemic injury in rats involves the NF-κB pathway

    OpenAIRE

    En-ping Jiang; Hong Li; Jian-guang Chen; Shi-jie Yang

    2011-01-01

    The aim of this study was to investigate whether the gross saponins of Tribulus terrestris (GSTT), a traditional Chinese herbal medicine, have neuroprotective effects on rats subjected to middle cerebral artery occlusion (MCAO), through nuclear factor-κB (NF-κB) pathway and inflammatory mediators. Cerebral ischemia was produced by MCAO in either untreated (control) or GSTT-pretreated rats, and the animals were examined for infarct volume, cerebral edema, neuro-behavioral abnormality and patho...

  3. Electroacupuncture-attenuated ischemic brain injury increases insulin-like growth factor-1expression in a rat model of focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Huanmin Gao; Ling Wang; Yunliang Guo

    2010-01-01

    Acupuncture has recently gained popularity in many countries as an alternative and complementary therapeutic intervention.Previous studies have shown that changes in genes,proteins,and their metabolites were measureable during acupuncture for treatment of cerebral ischemia.Through the use of in situ hybridization and immunohistochemistry,the present study confirmed that electroacupuncture increased insulin-like growth factor-1 mRNA and protein expression in the corpus striatum following cerebral ischemia,reduced brain edema following middle cerebral artery occlusion repeffusion,and decreased infarct volume.Results suggested that electroacupuncture is effective in the relief of cerebral ischemia by increasing endogenous insulin-like growth factor-1 expression.

  4. Expression of insulin-like growth factor-1 mRNA and protein level of corpora striata in ischemic side at the early stage of middle cerebral artery ischemia/reperfusion in rhesus monkeys

    Institute of Scientific and Technical Information of China (English)

    Huanmin Gao; Rui Zhang; Yunliang Guo

    2006-01-01

    BACKGROUND: Insulin-like growth factor-I(IGF-1), as one of the important members of growth factor family,participants in the regulation of many physiological functions and behaviors, having very strong neuroprotective effect. However, the expression of IGF-1 following cerebral ischemia/reperfusion is still disputed.OBJ ECTIVE: To observe the expression of IGF-1 and protein of corpora striata in ischemic side at the early stage of middle cerebral artery ischemia/reperfusion in rhesus monkey.DESIGN: A completely randomized grouping design, controlled animal experimentSETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of Medical College of Qingdao University.MATERIALS: ① Totally 17 rhesus monkeys , of either gender, aged 4 to 5 years, were enrolled . Seven rhesus monkeys observed with gene chip were randomly divided into 2 groups: sham operation group (n=3)and ischemia/reperfusion group (n=4). Ten rhesus monkeys observed with in situ hybridization and immunohistochemistry method were randomly divided into 2 groups: sham operation group (n=3)and ischemia/reperfusion group (n=7). Rhesus monkeys observed under microscope were divided into 2 groups: sham operation group (n=6) and ischamia/reperfusion group (n=11). ② Materials used in the experiment: cresyl violet (Sigma Company, America); immunohistochemical reagent kit ( Huamei Bio-engineering Company); In situ hybridization reagent kit (Boshide Bio-engineering Co. Ltd, Wuhan); 12 800 dots chip (Boxing Company,Shanghai).METHODS: This experiment was carried out at the Institute of Cerebrovascular Disease, Affiliated Hospital of Medical College of Qingdao University from January 2001 to December 2003. ① The onset area of middle cerebral artery was blocked for 2 hours, middle cerebral artery ischemia/reperfusion models were created.② After ischemia/reperfusion for 24 hours, cerebral tissue sections of rhesus monkeys were prepared and stained with cresyl violet. Image analysis was performed with 500IW

  5. Association between Serum Alkaline Phosphatase Level and Cerebral Small Vessel Disease.

    Directory of Open Access Journals (Sweden)

    Han-Bin Lee

    Full Text Available Serum alkaline phosphatase (ALP is a marker of vascular calcification. A high serum ALP level is associated with an increase in cardiovascular events, and predicts poor functional outcome in patients with stroke. We investigated whether serum ALP was associated with cerebral small vessel disease (cSVD and large cerebral artery stenosis (LCAS.We evaluated vascular risk factors, brain magnetic resonance images (MRIs, and MR angiograms from 1,011 neurologically healthy participants. The presence of silent lacunar infarction (SLI and moderate-to-severe cerebral white matter hyperintensities (MS-cWMH were evaluated as indices of cSVD on brain MRIs. Findings of extracranial arterial stenosis (ECAS or intracranial arterial stenosis (ICAS were considered to be indices of LCAS on MR angiograms.Subjects with SLI (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.27-3.42; p = 0.004 and MS-cWMH (OR: 1.48; 95% CI; 1.03-2.13, p = 0.036 were significantly more likely to have ALP levels in the third tertile (ALP ≥ 195 IU/L than the first tertile (ALP ≤ 155 IU/L, after adjusting for cardiovascular risk factors. The mean serum ALP level was significantly higher in patients with SLI or MS-cWMH compared to patients without those findings. After adjustment for confounding factors, the multivariate model found that the statistical significance of serum ALP remained when the presence of SLI (OR: 1.05 per 10 IU/L increase in ALP; 95% CI: 1.02-1.08; p = 0.003 or MS-cWMH (OR: 1.03 per 10 IU/L increase in ALP; 95% CI: 1.00-1.06; p = 0.025 were added to the model. There were no differences in the proportions of patients with LCAS, ICAS, and ECAS across the serum ALP tertiles.Our study of neurologically healthy participants found a positive association between serum ALP level and indicators of cSVD, but no association between serum ALP level and the indicators of LCAS.

  6. Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non–Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate clinical and physico-dosimetric variables affecting clinical outcome of patients treated with Gamma Knife radiosurgery (GKRS) for brain metastases from non–small cell lung cancer (NSCLC). Methods and Materials: Between 2001 and 2006, 373 patients (298 men and 75 women, median age 65 years) with brain metastases from NSCLC underwent GKRS. All of them had KPS ≥ 60%, eight or fewer brain metastases, confirmed histopathological diagnosis and recent work-up (3. Median marginal dose was 22.5 Gy at 50% isodose.; median 10 Gy and 12 Gy isodose volumes were 30.8 cm3 and 15.8 cm3, respectively. Follow-up with MRI was performed every 3 months. Overall survival data were collected from internal database, telephone interviews, and identifying registries. Results: Mean follow-up after GKRS was 51 months (range, 6 to 96 months); mean overall survival was 14.2 months. Of 373 patients, 29 were alive at time of writing, 104 had died of cerebral progression, and 176 had died of systemic progression. In 64 cases it was not possible to ascertain the cause. Univariate and multivariate analysis were adjusted for the following: RPA class, surgery, WBRT, age, gender, number of lesions, median tumor volume, median peripheral dose, and 10 Gy and 12 Gy volumes. Identified RPA class and overall tumor volume >5 cc were the only two covariates independently predictive of overall survival in patients who died of cerebral progression. Conclusions: Global volume of brain disease should be the main parameter to consider for performing GKRS, which is a first-line therapy for patient in good general condition and controlled systemic disease.

  7. Structural characterization of the human cerebral myelin sheath by small angle x-ray scattering

    Science.gov (United States)

    DeFelici, M.; Felici, R.; Ferrero, C.; Tartari, A.; Gambaccini, M.; Finet, S.

    2008-10-01

    Myelin is a multi-lamellar membrane surrounding neuronal axons and increasing their conduction velocity. When investigated by small-angle x-ray scattering (SAXS), the lamellar quasi-periodical arrangement of the myelin sheath gives rise to distinct peaks, which allow the determination of its molecular organization and the dimensions of its substructures. In this study we report on the myelin sheath structural determination carried out on a set of human brain tissue samples coming from surgical biopsies of two patients: a man around 60 and a woman nearly 90 years old. The samples were extracted either from white or grey cerebral matter and did not undergo any manipulation or chemical-physical treatment, which could possibly have altered their structure, except dipping them into a formalin solution for their conservation. Analysis of the scattered intensity from white matter of intact human cerebral tissue allowed the evaluation not only of the myelin sheath periodicity but also of its electronic charge density profile. In particular, the thicknesses of the cytoplasm and extracellular regions were established, as well as those of the hydrophilic polar heads and hydrophobic tails of the lipid bilayer. SAXS patterns were measured at several locations on each sample in order to establish the statistical variations of the structural parameters within a single sample and among different samples. This work demonstrates that a detailed structural analysis of the myelin sheath can also be carried out in randomly oriented samples of intact human white matter, which is of importance for studying the aetiology and evolution of the central nervous system pathologies inducing myelin degeneration.

  8. Persimmon leaf flavonoid promotes brain ischemic tolerance**

    Institute of Scientific and Technical Information of China (English)

    Mingsan Miao; Xuexia Zhang; Ming Bai; Linan Wang

    2013-01-01

    Persimmon leaf flavonoid has been shown to enhance brain ischemic tolerance in mice, but its mechanism of action remains unclear. The bilateral common carotid arteries were occluded using a micro clip to block blood flow for 10 minutes. After 10 minutes of ischemic preconditioning, 200, 100, and 50 mg/kg persimmon leaf flavonoid or 20 mg/kg ginaton was intragastrical y administered per day for 5 days. At 1 hour after the final administration, ischemia/reperfusion models were estab-lished by blocking the middle cerebral artery for 2 hours. At 24 hours after model establishment, compared with cerebral ischemic rats without ischemic preconditioning or drug intervention, plasma endothelin, thrombomodulin and von Wil ebrand factor levels significantly decreased and intercel-lular adhesion molecule-1 expression markedly reduced in brain tissue from rats with ischemic pre-conditioning. Simultaneously, brain tissue injury reduced. Ischemic preconditioning combined with drug exposure noticeably improved the effects of the above-mentioned indices, and the effects of 200 mg/kg persimmon leaf flavonoid were similar to 20 mg/kg ginaton treatment. These results indicate that ischemic preconditioning produces tolerance to recurrent severe cerebral ischemia. However, persimmon leaf flavonoid can elevate ischemic tolerance by reducing inflammatory reactions and vascular endothelial injury. High-dose persimmon leaf flavonoid showed an identical effect to ginaton.

  9. Pre-ischemic exercise alleviates oxidative damage following ischemic stroke in rats

    OpenAIRE

    Feng, Rui; Zhang, Min; Wang, Xiao; Li, Wen-bin; REN, SHI-QING; Feng ZHANG

    2014-01-01

    Physical exercise has been proved to be neuroprotective in clinical trials and animal experiments. However, the exact mechanism underlying this neuroprotective effect remains unclear. The aim of the present study was to explore whether pre-ischemic treadmill training could act as a form of ischemic preconditioning in a rat following ischemic stroke by reducing oxidative damage. Fifty-four rats were randomly divided into three groups (n=18 per group): Sham surgery, middle cerebral artery occlu...

  10. Ischemic brain edema following occlusion of the middle cerebral artery in the rat. I: The time courses of the brain water, sodium and potassium contents and blood-brain barrier permeability to 125I-albumin

    International Nuclear Information System (INIS)

    The present study was undertaken to analyze the roles of brain cations and of the blood-brain barrier (BBB) to albumin in the development of ischemic brain edema. Using the rat middle cerebral artery (MCA) occlusion model, changes in the brain water, sodium, and potassium contents were followed for a period of seven days. The permeability of the BBB to proteins was also followed by 125I-albumin transfer from the blood into the brain. A significant edema developed as early as three hours after MCA occlusion. This progressed rapidly to reach a maximum on the third day, gradually regressing thereafter. The increase in the brain water contents showed a parallel time course to the increase in the sodium and decrease in the potassium contents. A significant increase in the BBB permeability to albumin occurred 72 hours after MCA occlusion. However, there was no correlation between the brain water content and BBB permeability to albumin in the hemispheres studied 72 hours after MCA occlusion. The correlation between the brain water and sodium contents was not clear during the first six hours, but became highly significant thereafter. The data suggest that an increase in the BBB permeability to sodium occurred 12-48 hours after MCA occlusion, which, together with an antecedent intracellular shift of sodium, resulted in a massive influx of water and sodium into the brain. The BBB permeability change to sodium, not to proteins, seems to play a predominant role in the pathogenesis underlying ischemic brain edema

  11. Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Eleni Dokoutsidou

    2009-05-01

    Full Text Available Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive, carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet.Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

  12. Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data.

    Science.gov (United States)

    Peres, Roxane; De Guio, François; Chabriat, Hugues; Jouvent, Eric

    2016-04-01

    Cerebral small vessel diseases of the brain are a major determinant of cognitive impairment in the elderly. In small vessel diseases, the most easily identifiable lesions, both at post-mortem evaluation and magnetic resonance imaging, lie in subcortical areas. However, recent results obtained post-mortem, particularly in severe cases, have highlighted the burden of cortex lesions such as microinfarcts and diffuse neuronal loss. The recent development of image post-processing methods allows now assessing in vivo multiple aspects of the cerebral cortex. This systematic review aimed to analyze in vivo magnetic resonance imaging studies evaluating cortex alterations at different stages of small vessel diseases. Studies assessing the relationships between small vessel disease magnetic resonance imaging markers obtained at the subcortical level and cortex estimates were reviewed both in community-dwelling elderly and in patients with symptomatic small vessel diseases. Thereafter, studies analyzing cortex estimates in small vessel disease patients compared with healthy subjects were evaluated. The results support that important cortex alterations develop along the course of small vessel diseases independently of concomitant neurodegenerative processes. Easy detection and quantification of cortex changes in small vessel diseases as well as understanding their underlying mechanisms are challenging tasks for better understanding cognitive decline in small vessel diseases. PMID:26787108

  13. Treatment of Ischemic Apoplexy Based on the Theory of "Lingering Illness Affecting Collaterals"

    Institute of Scientific and Technical Information of China (English)

    Feng Lingmei; Sun Yan; Duan Shumin

    2007-01-01

    @@ Ischemic apoplexy, also called ischemic cerebrovascular disease (including cerebral thrombosis, cerebral embolism and transient cerebral ischemic attack), belongs to the TCM category of "wind-stroke syndrome". The increasingly high incidence of the disease has imposed serious influence on life quality of people. Based on the theory of "lingering illness affecting collaterals", we have treated the disease by acupuncture and oral administration of leech capsule and centipede capsule,with good therapeutic results reported as follows.

  14. MRI of acute cerebral infarction

    International Nuclear Information System (INIS)

    Sequential changes of magnetic resonance imaging (MRI) in sixteen patients with acute cerebral infarction are studied in comparison with the findings of computed tomography (CT). The sixteen patients were examined within 36 hours from the onset of syptoms on resistive type MRI (0.15T) using T1 weighted image (IR2000/500) and T2 weighted image (SE2000/80), and on CT. In general, large infarcted lesions of the cortexsubcortex seemed to be visualized earlier than small lesions of the basal ganglia and brainstem. In 8 patients, the infarcted lesions were detected on MRI earlier than on CT. For example, early detecting time within 12 hours were 2, 6, 7, and 10 hours after onset. In two patients of this group, lesions were detected on T2 weighted image earlier than on T1-weighted image. In two cases, small lesions of the brainstem were detected only on MRI. The size of abnormal findings gradually developed and reached a maximum on days 5 to 7 sequentially. The difference between infarction and perifocal edema was not clear even on MRI. The changes gradually subsided and assumed a stable size after about 2 months. Contrast enhancement effect was observed in four patients. In two of these cases, the signal intensity of T2-weighted imaging was decreased just at the region which was enhanced with contrast medium. MRI is useful for early diagnosis of ischemic cerebral infarction, and may eludidate some aspects of the pathophysiology of ischemic stroke. (author)

  15. Novel COL4A1 mutations cause cerebral small vessel disease by haploinsufficiency

    Science.gov (United States)

    Lemmens, Robin; Maugeri, Alessandra; Niessen, Hans W. M.; Goris, An; Tousseyn, Thomas; Demaerel, Philippe; Corveleyn, Anniek; Robberecht, Wim; van der Knaap, Marjo S.; Thijs, Vincent N.; Zwijnenburg, Petra J.G.

    2013-01-01

    Mutations in COL4A1 have been identified in families with hereditary small vessel disease of the brain presumably due to a dominant-negative mechanism. Here, we report on two novel mutations in COL4A1 in two families with porencephaly, intracerebral hemorrhage and severe white matter disease caused by haploinsufficiency. Two families with various clinical presentations of cerebral microangiopathy and autosomal dominant inheritance were examined. Clinical, neuroradiological and genetic investigations were performed. Electron microscopy of the skin was also performed. In one of the families, sequence analysis revealed a one base deletion, c.2085del, leading to a frameshift and a premature stopcodon, p.(Gly696fs). In the other family, a splice site mutation was identified, c.2194-1G>A, which most likely leads to skipping of an exon with a frameshift and premature termination as a result. In fibroblasts of affected individuals from both the families, nonsense-mediated decay (NMD) of the mutant COL4A1 messenger RNAs (mRNAs) and a clear reduction of COL4A1 protein expression were demonstrated, indicating haploinsufficiency of COL4A1. Moreover, thickening of the capillary basement membrane in the skin was documented, similar to reports in patients with COL4A1 missense mutations. These findings suggest haploinsufficiency, a different mechanism from the commonly assumed dominant-negative effect, for COL4A1 mutations as a cause of (antenatal) intracerebral hemorrhage and white matter disease. PMID:23065703

  16. Cerebral small vessel disease affects white matter microstructure in mild cognitive impairment.

    Science.gov (United States)

    Papma, Janne M; de Groot, Marius; de Koning, Inge; Mattace-Raso, Francesco U; van der Lugt, Aad; Vernooij, Meike W; Niessen, Wiro J; van Swieten, John C; Koudstaal, Peter J; Prins, Niels D; Smits, Marion

    2014-06-01

    Microstructural white matter deterioration is a frequent finding in mild cognitive impairment (MCI), potentially underlying default mode network (DMN) dysfunctioning. Thus far, microstructural damage in MCI has been attributed to Alzheimer's disease pathophysiology. A cerebrovascular role, in particular the role of cerebral small vessel disease (CSVD), received less interest. Here, we used diffusion tensor imaging (DTI) to examine the role of CSVD in microstructural deterioration within the normal appearing white matter (NAWM) in MCI. MCI patients were subdivided into those with (n = 20) and without (n = 31) macrostructural CSVD evidence on MRI. Using TBSS we performed microstructural integrity comparisons within the whole brain NAWM. Secondly, we segmented white matter tracts interconnecting DMN brain regions by means of automated tractography segmentation. We used NAWM DTI measures from these tracts as dependent variables in a stepwise-linear regression analysis, with structural and demographical predictors. Our results indicated microstructural deterioration within the anterior corpus callosum, internal and external capsule and periventricular white matter in MCI patients with CSVD, while in MCI patients without CSVD, deterioration was restricted to the right perforant path, a tract along the hippocampus. Within the full cohort of MCI patients, microstructure within the NAWM of the DMN fiber tracts was affected by the presence of CSVD. Within the cingulum along the hippocampal cortex we found a relationship between microstructural integrity and ipsilateral hippocampal volume and the extent of white matter hyperintensity. In conclusion, we found evidence of CSVD-related microstructural damage in fiber tracts subserving the DMN in MCI. PMID:24115179

  17. Pre-Ischemic Treadmill Training for Prevention of Ischemic Brain Injury via Regulation of Glutamate and Its Transporter GLT-1

    Directory of Open Access Journals (Sweden)

    Jingchun Guo

    2012-07-01

    Full Text Available Pre-ischemic treadmill training exerts cerebral protection in the prevention of cerebral ischemia by alleviating neurotoxicity induced by excessive glutamate release following ischemic stroke. However, the underlying mechanism of this process remains unclear. Cerebral ischemia-reperfusion injury was observed in a rat model after 2 weeks of pre-ischemic treadmill training. Cerebrospinal fluid was collected using the microdialysis sampling method, and the concentration of glutamate was determined every 40 min from the beginning of ischemia to 4 h after reperfusion with high-performance liquid chromatography (HPLC-fluorescence detection. At 3, 12, 24, and 48 h after ischemia, the expression of the glutamate transporter-1 (GLT-1 protein in brain tissues was determined by Western blot respectively. The effect of pre-ischemic treadmill training on glutamate concentration and GLT-1 expression after cerebral ischemia in rats along with changes in neurobehavioral score and cerebral infarct volume after 24 h ischemia yields critical information necessary to understand the protection mechanism exhibited by pre-ischemic treadmill training. The results demonstrated that pre-ischemic treadmill training up-regulates GLT-1 expression, decreases extracellular glutamate concentration, reduces cerebral infarct volume, and improves neurobehavioral score. Pre-ischemic treadmill training is likely to induce neuroprotection after cerebral ischemia by regulating GLT-1 expression, which results in re-uptake of excessive glutamate.

  18. New angiographic measurement tool for analysis of small cerebral vessels: application to a subarachnoid haemorrhage model in the rat

    International Nuclear Information System (INIS)

    Exact quantification of vasospasm by angiography is known to be difficult especially in small vessels. The purpose of the study was to develop a new method for computerized analysis of small arteries and to demonstrate feasibility on cerebral angiographies of rats acquired on a clinical angiography unit. A new software tool analysing grey values and subtracting background noise was validated on a vessel model. It was tested in practice in animals with subarachnoid haemorrhage (SAH). A total of 28 rats were divided into four groups: SAH untreated, SAH treated with local calcium antagonist, SAH treated with placebo, and sham-operated. The diameters of segments of the internal carotid, caudal cerebral, middle cerebral, rostral cerebral and the stapedial arteries were measured and compared to direct measurements of the diameters on magnified images. There was a direct correlation between the cross-sectional area of vessels measured in a phantom and the measurements acquired using the new image analysis method. The spread of repeated measurements with the new software was small compared to the spread of direct measurements of vessel diameters on magnified images. Application of the measurement tool to experimental SAH in rats showed a statistically significant reduction of vasospasm in the SAH groups treated with nimodipine-releasing pellets in comparison to all the other groups combined. The presented computerized method for analysis of small intracranial vessels is a new method allowing precise relative measurements. Nimodipine-releasing subarachnoidal pellets reduce vasospasm, but further testing with larger numbers is necessary. The tool can be applied to human angiography without modification and offers the promise of substantial progress in the diagnosis of vasospasm after SAH. (orig.)

  19. Association of Chronic Kidney Disease and Cerebral Small Vessel Disease with Cognitive Impairment in Elderly Patients with Type 2 Diabetes

    OpenAIRE

    Umemura, Toshitaka; Kawamura, Takahiko; Umegaki, Hiroyuki; Kawano, Naoko; Mashita, Shinichi; Sakakibara, Toshimasa; Hotta, Nigishi; Sobue, Gen

    2013-01-01

    Background/Aims In recent years, the relationship between chronic kidney disease (CKD) and cognitive impairment has been attracting attention. Cerebral small vessel disease (SVD) is also associated with an increased risk of cognitive impairment. However, it is still unknown whether CKD markers are associated with cognitive impairment independently of SVD in elderly diabetic patients. Methods Seventy-nine type 2 diabetic patients (mean age, 76.0 years) were enrolled in the present study. CKD w...

  20. Research progress of the mechanism of cerebral ischemic reperfusion injury%脑梗死缺血再灌注损伤机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    陈念; 王立平

    2014-01-01

    脑缺血再灌注损伤是目前急性脑梗死的研究热点,其机制较复杂,近年来不断有研究发现脑缺血再灌注损伤还与Na+-K+-ATP酶、谷胱甘肽过氧化物酶、一氧化氮合酶、过氧化物酶体增殖受体γ、Caspase-3、水通道蛋白4等有关。通过这些研究,可以尽早地给予干预措施,减轻脑梗死后再灌注损伤的程度,挽救更多的濒死脑组织,提高患者日常生活能力。%Cerebral ischemia reperfusion injury is a research hotspot of acute cerebral infarction at present,and its mechanism is complex.In recent years,the study found that cerebral ischemia reperfusion injury has relationship with Na +-K +-ATP enzyme, glutathione peroxidase,nitric oxide synthas,peroxisome proliferators activated receptor gamma,Caspase-3,aquapon-4 and so on. Through this research,we can give intervention measures as soon as possible,reduce the degree of reperfusion injury after cerebral infarction,save more brain death,improve the ability of daily life of the patients.

  1. The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles.

    LENUS (Irish Health Repository)

    Grobman, William A

    2013-10-01

    The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate\\/severe cerebral palsy (CP) or death.

  2. Ischemic Stroke

    OpenAIRE

    Eleni Dokoutsidou; Konstantina Antoniou

    2009-01-01

    Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etio...

  3. Pattern and Rate of Cognitive Decline in Cerebral Small Vessel Disease: A Prospective Study.

    Directory of Open Access Journals (Sweden)

    Andrew J Lawrence

    Full Text Available Cognitive impairment, predominantly affecting processing speed and executive function, is an important consequence of cerebral small vessel disease (SVD. To date, few longitudinal studies of cognition in SVD have been conducted. We determined the pattern and rate of cognitive decline in SVD and used the results to determine sample size calculations for clinical trials of interventions reducing cognitive decline.121 patients with MRI confirmed lacunar stroke and leukoaraiosis were enrolled into the prospective St George's Cognition And Neuroimaging in Stroke (SCANS study. Patients attended one baseline and three annual cognitive assessments providing 36 month follow-up data. Neuropsychological assessment comprised a battery of tests assessing working memory, long-term (episodic memory, processing speed and executive function. We calculated annualized change in cognition for the 98 patients who completed at least two time-points.Task performance was heterogeneous, but significant cognitive decline was found for the executive function index (p<0.007. Working memory and processing speed decreased numerically, but not significantly. The executive function composite score would require the smallest samples sizes for a treatment trial with an aim of halting decline, but this would still require over 2,000 patients per arm to detect a 30% difference with power of 0.8 over a three year follow-up.The pattern of cognitive decline seen in SVD over three years is consistent with the pattern of impairments at baseline. Rates of decline were slow and sample sizes would need to be large for clinical trials aimed at halting decline beyond initial diagnosis using cognitive scores as an outcome measure. This emphasizes the importance of more sensitive surrogate markers in this disease.

  4. Multiparametric multidetector computed tomography scanning on suspicion of hyperacute ischemic stroke: validating a standardized protocol Avaliação multiparamétrica por tomografia computadorizada multidetectores na suspeita de isquemia cerebral hiperaguda: validando um protocolo padronizado

    Directory of Open Access Journals (Sweden)

    Felipe Torres Pacheco

    2013-06-01

    Full Text Available Multidetector computed tomography (MDCT scanning has enabled the early diagnosis of hyperacute brain ischemia. We aimed at validating a standardized protocol to read and report MDCT techniques in a series of adult patients. The inter-observer agreement among the trained examiners was tested, and their results were compared with a standard reading. No false positives were observed, and an almost perfect agreement (Kappa>0.81 was documented when the CT angiography (CTA and cerebral perfusion CT (CPCT map data were added to the noncontrast CT (NCCT analysis. The inter-observer agreement was higher for highly trained readers, corroborating the need for specific training to interpret these modern techniques. The authors recommend adding CTA and CPCT to the NCCT analysis in order to clarify the global analysis of structural and hemodynamic brain abnormalities. Our structured report is suitable as a script for the reproducible analysis of the MDCT of patients on suspicion of ischemic stroke.A tomografia computadorizada multidetectores (TCMD permitiu o diagnóstico precoce de isquemia cerebral hiperaguda. O presente estudo objetivou validar a interpretação e a descrição padronizada de um protocolo de TCMD multiparamétrica em uma série de pacientes adultos. A concordância entre os examinadores foi testada, e seus resultados confrontados com uma leitura padrão. Não foram observados resultados falso-positivos, e foi documentado um elevado grau de concordância (Kappa>0,81 quando os dados da angiotomografia (ATC e dos mapas de perfusão cerebral por TC (PCTC foram adicionados à análise da TC sem contraste (TCSC. A concordância interobservador foi superior para os leitores melhor treinados, corroborando a necessidade de formação específica para a interpretação dos exames. Os autores recomendam acrescer a interpretação da ATC e da PCTC à análise da TCSC, visando à análise global das anormalidades cerebrais estruturais e hemodin

  5. Azelnidipine, a long-acting calcium channel blocker, could control hypertension without decreasing cerebral blood flow in post-ischemic stroke patients. A 123I-IMP SPECT follow-up study

    International Nuclear Information System (INIS)

    Azelnidipine, a long-acting calcium channel blocker, is highly lipid soluble and selective for the vascular wall, and is expected to have an increasing effect on cerebral blood flow (CBF). The aim of this study is to investigate its safety and efficacy in stroke patients in the chronic stage as far as CBF is concerned using N-isopropyl-p-123I-iodo amphetamine (123I-IMP) single-photon emission computed tomography (SPECT). The patients were orally administered 8 or 16 mg of azelnidipine. Regional CBF was evaluated by 123I-IMP SPECT using three-dimensional stereotactic region-of-interest (ROI) template (3D-SRT), a technique using anatomical standardization and ROI template consisting of 636 ROIs for the whole brain. Mean hemispheric CBF was defined as the mean value of the corpus callosum, and the precentral, central, parietal, angular and temporal gyri. Mean hemispheric and regional CBF after 1, 3 and 6 months were analyzed using a one-way repeated-measures analysis of variance. Ten post-ischemic stroke patients with hypertension were enrolled between October 2005 and October 2007, and all of them were well controlled with normal blood pressure (before: 172.3±16.6/88.4±14.0 mm Hg; 6 months: 128.7±15.9/70.9±10.1 mm Hg). No vascular events were observed during the study period. The mean hemispheric CBF was maintained during the study period (before: 46.0±9.7 ml per 100 g per min; 6 months: 49.3±11.1 ml per 100 g per min). The regional CBF was also maintained. In the chronic stage of ischemic stroke, azelnidipine could safely decrease systemic blood pressure without decreasing CBF. (author)

  6. Anesthetic Management and Postoperative Care of a Patient with CADASIL (Cerebral Arteriopathy, Autosomal Dominant, with Subcortical Infarcts and leukoencephalopathy) for Cesarean Section

    OpenAIRE

    Sousan Rasooli; Farnaz Moslemi; Simin Tagavi

    2014-01-01

    CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy) is an infrequent inherited small artery disease that could have anesthetic implications. However these have rarely been reported. We present an anesthetic experience of a female patient previously diagnosed with CADASIL, who had suffered an ischemic vascular cerebral accident with a MRI compatible with leukoencephalopathy, and who was dependent for daily activities, mood alterations, apathy,...

  7. The Incidence and Risk Factors of Associated Acute Myocardial Infarction (AMI) in Acute Cerebral Ischemic (ACI) Events in the United States

    OpenAIRE

    Ali Seifi; Kevin Carr; Mitchell Maltenfort; Michael Moussouttas; Lee Birnbaum; Augusto Parra; Owoicho Adogwa; Rodney Bell; Fred Rincon

    2014-01-01

    OBJECTIVES: To determine the association between myocardial infarction (AMI) and clinical outcome in patients with primary admissions diagnosis of acute cerebral ischemia (ACI) in the US. METHODS: Data from Nationwide Inpatient Sample (NIS) was queried from 2002-2011 for inpatient admissions of patients with a primary diagnosis of ACI with and without AMI using International Classification of Diseases, Ninth Revision, Clinical Modification coding (ICD-9). A multivariate stepwise regression an...

  8. A Pilot Study for the Neuroprotective Effect of Gongjin-dan on Transient Middle Cerebral Artery Occlusion-Induced Ischemic Rat Brain

    OpenAIRE

    Yun-Young Sunwoo; Sang In Park; Yong-An Chung; Jisoo Lee; Moon-Seo Park; Kyung-Sool Jang; Lee-So Maeng; Dong-Kyu Jang; Ruth Im; Yu Jin Jung; Soon A. Park; Eun-Sun Kang; Min-Wook Kim; Young-Min Han

    2012-01-01

    In this study, we investigated whether gongjin-dan improves functional recovery and has neuroprotective effects on reducing the infarct volume after transient middle cerebral artery occlusion (MCAo). Infarct volume was measured using TTC staining and glucose utilization by F-18 FDG PET. Functional improvement was evaluated with the Rota-rod, treadmill, Garcia score test, and adhesive removal test. At 14 days after MCAo, neuronal cell survival, astrocytes expansion, and apoptosis were assessed...

  9. Melatonin Counteracts at a Transcriptional Level the Inflammatory and Apoptotic Response Secondary to Ischemic Brain Injury Induced by Middle Cerebral Artery Blockade in Aging Rats

    OpenAIRE

    Paredes, Sergio D.; Rancan, Lisa; Kireev, Roman; González, Alberto; Louzao, Pedro; González, Pablo; Rodríguez-Bobada, Cruz; García, Cruz; Vara, Elena; Tresguerres, Jesús A.F.

    2015-01-01

    Abstract Aging increases oxidative stress and inflammation. Melatonin counteracts inflammation and apoptosis. This study investigated the possible protective effect of melatonin on the inflammatory and apoptotic response secondary to ischemia induced by blockade of the right middle cerebral artery (MCA) in aging male Wistar rats. Animals were subjected to MCA obstruction. After 24 h or 7 days of procedure, 14-month-old nontreated and treated rats with a daily dose of 10 mg/kg melatonin were s...

  10. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    Directory of Open Access Journals (Sweden)

    Sueli Luciano Pires

    2004-09-01

    Full Text Available Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é significativamente freqüente (87,8% entre pacientes idosos com AVCi, independentemente do sexo e da faixa etária. Tabagismo (46,9% e etilismo (35,1% revelaram-se fatores de riscos modificáveis freqüentes especialmente entre os homens. As cardiopatias (27,0%, o Diabete Melito (19,9% e as dislipidemias (15,6% também se revelaram fatores de risco modificáveis freqüentes em pacientes idosos com AVCi, em ambos os sexos e em ambas as faixas etárias estudadas (60 a 70 anos e mais que 71 anos. Foi relativamente baixa a freqüência de hiperuricemia nesta amostra.Two hundred and sixty two patients with clinical diagnosis of permanent ischemic stroke, all of them aged 60 or more were retrospectively studied from the 1015 cerebrovascular diseases (CVD records of the Atherosclerosis Ligue of the Neurology Clinics of the ISCMSP, from 1990 to 2002. The study emphasized modifiable risk factors frequencies for ischemic stroke in this population, considering gender and age of the patients. Results have evidenced that systemic arterial hypertension is a main risk factor significantly frequent in old people (87.8%, independently of gender and age. Smoking (46.9% and alcohol consumption (35.1% have revealed to be very frequent important modifiable risk factors especially among men. Lower frequencies have been presented for cardiac diseases (27.0%, Diabetes Melitus (19.9%, and dislipidemia (15.6% as risk factors for ischemic stroke in old people of both

  11. Comparative study on the clinical outcomes of direct PTA and intravenous rtPA thrombolytic therapy for acute cerebral ischemic stroke

    International Nuclear Information System (INIS)

    The outcomes of direct percutaneous transluminal angioplasty (PTA) and intravenous recombinant tissue plasminogen activator (rtPA) were compared in the treatment of acute cerebral infarction. The comparative study was conducted on 25 consecutive cases treated by direct PTA before October 2005 and 25 cases treated by intravenous rtPA between October 2005 and March 2007. In the treatments with direct PTA for acute cerebral arterial occlusion, the blood clot was broken up with a balloon using MRI and MR angiography (MRA) as an indication, and urokinase was administered. In the direct PTA treatment group, the recanalization rate was 88%, the good outcome rate (mRS 0-2) was 52%, and the bleeding complication rate was 16%. In the intravenous rtPA group, on the other hand, comparable results were obtained with a good outcome rate (mRS 0-2) of 56% and a bleeding complication rate of 12%. The recanalization rate was higher in the direct PTA group, while the outcome and the complication rate were similar to those in the intravenous rtPA group. These findings suggest that the time elapsed after stoke until recanalization, rather than the recanalization rate, represents an important prognostic determinant in acute cerebral arterial occlusive diseases. (author)

  12. MR imaging of ischemic penumbra

    International Nuclear Information System (INIS)

    Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra

  13. MR imaging of ischemic penumbra

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Osamu E-mail: abediag-tky@umin.ac.jp; Aoki, Shigeki; Shirouzu, Ichiro; Kunimatsu, Akira; Hayashi, Naoto; Masumoto, Tomohiko; Mori, Harushi; Yamada, Haruyasu; Watanabe, Makoto; Masutani, Yoshitaka; Ohtomo, Kuni

    2003-04-01

    Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra.

  14. Imaging of rat cerebral ischemia-reperfusion injury using99mTc-labeled duramycin

    International Nuclear Information System (INIS)

    Objectives: Prompt identification of necrosis and apoptosis in the infarct core and penumbra region is critical in acute stroke for delineating the underlying ischemic/reperfusion molecular pathologic events and defining therapeutic alternatives. The objective of this study was to investigate the capability of 99mTc-labeled duramycin in detecting ischemia-reperfusion injury in rat brain after middle cerebral artery (MCA) occlusion. Methods: Ischemic cerebral injury was induced in ten rats by vascular insertion of a nylon suture in the left MCA for 3 hr followed by 21–24 hr reperfusion. After i.v. injection of 99mTc-duramycin (1.0-3.5 mCi), dynamic cerebral images were acquired for 1 hr in six rats using a small-animal SPECT imager. Four other rats were imaged at 2 hr post-injection. Ex vivo images were obtained by autoradiography after sacrifice. Histologic analyses were performed to assess cerebral infarction and apoptosis. Results: SPECT images showed that 99mTc-duramycin uptake in the left cerebral hemisphere was significantly higher than that in the right at 1 and 2 hr post-injection. The level of radioactive uptake in the ischemic brain varied based on ischemic severity. The average ratio of left cerebral hot-spot uptake to right hemisphere radioactivity, as determined by computerized ROI analysis, was 4.92 ± 0.79. Fractional washout at 1 hr was 38.2 ± 4.5% of peak activity for left cerebral hot-spot areas and 80.9 ± 2.0% for remote control areas (P 99mTc-duramycin SPECT imaging may be useful for detecting and quantifying ongoing apoptotic neuronal cell loss induced by ischemia-reperfusion injury.

  15. Perinatal Hypoxic-Ischemic Encephalopathy

    OpenAIRE

    Ming-Chi Lai; San-Nan Yang

    2010-01-01

    Perinatal hypoxic-ischemic encephalopathy (HIE) is an important cause of brain injury in the newborn and can result in long-term devastating consequences. Perinatal hypoxia is a vital cause of long-term neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, and/or cerebral palsy in the newborn. In the mammalian developing brain, ongoing research into pathophysiological mechanism of neuronal injury and therapeutic strategy after perinatal hypoxia...

  16. Clinical Study on the Relationships Between Plasma Platelet and FIB Levels and Cerebral Ischemic Stroke%血小板、纤维蛋白原水平与缺血性脑卒中关系的临床研究

    Institute of Scientific and Technical Information of China (English)

    高俊丽

    2012-01-01

    目的 探讨缺血性脑卒中与血小板、血浆纤维蛋白原之间关系. 方法 选取缺血性脑卒中患者235例和健康者156例,进行血小板(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)及纤维蛋白原(FIB)水平检测.在人院时和出院后6个月分别评价脑卒中组患者的血小板和纤维蛋白原水平,并给予为期2年的随访. 结果 缺血性脑卒中组与健康组比较,MPV、PDW、FIB明显升高(P<0.05),PLT明显降低(P<0.05);患者的纤维蛋白原水平和神经功能损伤之间具有明显的相关性(r=0.761,P<0.05). 结论 观察PLT、MPV、PDW及FIB水平变化对病情诊断和病情判断具有重要的指导意义.%Objective To investigate the associations between the levels of plasma platelet (PLT) and fibrinogen (FIB) and cerebral ischemic stroke. Methods The levels of plasma PLT, mean platelet volume(MPV), platelet distribution width (PDW) and FIB in the blood were measured in 235 patients with cerebral ischemic stroke and 156 healthy controls. The PLT and FIB levels in the patients with cerebral ischemic stroke were evaluated on admission and six months after discharge and were followed up for two years. Results Compared with those in the control group, the levels of plasma MPV, PDW and FIB were significantly increased in the cerebral ischemic stroke group (P<0.05), while the level of PLT was markedly decreased (P< 0.05 ). A statistical correlation was revealed between the serum FIB level and the neurologic impairment (r = 0.761, P<0.05). Conclusions The measurements of the PLT, MPV, PDW and FIB are of clinical significance to the diagnosis and judgment of the conditions of cerebral ischemic stroke.

  17. 依达拉奉对脑缺血大鼠内源性神经干细胞的影响%Effects of edaravone on endogenous neural stem cells in cerebral ischemic rats

    Institute of Scientific and Technical Information of China (English)

    韩秋; 沈丽华; 张翠; 吴二兵; 刘小菲

    2011-01-01

    BACKGROUND: Edaravone (MCI-186) is a novel free radical scavenger. Many studies have confirmed that MCI-186 can inhabit brain edema in acute cerebral infarction and produce neuroprotective effects. OBJECTIVE: To investigate the effect of free radical scavenger MCI-186 on endogenous neural stem cells around ischemic brain regions after cerebral infarction. METHODS: The middle cerebral artery ischemia and reperfusion model of SD rats was established with Longa method and divided into two groups. They were administered with MCI-186 or phosphate buffered solution (PBS) immediately after artery occlusion. The contents of malondialdehyde and brain derived neurotrophic factor expressions around ischemic brain regions were monitored at 1, 3 and 7 days chronologically. Immunohistochemistry was used to monitor the expression of Nestin and Caspase-3 positive cells around the ischemic area. Neurological function was evaluated at the same time. RESULTS AND CONCLUSION: Compared with sham-surgery group, the malondialdehyde content in PBS group was increased, but reduced in the MCI-186 group (P< 0.01). The levels of brain derived neurotrophic factor protein and mRNA were both significantly increased in the PBS group at day 1 after ischemia (P< 0.01). MCI-186 enhanced the secretions and prolonged high level to day 3 compared with sham group and PBS group (P< 0.01). At days 3 and 7, the number of Nestin-positive cells in ischemic brain in MCI-186 group was notably higher than that in PBS group (P< 0.05), while Caspase-3 positive cells decreased (P< 0.05). The neurological function was obviously improved in MCI-186 group than that in PBS group at day 7. MCI-186 can inhibit lipid peroxidation, increase the secretion of brain derived neurotrophic factor in ischemic brain, protect neural stem cells from apoptosis, and confer neuroprotective effects.%背景:依达拉奉 (MCI-186)是一种新型自由基清除剂,已证实其能减轻急性脑梗死后的脑组织水肿、具

  18. Changes in synapse quantity and growth associated protein 43 expression in the motor cortex of focal cerebral ischemic rats following catalpol treatment

    Institute of Scientific and Technical Information of China (English)

    Dong Wan; Huifeng Zhu; Yong Luo; Peng Xie

    2011-01-01

    The present study investigated the effects of catalpol, the main constituent of the Chinese herb Rehmannia root, on neurons following brain ischemia. A rat model of focal permanent brain ischemia was established using electrocoagulation. The rats were intraperitoneally injected with catalpol, at a dose of 5 mg/kg, daily for 1 week. Results showed that the number of neuronal synapses in the motor cortex and growth associated protein 43 expression were increased following catalpol treatment, indicating that catalpol might contribute to neuroplasticity and ameliorate functional neurological deficits induced by cerebral ischemia.

  19. Photodynamic impact induces ischemic tolerance in models in vivo and in vitro

    Science.gov (United States)

    Demyanenko, Svetlana; Sharifulina, Svetlana; Berezhnaya, Elena; Kovaleva, Vera; Neginskaya, Maria; Zhukovskaya, Ludmila

    2016-04-01

    Ischemic tolerance determines resistance to lethal ischemia gained by a prior sublethal stimulus (i.e., preconditioning). We reproduced this effect in two variants. In vitro the preliminary short (5 s) photodynamic treatment (PDT) (photosensitizer Photosens, 10 nM, 30 min preincubation; laser: 670 nm, 100 mW/cm2) significantly reduced the necrosis of neurons and glial cells in the isolated crayfish stretch receptor, which was caused by following 30-min PDT by 66% and 46%, respectively. In vivo PDT of the rat cerebral cortex with hydrophilic photosensitizer Rose Bengal (i.v. administration, laser irradiation: 532 nm, 60 mW/cm2, 3 mm beam diameter, 30 min) caused occlusion of small brain vessels and local photothrombotic infarct (PTI). It is a model of ischemic stroke. Cerebral tissue edema and global necrosis of neurons and glial cells occurred in the infarction core, which was surrounded by a 1.5 mm transition zone, penumbra. The maximal pericellular edema, hypo- and hyperchromia of neurons were observed in penumbra 24 h after PTI. The repeated laser irradiation of the contralateral cerebral cortex also caused PTI but lesser as compared with single PDT. Preliminary unilateral PTI provided ischemic tolerance: at 14 day after second exposure the PTI volume significantly decreased by 24% than in the case of a single exposure. Sensorimotor deficits in PDT-treated rats was registered using the behavioral tests. The preliminary PTI caused the preconditioning effect.

  20. Activated conduction by small incision and moderate stimulation for treatment of cerebral palsy in 182 cases

    Institute of Scientific and Technical Information of China (English)

    Wenying Wang; Jianhua Shi; Mingjiang Yu; Dazhi Zhang

    2006-01-01

    BACKGROUND: Internationally, methods to treat cerebral palsy (CP) are basically the same, including correction of deformity with orthopaedic operation, selective posterior rhizotomy(SPR), rehabilitation therapy and so on. Domestic methods to treat CP are basically close to the international methods. Traditional Chinese medical therapies, such as, acupuncture and moxibustion, acupoint injection, massage and so on, also have good curative effects.OBJECTIVE: To observe the effect of activated conduction by small incision and moderate stimulation (ACSIMS) on limb function and living ability in patients with spastic CP at different degrees. DESIGN: Retrospective case analysis.SETTING: Department of Medical Education, Shanxi Medical College for Continuing Education. PARTICIPANTS: A total of 182 patients with CP, including 97 males and 85 females, aged 3 to 23 years, who received treatment in Beijing Haidian District Diaoyutai Hospital during October 1996 to September 2005, were involved in this trial. The involved patients met the diagnostic criteria proposed in 2004 National Special Seminar of Cerebral Palsy. According to typing criteria of CP purposed in 1990 Brioni International Conference, the involved patients were typed: 117 with spastic CP, 14 with involuntary movement CP, 19 with defective coordination CP, 5 with hypotonia CP and 27 with mixed type CP. The guardians of underage patients and adult patients themselves were all informed of the therapeutic regimens. METHODS: ①According to CP typing assessment quantitative criteria of Li, the involved patients were assigned from limb position, daily living and movement 3 aspects: mild 23, moderate 75, severe 62 and extremely severe 22. ② Operation methods: The lower limb of moderate spastic CP patient was taken as an example. A median incision or paramedian incision was made between L2 and S1, and it was also the first incision in lower limb. The secorid incision was made at the center of buttock or at the

  1. Glibenclamide for the Treatment of Ischemic and Hemorrhagic Stroke

    OpenAIRE

    Nicholas Caffes; Kurland, David B.; Volodymyr Gerzanich; J. Marc Simard

    2015-01-01

    Ischemic and hemorrhagic strokes are associated with severe functional disability and high mortality. Except for recombinant tissue plasminogen activator, therapies targeting the underlying pathophysiology of central nervous system (CNS) ischemia and hemorrhage are strikingly lacking. Sur1-regulated channels play essential roles in necrotic cell death and cerebral edema following ischemic insults, and in neuroinflammation after hemorrhagic injuries. Inhibiting endothelial, neuronal, astrocyti...

  2. Associations between arterial stiffness, depressive symptoms and cerebral small vessel disease: cross-sectional findings from the AGES-Reykjavik Study

    Science.gov (United States)

    van Sloten, Thomas T.; Mitchell, Gary F.; Sigurdsson, Sigurdur; van Buchem, Mark A.; Jonsson, Palmi V.; Garcia, Melissa E.; Harris, Tamara B.; Henry, Ronald M.A.; Levey, Andrew S.; Stehouwer, Coen D.A.; Gudnason, Vilmundur; Launer, Lenore J.

    2016-01-01

    Background Arterial stiffness may contribute to depression via cerebral microvascular damage, but evidence for this is scarce. We therefore investigated whether arterial stiffness is associated with depressive symptoms and whether cerebral small vessel disease contributes to this association. Methods This cross-sectional study included a subset of participants from the AGES-Reykjavik study second examination round, which was conducted from 2007 to 2011. Arterial stiffness (carotid–femoral pulse wave velocity [CFPWV]), depressive symptoms (15-item geriatric depression scale [GDS-15]) and cerebral small vessel disease (MRI) were determined. Manifestations of cerebral small vessel disease included higher white matter hyperintensity volume, subcortical infarcts, cerebral microbleeds, Virchow–Robin spaces and lower total brain parenchyma volume. Results We included 2058 participants (mean age 79.6 yr; 59.0% women) in our analyses. Higher CFPWV was associated with a higher GDS-15 score, after adjustment for potential confounders (β 0.096, 95% confidence interval [CI] 0.005–0.187). Additional adjustment for white matter hyperintensity volume or subcortical infarcts attenuated the association between CFPWV and the GDS-15 score, which became nonsignificant (p > 0.05). Formal mediation tests showed that the attenuating effects of white matter hyperintensity volume and subcortical infarcts were statistically significant. Virchow–Robin spaces, cerebral microbleeds and cerebral atrophy did not explain the association between CFPWV and depressive symptoms. Limitations Our study was limited by its cross-sectional design, which precludes any conclusions about causal mediation. Depressive symptoms were assessed by a self-report questionnaire. Conclusion Greater arterial stiffness is associated with more depressive symptoms; this association is partly accounted for by white matter hyperintensity volume and subcortical infarcts. This study supports the hypothesis that

  3. 应用心肺复苏仪对心搏骤停患者心脑缺血性损伤的影响%The effect of resuscitator CPR on cardio-cerebral ischemic injury of cardiac arrest patients

    Institute of Scientific and Technical Information of China (English)

    曹春水; 黄亮; 吕农华; 占钻; 殷勤; 杨继斌; 熊华威

    2013-01-01

    目的 比较徒手和心肺复苏(CPR)仪行CPR对心搏骤停患者心脑缺血性损伤的影响,探讨CPR仪在CPR中的应用价值.方法 采用前瞻性、双盲、随机对照的临床研究方法,将87例心搏骤停患者按数字表法随机分成两组,分别进行徒手CPR(n=42)及心肺复苏仪(n=45)CPR,记录两组患者自主循环恢复(ROSC)率、复苏时间、存活时间及死亡率.对46例ROSC维持>24 h的患者血清心型脂肪酸结合蛋白、血清肌钙蛋白I含量及血清S100蛋白、神经元特异性烯醇化酶的含量进行监测;比较两组CPR方法对患者心脑缺血性损伤的影响.结果 两组患者血清心型脂肪酸结合蛋白、血清肌钙蛋白I、血清S100蛋白、神经元特异性烯醇化酶较健康志愿者明显升高,CPR仪CPR组明显低于徒手CPR组;徒手CPR组复苏持续时间小于CPR仪CPR组;CPR仪组患者ROSC持续>24 h例数明显多于徒手CPR组,差异有统计学意义;但患者的ROSC率和死亡率差异无统计学意义.结论 应用心肺复苏仪行CPR更能持久、有效地使心、脑血管再灌注,减轻心脑组织细胞缺血性损伤,但不能提高CPR成功率和降低死亡率.%Objective To compare the effect of barehanded CPR and resuscitator CPR on cardiac arrest cardio - cerebral ischemic injury, and investigate the value of application resuscitator on CPR. Methods The prospective, double blinded and randomized controlled clinical trail was designed. 87 cardiac arrest patients were randomly divided into two groups according to table of random number, barehanded CPR and resuscitator CPR were carried out respectively. The rate of ROSC and mortality of the patients in two groups were recorded and the duration of CPR and survival time were also recorded. The content of myocardial damage markers serum heart fatty acid - binding protein ( H - FABP) and cardial troponin I(cTnI) , the content of serum S100 protein and neuron specific enolase (NSE) in patients of ROSC

  4. Bleeding risk during latent period after gamma knife surgery for small cerebral arteriovenous malformation. Comparison with natural history

    International Nuclear Information System (INIS)

    We studied the bleeding risk during latency period after gamma knife surgery (GKS) for small (3 cm or less) cerebral arteriovenous malformations (AVMs). We analyzed 720 cases with a natural history and 100 cases with GKS. The incidence of bleeding was calculated from the data of the former cases according to the history of bleeding and their age and was compared with the actual number obtained from the latter. The estimated incidence of bleeding was 1.6 for unruptured AVMs and 5.5 for ruptured AVMs, whereas the actual incidence of bleeding was 2 for unruptured and 0 for ruptured. The difference was statistically significant in the ruptured but was not significant in the unruptured. These results lead us to conclude that the bleeding risk during latency period after GKS for small AVMs is almost the same in the unruptured, but is decreased in the ruptured. (author)

  5. Magnetic resonance imaging in acute ischemic stroke

    International Nuclear Information System (INIS)

    This paper summarizes current MRI technology used in the diagnosis of acute cerebral infarction and discusses tasks for further improvement of MRI technology. First, the principles and methods of MRI imaging are described in terms of 1) diffusion-weighted imaging (DWI) and ADC maps, 2) perfusion imaging, 3) the fluid-attenuated inversion recovery (FLAIR) method, and 4) MR angiography (MRA). Then, the actual use of MRI in the early phase of ischemic cerebrovascular disorders is discussed focusing on general MRI procedures, cases in which an ischemic lesion dose not yield a high signal with DWI in the acute phase, and chronological changes in DWI signal strength and ADC. Third, chronological changes in acute cerebrovascular disorder in an animal model of local cerebral ischemia are summarized in terms of expansion of reduced ADC areas and ischemic penumbras in the acute phase of cerebral ischemia. Finally, chronological changes in acute ischemic disorders in patients with cerebrovascular disorders are assessed by reviewing the development of reduced ADC and expansion of DWI lesions. Whether MRI can identify cerebral tissues that can be rescued by the reperfusion method by examining the mismatchs between perfusion images and DWI, relative CBV, and ADC is also discussed. (K.H.)

  6. Correlation of cognitive impairment with ischemic stroke-inducing cerebral artery%缺血性卒中责任动脉与认知障碍的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张卫; 恽晓平

    2014-01-01

    Objective To explore the correlation of cognitive impairment with ischemic strokeinducing cerebral artery,in order to predict and find the correlations between different cognitive dysfunction and different intracranial arterial occlusion.Methods We used Montreal Cognitive Assessment (MoCA) to evaluate neuropsychological statuses in the 250 patients,who developed first time acute myocardial infarction for 2 weeks.MoCA scores and other neuropsychological cognitive assessment scores were recorded.Patients were grouped by the location of intracranial arterial occlusion.The neuropsychological cognitive assessment results were analyzed between groups.Results Middle cerebral artery occlusion was correlated with impairments of visual spatial/executive,attention,language and memory (B=-1.875 ~-1.094,P<0.05).Anterior cerebral artery and vertebral basilar artery occlusion had correlations with attention impairment (B =-3.977,B =-1.833,P<0.01).Posterior cerebral artery occlusion could cause visual spatial/executive,language and memory impairment(B=-1.714 ~-1.095,P<0.05).No correlation of cognitive impairment characteristics with anterior choroidal artery occlusion was found.Conclusions Different arterial occlusion can cause different characteristics of impairment in cognitive function,which can help to predict cognitive impairment after sub-acute stroke.It suggests that some cognitive assessments must be conducted in sub-acute stroke management.%目的 从责任动脉角度探讨缺血性卒中与认知障碍之间的关系,寻找不同责任动脉阻塞所致的特征性认知领域损害及其内在联系以期及早预测认知障碍. 方法 应用蒙特利尔认知评估量表(MoCA)北京版,对250例首次急性发病2周左右的缺血性卒中患者进行认知功能评估,记录其MoCA评分及各单项认知领域评分.按阻塞责任动脉分组,将各组的MoCA认知评估结果进行相关分析. 结果 大脑中动脉供血区梗死与视空间/执行

  7. Analysis of clinical risk factors for cerebral infarction resulting from tran-sient ischemic attact%短暂性脑缺血发作短期进展至脑梗死危险因素分析

    Institute of Scientific and Technical Information of China (English)

    裴晓蕊

    2015-01-01

    Objective To explore the clinical risk factors on cerebral infarction in progressing after transient ischemic attact (TIA) in a short time (in 30 days). Methods A total of 162 cases of TIA administrated in our hospital were per-formed to retrospective analyze. All cases were divided into two groupsCIP group and non-CIP group, and gender, age, the history of tobacco, alcohol, family history of cerebral infarction, cerebral infarction, hypertension, systolic pressure, diastolic pressure, diabetes and heart disease, fasting blood glucose level, hyperlipoidemi, hyperhocysteinemia, duration of TIA>30 min, frequent attacks>3 times, carotid atheroscalerotic plaques, intracal angiostenosis of two groups were an-alyzed. The progressing to cerebral infarction of the different ABCD2 scores in 30 days were observed. Results The his tory of hypertension, history of diabetes, duration of TIA>30 min were more in CIP group than in non-CIP group(P30 min and the ABCD2 scale are related factors for CIP.%目的:探讨短暂性脑缺血发作短期(30 d内)进展至脑梗死的临床危险因素。方法分析我院神经内科162例短暂性脑缺血发作进展至脑梗死患者的临床资料,按住院期间是否发生脑梗死,将其分为进展组及非进展组,对两组患者的性别、年龄、吸烟史、饮酒史、脑卒中家族史、既往脑梗死病史、高血压病史、入院时收缩压、舒张压、糖尿病史、空腹血糖、心脏病、高脂血症、高同型半胱氨酸血症、单次发作持续时间>30 min、发作次数>3次、颈动脉斑块、脑血管狭窄进行比较,并采用ABCD2评分法观察短暂性脑缺血发作患者30 d内进展为脑梗死的情况。结果进展组患者中有高血压、糖尿病史以及单次发作持续时间>30 min者较非进展组多见(P30 min、ABCD2评分≥4分与短暂性脑缺血发作进展至脑梗死的发生相关。

  8. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  9. Onset rule and risk factors of ischemic cerebral stroke after surgical operation%外科手术后缺血性脑卒中的发生规律及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈运红; 田成林

    2012-01-01

    Objective To study the onset rule and risk factors of ischemic cerebral stroke(ICS) after general surgery without involement of cardiovascular system and intracranial part. Methods Twenty-eight patients with ICS occurred 14 days after general surgery in our department from January 2010 to December 2011 were enrolled in this study. Those who underwent intravascular, intracranial and cardiac operation were excluded. Demographic data, operation type, anesthesia method.onset time and risk factors of ICS,and images of the patients were recorded. Results Among the 51 000 patients after general surgical operation,ICS occurred in 28(8 males and 20 females) at the age of 50 ?84 years(mean 66. 5 + 10. 8 years),usually 3 days after operation. Eighteen patients had a history of hypertension, diabetes mellitus (DM) ,atrial fibrillation( AF), coronary heart disease and ICS. Orthopedic surgery was the most common procedure for ICS. Cerebral infarction of internal carotid artery system.vertebrobasilar artery,both internal carotid artery system and vertebrobasilar artery system was observed in 22,4 and 2 patients,respectively. Conclusion Advanced age, major operation of osteoarticule and other sites, history of hypertension, DM, AF and ischemic heart disease are the risk factors for ICS after surgical operation. ICS usually occurs 3 days after surgical operation.%目的 探讨未侵入心血管系统和颅内的一般外科手术后缺血性脑卒中的发生规律和危险因素.方法 对2010年1月~2011年12月我院普通外科手术后14 d内发生缺血性脑卒中的28例患者连续登记,除外血管内手术、心脏手术和颅内手术.登记患者的一般人口学特征、手术类型、麻醉方式、脑卒中发生时间、脑卒中危险因素和影像检查结果.结果 51 000例普通外科手术患者中,共有28例术后14d内发生缺血性脑卒中,男性8例,女性20例,平均年龄(66.5±10.8)岁.脑卒中最常发生于术后3d以内.18例患者存在

  10. Anesthetic Management and Postoperative Care of a Patient with CADASIL (Cerebral Arteriopathy, Autosomal Dominant, with Subcortical Infarcts and leukoencephalopathy for Cesarean Section

    Directory of Open Access Journals (Sweden)

    Sousan Rasooli

    2014-07-01

    Full Text Available CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy is an infrequent inherited small artery disease that could have anesthetic implications. However these have rarely been reported. We present an anesthetic experience of a female patient previously diagnosed with CADASIL, who had suffered an ischemic vascular cerebral accident with a MRI compatible with leukoencephalopathy, and who was dependent for daily activities, mood alterations, apathy, and urine incontinence. We discuss anesthetic management of CADASIL patient, considering protection from further cerebral ischemia.

  11. Cerebrovascular endothelin receptor upregulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, Lars

    2009-01-01

    Stroke is a serious neurological disease and the third leading cause of death in the western world. In roughly 15 % of the cases, the cause is due to an intracranial haemorrhage, and the remaining 85 % represent ischemic strokes. Ischemic stroke is caused by the occlusion of a cerebral artery eit...

  12. Cerebrovascular endothelin receptor upregulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, Lars

    2009-01-01

    Stroke is a serious neurological disease and the third leading cause of death in the western world. In roughly 15 % of the cases, the cause is due to an intracranial haemorrhage, and the remaining 85 % represent ischemic strokes. Ischemic stroke is caused by the occlusion of a cerebral artery...

  13. Vitamin D status and vascular dementia due to cerebral small vessel disease in the elderly Asian Indian population.

    Science.gov (United States)

    Prabhakar, Puttachandra; Chandra, Sadanandavalli Retnaswami; Supriya, Manjunath; Issac, Thomas Gregor; Prasad, Chandrajit; Christopher, Rita

    2015-12-15

    Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, pvitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. PMID:26671097

  14. The incidence and risk factors of associated acute myocardial infarction (AMI in acute cerebral ischemic (ACI events in the United States.

    Directory of Open Access Journals (Sweden)

    Ali Seifi

    Full Text Available OBJECTIVES: To determine the association between myocardial infarction (AMI and clinical outcome in patients with primary admissions diagnosis of acute cerebral ischemia (ACI in the US. METHODS: Data from Nationwide Inpatient Sample (NIS was queried from 2002-2011 for inpatient admissions of patients with a primary diagnosis of ACI with and without AMI using International Classification of Diseases, Ninth Revision, Clinical Modification coding (ICD-9. A multivariate stepwise regression analysis was performed to assess the correlation between identifiable risk factors and clinical outcomes. RESULTS: During 10 years the NIS recorded 886,094 ACI admissions with 17,526 diagnoses of AMI (1.98%. The overall cumulative mortality of cohort was 5.65%. In-hospital mortality was associated with AMI (aOR 3.68; 95% CI 3.49-3.88, p≤0.0001, rTPA administration (aOR 2.39 CI, 2.11-2.71, p<0.0001, older age (aOR 1.03, 95% CI, 1.03-1.03, P<0.0001 and women (aOR 1.06, 95% CI 1.03-1.08, P<0.0001. Overall, mortality risk declined over the course of study; from 20.46% in 2002 to 11.8% in 2011 (OR 0.96, 95% CI 0.95-0.96, P<0.0001. Survival analysis demonstrated divergence between the AMI and non-AMI sub-groups over the course of study (log-rank p<0.0001. CONCLUSION: Our study demonstrates that although the prevalence of AMI in patients hospitalized with primary diagnosis of ACI is low, it negatively impacts survival. Considering the high clinical burden of AMI on mortality of ACI patients, a high quality monitoring in the event of cardiac events should be maintained in this patient cohort. Whether prompt diagnosis and treatment of associated cardiovascular diseases may improve outcome, deserves further study.

  15. Long-term neurodevelopmental outcome with hypoxic-ischemic encephalopathy

    OpenAIRE

    Perez, Anna; Ritter, Susanne; Brotschi, Barbara; Werner, Helen; Caflisch, Jon; Martin, Ernst; Latal, Beatrice

    2013-01-01

    OBJECTIVES: To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy (HIE) without major disability, and to examine neonatal injury patterns detected on cerebral magnetic resonance imaging (MRI) in relation to later deficits. STUDY DESIGN: Prospectively enrolled children with HIE and neonatal cerebral MRI data (n = 68) were examined at a mean age of 11.2 years (range, 8.2-15.7 years). Eleven children had a major disability (ie, cerebral palsy or...

  16. Analysis of recurrence cause of cerebral infarction attacking in patients above 75 years old with ischemic cerebral infarction after taking aspirin%75岁以上缺血性脑梗死老年患者服用阿司匹林后再发脑梗死原因分析

    Institute of Scientific and Technical Information of China (English)

    常富业; 赖杰; 贾丽华; 胡秋莹; 陈燕; 袁英; 李云; 李长新; 原向芝; 万继峰; 李云超; 孙莹; 宋昕

    2009-01-01

    目的 研究70岁以上缺血性脑梗死患者服用阿司匹林后脑梗死再发的相关因素.方法 采用随机、平行对照的方法 ,将既往已发脑梗死患者分为脑梗死再发组和脑梗死未再发组.观察研究时间窗内一般自身因素、生活方式、疾病相关因素及实验室检查指标的变化,探讨高龄患者服用阿司匹林后脑梗死再发的原因.结果 2组患者在体型、职业性质、饮酒方面无明显差异.在饮食结构、生活规律、睡眠质量、吸烟、锻炼、性格、就医、家族史和合并病等方面存在明显差异(P均cerebral infarction attacking in patients above 75 years old with ischemic cerebral infarction after taking aspirin. Methods The patients who had suffered from cere-bral infarction were randomly divided into recurrent group and non-recurrent group with the methods of random selection and parallel contrast. The general auto-factors, living style, factors related to the disease and changes of indexes of lab tests were observed to explore the cause of the recurrence of cerebral infarction attacking senior patients after taking aspirin. Results There were no significant differences between the two groups in body type, career and drinking alcohol, but there was dis-tinct differences (P < 0.05) in dietary structure, living pattern, sleeping

  17. Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion

    Directory of Open Access Journals (Sweden)

    Chao Zhang

    2015-01-01

    Full Text Available Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture manipulations and durations may result in different therapeutic effects. In the present study, the Neiguan (PC6 acupoint of rats with occluded middle cerebral arteries was needled at a fixed frequency (3 Hz with different durations, i.e., 5, 60 and 180 seconds under a twisting-rotating acupuncture method. Results showed that different durations of acupuncture had different therapeutic effects, with 60 seconds yielding a better therapeutic effect than the other two groups. This duration of treatment demonstrated rapid cerebral blood flow, encouraging recovery of neurological function, and small cerebral infarct volume. Experimental findings indicated that under 3 Hz frequency, the treatment of needling Neiguan for 60 seconds is effective for ischemic stroke

  18. The value of performing head CT in screening for cerebral metastases in patients with potentially resectable non-small cell lung cancer: experience from a UK cardiothoracic centre

    International Nuclear Information System (INIS)

    AIM: To evaluate the whether screening for cerebral metastases in neurologically intact patients with potentially resectable non-small cell lung cancer patients is both worthwhile and cost-effective. METHODS: We prospectively performed computed tomography (CT) of the head in 105 consecutive patients with potentially resectable lung cancer over an 18-month period. None of these patients had neurological symptoms or signs. RESULTS: Five patients (4.8%) with cerebral metastases were identified using CT. At our institution the financial saving of avoiding five thoracotomies was 45,000 Pounds, whilst the cost of performing 105 head CTs was 16,000 Pounds. This represented a substantial saving for the healthcare provider and preserved the quality of life in five patients. CONCLUSIONS: We conclude that screening for cerebral metastases in neurologically intact patients with potentially resectable non small cell lung cancer patients is both worthwhile and cost effective

  19. Cerebral Arteriosclerosis

    Science.gov (United States)

    ... the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in ...

  20. Transient acute renal failure and functional hemispheric depression after cerebral arteriography in diabetic patients

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Lund, P; Praestholm, J

    1981-01-01

    Cerebral angiography was carried out in two diabetic patients in the evaluation of minor vascular ischemic episodes. A transient acute renal failure following cerebral angiography was accompanied by a transient comatose episode with severe unilateral neurological deficits. A functional depression...

  1. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...... haemodynamics' includes cerebral blood flow (CBF), cerebral blood flow velocity, and cerebral blood volume (CBV). Therapy aimed at changing vascular anatomy is not available. Therefore, prevention of disturbances in CBF and CBV is pivotal. However, continuous monitoring of CBF and CBV is still unavailable for....... Using it even without knowing the exact level of CBF and CBV, it is possible to aim to keep CBF and CBV stable. Futureresearch should focus on development of monitoring tools, gaining more insight in neonatal cerebral autoregulation, and demonstrating clinical benefits of a 'cerebral perfusion...

  2. Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

    Directory of Open Access Journals (Sweden)

    van der Vlugt Maureen J

    2011-02-01

    Full Text Available Abstract Background Cerebral small vessel disease (SVD is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML and the normal appearing white matter (NAWM. Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white

  3. Small scale module of the rat granular retrosplenial cortex: an example of minicolumn-like structure of the cerebral cortex

    Directory of Open Access Journals (Sweden)

    Noritaka eIchinohe

    2012-01-01

    Full Text Available Structures associated with the small scale module called minicolumn can be observed frequently in the cerebral cortex. However, the description of functional characteristics remains obscure. A significant confounding factor is the marked variability both in the definition of a minicolumn and in the diagnostic markers for identifying a minicolumn (see for review, Jones, 2000, DeFelipe et al., 2003; Rockland and Ichinohe, 2004. Within a minicolumn, cell columns are easily visualized by conventional Nissl staining. Dendritic bundles were first discovered with Golgi methods, but are more easily seen with MAP2-immunohistochemisty. Myelinated axon bundles can be seen by Tau-immunohistochemistry or myelin staining. Axon bundles of double bouquet cell can be seen by calbindin-immunohistochemistry. The spatial interrelationship among these morphological elements is more complex than expected and is neither clear nor unanimously agreed upon. In this review, I would like to focus first on the minicolumnar structure found in layers 1 and 2 of the rat granular retrosplenial cortex (GRS. This modular structure was first discovered as a combination of prominent apical dendritic bundles from layer 2 pyramidal neurons and spatially-matched thalamocortical patchy inputs (Wyss et al., 2000. Further examination showed more intricate components of this modular structure, which will be reviewed in this paper. Second, the postnatal development of this structure and potential molecular players for its formation will be reviewed. Thirdly, I will discuss how this modular organization is transformed in mutant rodents with a disorganized layer structure in the cerebral cortex (i.e., reeler mouse and Shaking Rat Kawasaki. Lastly, the potential significance of this type of module will be discussed.

  4. Relationship between cerebral sodium-glucose transporter and hyperglycemia in cerebral ischemia.

    Science.gov (United States)

    Yamazaki, Yui; Harada, Shinichi; Tokuyama, Shogo

    2015-09-14

    Post-ischemic hyperglycemia exacerbates the development of cerebral ischemia. To elucidate this exacerbation mechanism, we focused on sodium-glucose transporter (SGLT) as a mediator that lead hyperglycemia to cerebral ischemia. SGLT transport glucose into the cell, together with sodium ion, using the sodium concentration gradient. We have previously reported that suppression of cerebral SGLT ameliorates cerebral ischemic neuronal damage. However, detail relationship cerebral between SGLT and post-ischemic hyperglycemia remain incompletely defined. Therefore, we examined the involvement of cerebral SGLT on cerebral ischemic neuronal damage with or without hyperglycemic condition. Cell survival rate of primary cultured neurons was assessed by biochemical assay. A mouse model of focal ischemia was generated using a middle cerebral artery occlusion (MCAO). Neuronal damage was assessed with histological and behavioral analyses. Concomitant hydrogen peroxide/glucose treatment exacerbated hydrogen peroxide alone-induced cell death. Although a SGLT family-specific inhibitor, phlorizin had no effect on developed hydrogen peroxide alone-induced cell death, it suppressed cell death induced by concomitant hydrogen peroxide/glucose treatment. α-MG induced a concentration-dependent and significant decrease in neuronal survival. PHZ administered on immediately after reperfusion had no effect, but PHZ given at 6h after reperfusion had an effect. Our in vitro study indicates that SGLT is not involved in neuronal cell death in non-hyperglycemic condition. We have already reported that post-ischemic hyperglycemia begins to develop at 6h after MCAO. Therefore, current our in vivo study show post-ischemic hyperglycemic condition may be necessary for the SGLT-mediated exacerbation of cerebral ischemic neuronal damage. PMID:26254165

  5. Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause

    OpenAIRE

    Kim, Dong-Han; Kang, Dong-Hun; Park, Jaechan; HWANG, Jeong-Hyun; Park, Seong-Hyun; Son, Won-Soo

    2015-01-01

    Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were...

  6. Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Elderen, Saskia G.C. van; Brandts, A.; Westenberg, J.J.M.; Grond, J. van der; Buchem, M.A. van; Kroft, L.J.M.; Roos, A. de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Tamsma, J.T.; Romijn, J.A.; Smit, J.W.A. [Leiden University Medical Center, Department of Endocrinology, Leiden (Netherlands)

    2010-05-15

    To evaluate, with the use of magnetic resonance imaging (MRI), whether aortic pulse wave velocity (PWV) is associated with cardiac left ventricular (LV) function and mass as well as with cerebral small vessel disease in patients with type 1 diabetes mellitus (DM). We included 86 consecutive type 1 DM patients (49 male, mean age 46.9 {+-} 11.7 years) in a prospective, cross-sectional study. Exclusion criteria included aortic/heart disease and general MRI contra-indications. MRI of the aorta, heart and brain was performed for assessment of aortic PWV, as a marker of aortic stiffness, systolic LV function and mass, as well as for the presence of cerebral white matter hyperintensities (WMHs), microbleeds and lacunar infarcts. Multivariate linear or logistic regression was performed to analyse the association between aortic PWV and outcome parameters, with covariates defined as age, gender, mean arterial pressure, heart rate, BMI, smoking, DM duration and hypertension. Mean aortic PWV was 7.1 {+-} 2.5 m/s. Aortic PWV was independently associated with LV ejection fraction (ss= -0.406, P = 0.006), LV stroke volume (ss=-0.407, P = 0.001), LV cardiac output (ss= -0.458, P = 0.001), and with cerebral WMHs (P < 0.05). There were no independent associations between aortic stiffness and LV mass, cerebral microbleeds or lacunar infarcts. Aortic stiffness is independently associated with systolic LV function and cerebral WMHs in patients with type 1 DM. (orig.)

  7. Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging

    International Nuclear Information System (INIS)

    To evaluate, with the use of magnetic resonance imaging (MRI), whether aortic pulse wave velocity (PWV) is associated with cardiac left ventricular (LV) function and mass as well as with cerebral small vessel disease in patients with type 1 diabetes mellitus (DM). We included 86 consecutive type 1 DM patients (49 male, mean age 46.9 ± 11.7 years) in a prospective, cross-sectional study. Exclusion criteria included aortic/heart disease and general MRI contra-indications. MRI of the aorta, heart and brain was performed for assessment of aortic PWV, as a marker of aortic stiffness, systolic LV function and mass, as well as for the presence of cerebral white matter hyperintensities (WMHs), microbleeds and lacunar infarcts. Multivariate linear or logistic regression was performed to analyse the association between aortic PWV and outcome parameters, with covariates defined as age, gender, mean arterial pressure, heart rate, BMI, smoking, DM duration and hypertension. Mean aortic PWV was 7.1 ± 2.5 m/s. Aortic PWV was independently associated with LV ejection fraction (ss= -0.406, P = 0.006), LV stroke volume (ss=-0.407, P = 0.001), LV cardiac output (ss= -0.458, P = 0.001), and with cerebral WMHs (P < 0.05). There were no independent associations between aortic stiffness and LV mass, cerebral microbleeds or lacunar infarcts. Aortic stiffness is independently associated with systolic LV function and cerebral WMHs in patients with type 1 DM. (orig.)

  8. Forame oval patente e acidente vascular cerebral isquêmico em jovens: associação causal ou estatística? Patent foramen ovale and ischemic stroke in young people: statistical association or causal relation?

    Directory of Open Access Journals (Sweden)

    Edson Marcio Negrão

    2007-05-01

    Full Text Available OBJETIVOS: Determinar se há evidências de uma relação causal entre forame oval patente (FOP e acidente vascular cerebral isquêmico (AVCI criptogênico em jovens. Analisar essa relação à luz dos critérios de causalidade. MÉTODOS: Avaliaram-se, retrospectivamente, 168 pacientes jovens com AVCI, divididos em dois grupos: criptogênico e de causa definida. Como parte da rotina, os pacientes foram submetidos a pesquisa de FOP por ecocardiograma transesofágico e/ou Doppler transcraniano, ambos associados ao teste de bolhas. Demonstrada a associação estatística univariada entre FOP e AVCI, procedeu-se a análise multivariada. RESULTADOS: Após análise multivariada, a associação FOP e AVCI criptogênico mostrou-se ainda estatisticamente significante, com razão de chance (RCajustada de 3,3 (IC95% 1,5-7,4. O número total de lesões no encéfalo também apresentou associação significativa com o AVCI criptogênico (RCajustada= 0,4 IC95% 0,2-0,9. A associação FOP e AVCI criptogênico satisfez todos os critérios de causalidade. CONCLUSÃO: A relação causal entre o FOP e o AVCI criptogênico em jovens é altamente provável. Esse fato deve ser considerado na decisão terapêutica.OBJECTIVES: To determine if there are evidences of a causal relation between patent foramen ovale (PFO x cryptogenic ischemic stroke (IS in the young population and to analyze this relation in terms of causal criteria. METHODS: A total of 168 young patients with IS was retrospectively evaluated and divided into two groups: cryptogenic and with a defined cause. As a routine procedure, the patients underwent investigation of the PFO by means of transesophageal echocardiogram and/or transcranial Doppler sonography, both of them associated with the bubble test. Multivariate analysis was performed after demonstration of univariate statistical association between PFO x IS. RESULTS: After multivariate analysis, the association between PFO x cryptogenic IS was still

  9. Clinical and magnetic resonance observations in cerebral small-vessel disease

    NARCIS (Netherlands)

    V.I.H. Kwa

    1999-01-01

    The study reported in this thesis tried to address the following questions: 1. Is it possible to detect genetic factors and vascular risk factors that are specifically associated with the development of small- or large-vessel disease? 2. Are the different clinical and MRI manifestations, that are at

  10. Thrombotic thrombocytopenic purpura: MRI demonstration of persistent small cerebral infarcts after clinical recovery

    International Nuclear Information System (INIS)

    Abnormalities in the brain of patients with thrombotic thrombocytopenic purpura (TTP) are infrequent on MRI, often reversible and mainly limited to symptomatic stages of the disease. We report a case in which high-resolution MRI demonstrated multiple persistent small cortical infarcts after clinical remission. High-resolution MRI investigations may detect clinically latent but permanent brain damage, and complement clinical judgement in guiding therapeutic decisions. (orig.)

  11. Persimmon leaf flavonoid induces brain ischemic tolerance in mice

    Institute of Scientific and Technical Information of China (English)

    Mingsan Miao; Xuexia Zhang; Linan Wang

    2013-01-01

    The persimmon leaf has been shown to improve cerebral ischemic outcomes; however, its mechanism of action remains unclear. In this study, mice were subjected to 10 minutes of ischemic preconditioning, and persimmon leaf flavonoid was orally administered for 5 days. Results showed that the persimmon leaf flavonoid significantly improved the content of tissue type plasminogen activator and 6-keto prostaglandin-F1 α in the cerebral cortex, decreased the content of thromboxane B2, and reduced the content of plasminogen activator inhibitor-1 in mice. Following optical microscopy, persimmon leaf flavonoid was also shown to reduce cell swelling and nuclear hyperchromatism in the cerebral cortex and hippocampus of mice. These results suggested that persimmon leaf flavonoid can effectively inhibit brain thrombosis, improve blood supply to the brain, and relieve ischemia-induced pathological damage, resulting in brain ischemic tolerance.

  12. Pre-ischemic exercise alleviates oxidative damage following ischemic stroke in rats.

    Science.gov (United States)

    Feng, Rui; Zhang, Min; Wang, Xiao; Li, Wen-Bin; Ren, Shi-Qing; Zhang, Feng

    2014-10-01

    Physical exercise has been proved to be neuroprotective in clinical trials and animal experiments. However, the exact mechanism underlying this neuroprotective effect remains unclear. The aim of the present study was to explore whether pre-ischemic treadmill training could act as a form of ischemic preconditioning in a rat following ischemic stroke by reducing oxidative damage. Fifty-four rats were randomly divided into three groups (n=18 per group): Sham surgery, middle cerebral artery occlusion (MCAO) without exercise and MCAO with exercise. Subsequent to treadmill training, ischemic stroke was induced by occluding the MCA for 1.5 h, followed by reperfusion. Six rats in each group were evaluated for neurological deficits and then sacrificed by decapitation to calculate the infarct volume. The remaining rats in each group were sacrificed to detect the level of superoxide dismutase (SOD) activity (n=6) and malondialdehyde (MDA) concentration (n=6). The results indicated that pre-ischemic exercise training reduced brain infarct volume and neurological deficits, increased SOD activity and decreased the concentration of MDA following ischemic stroke. In conclusion, treadmill exercise training prior to MCAO/reperfusion increased the antioxidant ability and decreased the oxidative damage in the brain subsequent to ischemic stroke. PMID:25187848

  13. Anticoagulation for the Acute Management of Ischemic Stroke

    OpenAIRE

    Robinson, Austin A.; Ikuta, Kevin; Soverow, Jonathan

    2014-01-01

    Few prospective studies support the use of anticoagulation during the acute phase of ischemic stroke, though observational data suggest a role in certain populations. Depending on the mechanism of stroke, systemic anticoagulation may prevent recurrent cerebral infarction, but concomitantly carries a risk of hemorrhagic transformation. In this article, we describe a case where anticoagulation shows promise for ischemic stroke and review the evidence that has discredited its use in some circums...

  14. Application of Diffusion Tensor Imaging Parameters to Detect Change in Longitudinal Studies in Cerebral Small Vessel Disease.

    Science.gov (United States)

    Zeestraten, Eva Anna; Benjamin, Philip; Lambert, Christian; Lawrence, Andrew John; Williams, Owen Alan; Morris, Robin Guy; Barrick, Thomas Richard; Markus, Hugh Stephen

    2016-01-01

    Cerebral small vessel disease (SVD) is the major cause of vascular cognitive impairment, resulting in significant disability and reduced quality of life. Cognitive tests have been shown to be insensitive to change in longitudinal studies and, therefore, sensitive surrogate markers are needed to monitor disease progression and assess treatment effects in clinical trials. Diffusion tensor imaging (DTI) is thought to offer great potential in this regard. Sensitivity of the various parameters that can be derived from DTI is however unknown. We aimed to evaluate the differential sensitivity of DTI markers to detect SVD progression, and to estimate sample sizes required to assess therapeutic interventions aimed at halting decline based on DTI data. We investigated 99 patients with symptomatic SVD, defined as clinical lacunar syndrome with MRI confirmation of a corresponding infarct as well as confluent white matter hyperintensities over a 3 year follow-up period. We evaluated change in DTI histogram parameters using linear mixed effect models and calculated sample size estimates. Over a three-year follow-up period we observed a decline in fractional anisotropy and increase in diffusivity in white matter tissue and most parameters changed significantly. Mean diffusivity peak height was the most sensitive marker for SVD progression as it had the smallest sample size estimate. This suggests disease progression can be monitored sensitively using DTI histogram analysis and confirms DTI's potential as surrogate marker for SVD. PMID:26808982

  15. Association of Chronic Kidney Disease and Cerebral Small Vessel Disease with Cognitive Impairment in Elderly Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Toshitaka Umemura

    2013-07-01

    Full Text Available Background/Aims: In recent years, the relationship between chronic kidney disease (CKD and cognitive impairment has been attracting attention. Cerebral small vessel disease (SVD is also associated with an increased risk of cognitive impairment. However, it is still unknown whether CKD markers are associated with cognitive impairment independently of SVD in elderly diabetic patients. Methods: Seventy-nine type 2 diabetic patients (mean age, 76.0 years were enrolled in the present study. CKD was defined as the presence of albuminuria and/or a low estimated glomerular filtration rate (eGFR 2. SVD was evaluated by the presence and severity of silent brain infarcts (SBIs and white matter lesions (WMLs on brain magnetic resonance imaging. Neuropsychological tests were assessed using four validated cognitive instruments. Results: In multiple linear regression analyses, albuminuria was associated with worse modified Stroop Color Word scores (β = 0.284, p = 0.017 and low eGFR was associated with reduced Digit Symbol Substitution scores (β = -0.224, p = 0.026 after adjustment for age, sex, education years, diabetes duration, hypertension, multiple SBIs, and advanced WMLs. In contrast, there were no significant associations between CKD markers and Mini-Mental State Examination or Word Recall scores. Conclusion: Our findings suggest that albuminuria and low eGFR are associated with frontal lobe dysfunction independently of SVD in elderly type 2 diabetic patients.

  16. Functional photoacoustic micro-imaging of cerebral hemodynamic changes in single blood vessels after photo-induced brain stroke

    Science.gov (United States)

    Liao, Lun-De; Chen, You-Yin; Lin, Chin-Teng; Li, Meng-Lin

    2013-03-01

    Studying the functional hemodynamic roles of individual cerebral cortical arterioles in maintaining both the structure and function of cortical regions during and after brain stroke in small animals is an important issue. Recently, functional photoacoustic microscopy (fPAM) has been proved as a reliable imaging technique to probe the total hemoglobin concentration (HbT), cerebral blood volume (CBV) and hemoglobin oxygen saturation (SO2) in single cerebral blood vessels of rats. Here, we report the application of fPAM associated with electrophysiology recordings to investigating functional hemodynamic changes in single cortical arterioles of rats with electrical forepaw stimulation after photo-induced ischemic stroke. Because of the weak optical focusing nature of our fPAM system, photo-induced ischemic stroke targeting single cortical arterioles can be easily conducted with simple adaptation. Functional HbT, CBV and SO2 changes associated with the induced stroke in selected arterioles from the anterior cerebral artery system were imaged with 36 x 65-μm spatial resolution. Experimental results showed that after photo-occlusion of a single arteriole, the functional changes of nearby arterioles in cerebral cortex only can be observed immediately after the stroke. After a few minutes of stroke onset, there are no significant functional changes under the forepaw stimulation, suggesting that alternate blood flow routes are not actively recruited. The fPAM with electrophysiology recordings complements existing imaging techniques and has the potential to offer a favorable tool for explicitly studying cerebral hemodynamics in small animal models of photo-indcued ischemic stroke.

  17. Effect of spironolactone on cerebrovascular microembolic signal, stroke recurrence and prognosis in patients with ischemic cerebral stroke%螺内酯对缺血性脑卒中患者脑血管微栓子信号、卒中复发及预后的影响

    Institute of Scientific and Technical Information of China (English)

    王亮亮; 周永; 朱向阳; 董政协; 黄怀宇; 汪芳; 王慧俐

    2013-01-01

    目的 研究螺内酯对缺血性脑卒中患者的脑血管微栓子信号(MES)、卒中复发及预后的影响.方法 将93例经颅多普勒(TCD)检测MES阳性的缺血性脑卒中患者随机分为常规治疗组(常规组,46例)及螺内酯治疗组(螺内酯组,47例).常规组给予肠溶阿司匹林、阿托伐他汀治疗;螺内酯组在常规组治疗基础上予螺内酯20 mg/d,连续用6个月.在治疗3个月、6个月时,用TCD仪检测患者双侧大脑中动脉的MES.在治疗6个月后,用美国国立卫生研究院卒中量表、改良Rankin量表和Barthel指数评定患者的预后;统计两组死亡、缺血性脑卒中复发和预后良好的例数.结果 治疗3个月和6个月时,螺内酯组的MES阳性率(46.8%,36.2%)显著低于常规组(70.5%,61.4%)(均P<0.05);治疗6个月后,两组患者死亡、缺血性脑卒中复发和预后良好的比率比较差异无统计学意义.结论 螺内酯可以明显降低缺血性脑卒中患者的脑血管MES阳性率,但对缺血性脑卒中的复发及神经功能恢复无明显影响.%Objective To research the effect of spironolactone on cerebrovascular microembolic signal(MES) , stroke recurrence and prognosis in patients with ischemic cerebral stroke. Methods Ninety three ischemic stroke patients of MES positive detected by transcranial Doppler (TCD) were randomly divided into the conventional therapy group (conventional group, 46 cases) and spironolactone treatment group ( spironolactone group, 47 cases). The patients in conventional group were given with aspirin and Atorvastatin therapy. Besides the treatments in conventional group, the patients in spironolactone group were recieved 20 mg of spironolactone per day, consecutive six months. At the treatment of 3 months and 6 months, the MES detection in patients with bilateral middle cerebral artery using TCD instrument. After 6 months of treatment, the prognosis of patients was evaluated with National institutes of health

  18. Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI

    Science.gov (United States)

    Shan, Yan; Zeng, Mengsu; Lin, Huandong; Yan, Hongmei

    2016-01-01

    Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2) patients by using 3.0 T high-resolution magnetic resonance imaging. Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age: 56.8 ± 7.5 years) were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV), flow-mediated dilation (FMD) of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs) were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease. Results. Mean PWV was 6.73 ± 2.00 m/s and FMD was 16.67 ± 9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14–3.2; P < 0.05) and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71–0.95; P < 0.05). Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease. PMID:27525261

  19. Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI.

    Science.gov (United States)

    Shan, Yan; Lin, Jiang; Xu, Pengju; Zeng, Mengsu; Lin, Huandong; Yan, Hongmei

    2016-01-01

    Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2) patients by using 3.0 T high-resolution magnetic resonance imaging. Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age: 56.8 ± 7.5 years) were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV), flow-mediated dilation (FMD) of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs) were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease. Results. Mean PWV was 6.73 ± 2.00 m/s and FMD was 16.67 ± 9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14-3.2; P < 0.05) and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71-0.95; P < 0.05). Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease. PMID:27525261

  20. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    Directory of Open Access Journals (Sweden)

    Robert Perna

    2015-01-01

    Full Text Available Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n=172 or hemorrhagic stroke (n=112 within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4 at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  1. Relaxin Peptide Hormones Are Protective During the Early Stages of Ischemic Stroke in Male Rats

    OpenAIRE

    Bergeron, Lindsay H.; Willcox, Jordan M.; Alibhai, Faisal J.; Barry J. Connell; Tarek M Saleh; Wilson, Brian C.; Alastair J S Summerlee

    2014-01-01

    The pregnancy hormone relaxin protects tissue from ischemic damage. The ability of relaxin-3, a relaxin paralog, to do so has not been explored. The cerebral expression levels of these peptides and their receptors make them logical targets for study in the ischemic brain. We assessed relaxin peptide-mediated protection, relative relaxin family peptide receptor (RXFP) involvement, and protective mechanisms. Sprague-Dawley rats receiving permanent (pMCAO) or transient middle cerebral artery occ...

  2. 缺血性脑血管病患者脑微出血的危险因素分析%Risk factors of cerebral microbleeds in patients with ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    卢俏丽; 李晨; 尹延英; 王欢; 徐梅松; 贾志荣

    2015-01-01

    目的:探讨缺血性脑血管病患者脑微出血( CMB)发生的危险因素,为脑卒中的预防及治疗提供临床依据。方法收集缺血性脑血管病135例患者的年龄、性别、体质量、身高、血压、血糖、血脂、有无吸烟史、饮酒史、心脏病史等临床资料,以及磁共振磁敏感加权成像检测CMB、无症状腔隙性脑梗死、脑白质病变情况,比较有无CMB、不同部位CMB及不同严重程度CMB患者的临床特点,采用Logistic回归对CMB的危险因素进行分析。结果135例患者中,发生CMB 55例,无CMB 80例;CMB出现在深部幕下35例、脑叶20例,其严重程度分为1级25例、2级26例、3级4例。深部幕下CMB患者年龄、BMI、收缩压水平、脑白质病变评分以及出现高血压、既往卒中史、无症状腔隙性脑梗死比例高于非CMB患者(P均<0.05),BMI及出现高血压、无症状腔隙性脑梗死比例高于脑叶CMB患者(P均<0.05),脑叶CMB患者年龄、脑白质疏松评分明显高于非CMB患者(P均<0.05)。 CMB 2级、3级患者出现高血压、既往卒中史、无症状腔隙性脑梗死比例以及脑白质疏松评分明显高于CMB 1级患者( P均<0.05)。 Logistic多元回归分析显示高龄、高血压、既往卒中史、无症状腔隙性脑梗死及脑白质病变( OR分别为7.536、0.432、0.470、0.413、2.158,P均<0.05)是CMB发生的独立危险因素。结论高龄、高血压、有腔隙性脑梗死、脑白质病变以及既往有卒中史患者易发生CMB,应注意再发脑卒中的可能。%Objective To investigate the risk factors of cerebral microbleeds ( CMB) in patients with ischemic cere-brovascular disease, and to provide clinical basis for the prevention and treatment of stroke.Methods The clinical data of 135 patients with ischemic cerebrovascular disease, including the age, sex, body mass index ( BMI) , height, blood pres-sure, blood

  3. The effect of hyperglycemia on lipid peroxidation in the global cerebral ischemia of the rat.

    OpenAIRE

    Roh, J. K.; Hong, S B; Yoon, B. W.; Kim, M.S.; Myung, H.

    1992-01-01

    To investigate the influence of hyperglycemia on ischemic brain damage, we measured brain ATP, lactate and malondialdehyde (MDA) levels in global cerebral ischemic models of Wistar rats. We induced global cerebral ischemia by the 4-vessel occlusion method. After 30 or 60 min of occlusion, and after 30 min of reperfusion, we measured brain ATP, lactate and MDA levels. During the ischemic period, brain ATP levels decreased to 30-70% of sham groups both in normoglycemic and hyperglycemic groups....

  4. Effects of melatonin on mitochondria after cerebral isehemic reperfusion

    Institute of Scientific and Technical Information of China (English)

    Wang Hongyu

    2000-01-01

    Melatonin has been regarded as a free radical scavenger and antioxidant. In both in vitro and in vivo experiments. Melatonin was found to protect cells, tissues and organs against oxidative damage induced by a variety of free radical generating agents and processes, e.g., ischemic reperfusion. The mechanisms underlying these interactions have not been defined. The goal of the present study was to observe the effects of melatonin on rnitochondria after cerebral ischemic reperfusion and the mechanisms of neuroprotection of melatonin by gerbil ischemic model. Male Mongolian gerbils were subjected to 10 min of forebrain ischemia by occlusion of both common carotid arteries under anesthesia. Melatonin(0.8 mg/kg) was administrated intraperitoneum 30 min befbre arteries occlusion. We measured the respiratory function of mitochondria, the activities of ATPase, the free mitochondrial calcium contents and the GSH level of mitochondria. The results show that oxidative phosphorylation function of mitochondria was damaged after cerebral ischemic reperfusion. And mitochondrial calcium was overloaded after cerebral ischemic reperfusion. And the level of GSH in mitochondria decreased after cerebral ischemic reperfision. It is concluded that melatonin have neuroprotection effects after cerebral ischemic repertusion and this effects probably related to the protection mitochondria.

  5. Protective effect of extract of Cordyceps sinensis in middle cerebral artery occlusion-induced focal cerebral ischemia in rats

    OpenAIRE

    Liu, Zhenquan; Li, Pengtao; ZHAO, Dan; Tang, Huiling; Guo, Jianyou

    2010-01-01

    Background Ischemic hypoxic brain injury often causes irreversible brain damage. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines. From the point of view of "self-medication" or "preventive medicine," Cordyceps sinensis was used in the prevention of cerebral ischemia in this paper. Methods The right middle cerebral artery occlusion model was used in the study. The effects of Cordyceps si...

  6. Insular Ischemic Stroke: Clinical Presentation and Outcome

    OpenAIRE

    Lemieux, F.; Lanthier, S.; Chevrier, M.-C.; de Gioia, L.; I. Rouleau; Cereda, C.; Nguyen, D.K.

    2012-01-01

    Background The insula is a small but complex structure located in the depth of the sylvian fissure, covered by the frontal, parietal and temporal operculum. Ischemic strokes limited to the insula are rare and have not been well studied. Our objective is to better define the clinical presentation and outcome of insular ischemic strokes (IIS). Methods We reviewed the institutional prospective, consecutive stroke database from two centers to identify patients with IIS seen between 2008 and 2010....

  7. Relationship Between HbAlc Levels and Cerebral Arterial Lesions in Patients With Ischemic Stroke With Different Glucose Metabolism%不同糖代谢状况缺血性脑卒中患者HbAlc水平与脑动脉病变程度的关系

    Institute of Scientific and Technical Information of China (English)

    詹红艳; 杨红英; 袁莉; 牛春华; 王丽英; 陈丽丽

    2015-01-01

    ObjectiveTo study the relationship between the level of glycosylated hemoglobin and cerebral arterial lesions in patients with ischemic stroke with different glucose metabolism.Methods 120 cases of ischemic stroke patients were chosen from June 2013 to June 2015 in Tangshan workers hospital, according to glucose metabolism is divided into normal group (n=20) and abnormal group (n=65), diabetes group (n=35). To analysis of HbA1c level, risk factors for cerebral artery disease, cerebral artery lesion sites and count of the three groups were compared. ResultsThere were no significant differences in gender, hypertension, smoking, TG, Hcy among the three groups (P>0.05), the differences were statistically signiifcant with alcohol, coronary heart disease, TC, HDL-C, HbAlc, LDL-C In the three groups of patients (P<0.05). In the patients with abnormal glucose metabolism and diabetes mellitus, cerebral blood vessel stenosis was dominated by moderate and severe cerebral artery stenosis, and the main was the main and the most affected (P<0.05).Conclusion Different levels of glucose metabolism affect cerebral vascular lesions and HbAlc level of cerebral artery stenosis, the location of the lesion and lesion count is affect brain artery disease are important risk factors.%目的研究不同糖代谢状况缺血性脑卒中患者的糖化血红蛋白水平与脑动脉病变程度的关系。方法选取2013年6月~2015年6月唐山市工人医院收治的缺血性脑卒中患者120例,根据糖代谢情况分为正常组(n=20)、异常组(n=65)、糖尿病组(n=35),比较三组的一般资料、分析HbAlc水平、脑动脉病变危险因素、脑动脉病变部位及支数。结果三组患者性别、高血压、吸烟、TG、Hcy等方面比较,差异无统计学意义(P>0.05),三组患者中饮酒、冠心病、HbAlc、TC、HDL-C、LDL-C比较,差异有统计学意义(P<0.05);三组患者中,正常组脑血管狭窄以轻度为主,

  8. Cerebral Hypoxia

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Hypoxia Information Page Synonym(s): Hypoxia, Anoxia Table of Contents ( ... Trials Organizations Publicaciones en Español What is Cerebral Hypoxia? Cerebral hypoxia refers to a condition in which ...

  9. Value of ABCD2 in predicting early ischemic stroke in patients diagnosed with transient ischemic attack.

    OpenAIRE

    Mojtaba Chardoli; Alireza Khajavi; Mohsen Nouri; Vafa Rahimi-Movaghar

    2013-01-01

    As a significant number of patients diagnosed with transient ischemic attack (TIA) at emergency department are at risk to develop TIA or cerebral vascular accident (CVA), several attempts have been made to figure out a predictive method to detect those at higher risk of such attacks. We aimed to evaluate the role of ABCD2 scoring which includes age, blood pressure, clinical symptoms, diabetes mellitus, and duration of symptoms in predicting short term outcome of the patients presenting with T...

  10. Predicting value of ABCD2 in early ischemic stroke in patients diagnosed with transient ischemic attack

    OpenAIRE

    Chardoli, Mojtaba; Khajavi, Alireza; Nouri, Mohsen; Rahimi-Movaghar, Vafa

    2012-01-01

    Abstract: Background: As a significant number of patients diagnosed with transient ischemic attack (TIA) at emergency department are at risk to develop TIA or cerebral vascular accident (CVA), several attempts have been made to figure out a predictive method to detect those at higher risk of such attacks. Therefore, the present study was aimed to evaluate the role of ABCD2 scoring including age, blood pressure, clinical features, duration, and diabetes mellitus (DM), in predicting short term ...

  11. Molecular identification of Emericella echinulata as a cause of Cerebral Aspergillosis in a patient following small bowel and liver transplantation

    Science.gov (United States)

    Molecular methods are now more commonly used for identification of the aspergilli and their teleomorphs and have led to reports of species not previously recognized as causing human disease. We report the first case of cerebral aspergillosis in a compromised patient caused by Emericella echinulata,...

  12. Cerebral MRI findings in very-low-birth-weight and small-for-gestational-age children at 15 years of age

    International Nuclear Information System (INIS)

    A high prevalence of abnormal cerebral MRI findings has been reported in low-birth-weight children. To compare MRI findings in very-low-birth-weight (VLBW) and term small-for-gestational-age (SGA) children with controls in early adolescence. Cerebral MRI was used to examine 55 VLBW, 54 SGA and 66 controls at 15 years of age. The MR images were qualitatively assessed, and size of ventricles, white-matter and grey-matter abnormalities were reported. The VLBW teenagers had a higher prevalence of various MRI abnormalities than SGA children and controls. Dilation of the ventricular system, especially of the occipital horns, was found in 82% of the VLBW group, in 19% of the SGA group and in 21% of controls. White-matter reduction was found in 53% of the VLBW, in 6% of the SGA and in 2% of controls. Corpus callosum thinning was found in 47% of the VLBW, in 2% of the SGA and in 6% of controls. Periventricular gliosis was found in 29% of the VLBW, in 4% of the SGA and in 8% of controls. Cerebral MRI pathology in white matter is a common finding in VLBW teenagers. The findings may indicate minor perinatal PVL with resulting loss of white-matter tissue and ventricular dilation. (orig.)

  13. Hemorrhagic transformation in ischemic posterior infarction by magnetic resonance imaging (MRI)

    International Nuclear Information System (INIS)

    Purpose: To describe the incidence, time course, and clinical correlates of hemorrhagic transformation (HT) of ischemic stroke in the posterior cerebral artery territory. Methods: Within 42 months 48 patients with 52 occipital lobe infarctions were examined by T1- and T2-weighted MR imaging. The extent and distribution of secondary hemorrhage were analysed at different intervals after stroke. Volume of ischemic and hemorrhagic infarction was measured planimetrically. Results: HT was observed in 71% of the infarcts between the 5th day and up to 1 year after stroke. HT was most frequently (88%) observed in the 2nd and 3rd month. HT was present in 55% of small infarcts (3), in 88% of medium size (10-50 cm3), and in all large (>50 cm3) infarcts. In 92% HT presented with petechial bleedings within the cortex (64%) or less frequently (28%) in subcortical structures. The latter types of HT showed no progression and did not increase the clinical deficits. Space-occupying bleedings occurred in only two large defects. Conclusions: In ischemic posterior infarction, HT can frequently be detected within the first three months after stroke and is predominantly of the petechial type and seems not to be relevant with regard to clinical deficits. (orig.)

  14. Effects of JPEG data compression on magnetic resonance imaging evaluation of small vessels ischemic lesions of the brain; Efeitos da compressao de dados JPEG na avaliacao de lesoes vasculares cerebrais isquemicas de pequenos vasos em ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Kuriki, Paulo Eduardo de Aguiar; Abdala, Nitamar; Nogueira, Roberto Gomes; Carrete Junior, Henrique; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: paulokuriki@gmail.com

    2006-01-15

    Objective: to establish the maximum achievable JPEG compression ratio without affecting quantitative and qualitative magnetic resonance imaging analysis of ischemic lesion in small vessels of the brain. Material and method: fifteen DICOM images were converted to JPEG with a compression ratio of 1:10 to 1:60 and were assessed together with the original images by three neuro radiologists. The number, morphology and signal intensity of the lesions were analyzed. Results: lesions were properly identified up to a 1:30 ratio. More lesions were identified with a 1:10 ratio then in the original images. Morphology and edges were properly evaluated up toa 1:40 ratio. Compression did not affect signal. Conclusion: small lesions were identified ( < 2 mm ) and in all compression ratios the JPEG algorithm generated image noise that misled observers to identify more lesions in JPEG images then in DICOM images, thus generating false-positive results.(author)

  15. Pre-ischemic treadmill training alleviates brain damage via GLT-1-mediated signal pathway after ischemic stroke in rats.

    Science.gov (United States)

    Wang, X; Zhang, M; Yang, S-D; Li, W-B; Ren, S-Q; Zhang, J; Zhang, F

    2014-08-22

    Physical exercise could play a neuroprotective role in both human and animals. However, the involved signal pathways underlying the neuroprotective effect are still not well established. This study was to investigate the possible signal pathways involved in the neuroprotection of pre-ischemic treadmill training after ischemic stroke. Seventy-two SD rats were randomly assigned into three groups (n=24/group): sham surgery group, middle cerebral artery occlusion (MCAO) group and MCAO with exercise group. Following three weeks of treadmill training exercise, ischemic stroke was induced by occluding the middle cerebral artery (MCA) in rat for 2 h, followed by reperfusion. Twenty-four hours after MCAO/reperfusion, 12 rats in each group were evaluated for neurological deficit scores and then sacrificed to measure the infarct volume (n=6) and cerebral edema (n=6). Six rats in each group were sacrificed to measure the expression level of glutamate transporter-1 (GLT-1), protein kinase C-α (PKC-α), Akt, and phosphatidylinositol 3 kinase (PI3K) (n=6). Two hundred and eighty minutes (4.67 h) after occlusion, six rats in each group were decapitated to detect the mRNA expression level of metabotropic glutamate receptor 5 (mGluR5) and N-methyl-D-aspartate receptor subunit type 2B (NR2B) (n=6).The results demonstrated that pre-ischemic treadmill training exercise reduced brain infarct volume, cerebral edema and neurological deficits, also decreased the over expression of PKC-α and increased the expression level of GLT-1, Akt and PI3K after ischemic stroke (pexercise (pexercise preconditioning ameliorated brain damage after ischemic stroke, which might be involved in two signal pathways: PKC-α-GLT-1-Glutamate and PI3K/Akt-GLT-1-Glutamate. PMID:24907601

  16. Gene expression profiling in the human middle cerebral artery after cerebral ischemia

    DEFF Research Database (Denmark)

    Vikman, P; Edvinsson, L

    2006-01-01

    We have investigated the gene expression in human middle cerebral artery (MCA) after ischemia. Ischemic stroke affects the perfusion in the affected area and experimental cerebral ischemia results in upregulation of vasopressor receptors in the MCA leading to the ischemic area. We obtained human...... MCA samples distributing to the ischemic area, 7-10 days post-stroke. The gene expression was examined with real-time polymerase chain reaction (PCR) and microarray, proteins were studied with immunohistochemistry. We investigated genes previously shown to be upregulated in animal models of cerebral...... ischemia (e.g. ET(A), ET(B), AT1, AT2, and 5-HT(2A/1B/1D)). Their mRNA expression was increased compared with controls, consistent with findings in experimental stroke. Immunohistochemistry showed upregulation of the receptors localized on the smooth muscle cells. The gene expression was profiled with...

  17. A more consistent intraluminal rhesus monkey model of ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Bo Zhao; Fauzia Akbary; Shengli Li; Jing Lu; Feng Ling; Xunming Ji; Guowei Shang; Jian Chen; Xiaokun Geng; Xin Ye; Guoxun Xu; Ju Wang; Jiasheng Zheng; Hongjun Li

    2014-01-01

    Endovascular surgery is advantageous in experimentally induced ischemic stroke because it causes fewer cranial traumatic lesions than invasive surgery and can closely mimic the pathophysiol-ogy in stroke patients. However, the outcomes are highly variable, which limits the accuracy of evaluations of ischemic stroke studies. In this study, eight healthy adult rhesus monkeys were randomized into two groups with four monkeys in each group:middle cerebral artery occlusion at origin segment (M1) and middle cerebral artery occlusion at M2 segment. The blood lfow in the middle cerebral artery was blocked completely for 2 hours using the endovascular microcoil placement technique (1 mm × 10 cm) (undetachable), to establish a model of cerebral ischemia. The microcoil was withdrawn and the middle cerebral artery blood lfow was restored. A revers-ible middle cerebral artery occlusion model was identiifed by hematoxylin-eosin staining, digital subtraction angiography, magnetic resonance angiography, magnetic resonance imaging, and neurological evaluation. The results showed that the middle cerebral artery occlusion model was successfully established in eight adult healthy rhesus monkeys, and ischemic lesions were apparent in the brain tissue of rhesus monkeys at 24 hours after occlusion. The rhesus monkeys had symp-toms of neurological deifcits. Compared with the M1 occlusion group, the M2 occlusion group had lower infarction volume and higher neurological scores. These experimental ifndings indicate that reversible middle cerebral artery occlusion can be produced with the endovascular microcoil technique in rhesus monkeys. The M2 occluded model had less infarction and less neurological impairment, which offers the potential for application in the ifeld of brain injury research.

  18. The neuroprotective mechanism of brain ischemic preconditioning

    Institute of Scientific and Technical Information of China (English)

    Xiao-qian LIU; Rui SHENG; Zheng-hong QIN

    2009-01-01

    Brain ischemia is one of the most common causes of death and the leading cause of adult disability in the world. Brain ischemic pre- conditioning (BIP) refers to a transient, sublethal ischemia which results in tolerance to later, otherwise lethal, cerebral ischemia. Many attempts have been made to understand the molecular and cellular mechanisms underlying the neuroprotection offered by ischemic preconditioning. Many studies have shown that neuroprotective mechanisms may involve a series of molecular regulatory pathways including activation of the N-methyI-D-aspartate (NMDA) and adenosine receptors; activation of intracellular signaling pathways such as mitogen activated protein kinases (MAPK) and other protein kinases; upregulation of Bcl-2 and heat shock proteins (HSPs); and activation of the ubiquitin-proteasome pathway and the autophagic-lysosomal pathway. A better understanding of the processes that lead to cell death after stroke as well as of the endogenous neuroprotective mechanisms by which BIP protects against brain ischemic insults could help to develop new therapeutic strategies for this devastating neurological disease. The purpose of the present review is to summarize the neuroprotective mechanisms of BIP and to discuss the possibility of mimicking ischemic preconditioning as a new strategy for preventive treatment of ischemia.

  19. Ischemic Stroke during Pregnancy and Puerperium

    Directory of Open Access Journals (Sweden)

    Elisabetta Del Zotto

    2011-01-01

    Full Text Available Ischemic stroke during pregnancy and puerperium represents a rare occurrence but it could be a serious and stressful event for mothers, infants, and also families. Whenever it does occur, many concerns arise about the safety of the mother and the fetus in relation to common diagnostic tests and therapies leading to a more conservative approach. The physiological adaptations in the cardiovascular system and in the coagulability that accompany the pregnant state, which are more significant around delivery and in the postpartum period, likely contribute to increasing the risk of an ischemic stroke. Most of the causes of an ischemic stroke in the young may also occur in pregnant patients. Despite this, there are specific conditions related to pregnancy which may be considered when assessing this particular group of patients such as pre-eclampsia-eclampsia, choriocarcinoma, peripartum cardiomiopathy, amniotic fluid embolization, and postpartum cerebral angiopathy. This article will consider several questions related to pregnancy-associated ischemic stroke, dwelling on epidemiological and specific etiological aspects, diagnostic issue concerning the use of neuroimaging, and the related potential risks to the embryo and fetus. Therapeutic issues surrounding the use of anticoagulant and antiplatelets agents will be discussed along with the few available reports regarding the use of thrombolytic therapy during pregnancy.

  20. CBF and CMRo2 during craniotomy for small supratentorial cerebral tumours in enflurane anaesthesia. A dose-response study

    International Nuclear Information System (INIS)

    In 14 patients with supratentorial cerebral tumours with midline shift ≤ 10 mm, cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRo2) were measured twice on the contralateral side of the craniotomy, using a modification of the Kety and Schmidt method. For induction of anaesthesia, thiopental, fentanyl and pancuronium were used. The anaesthesia was maintained with enflurane 1% in nitrous oxide 67%. Moderate hypocapnia to a level averaging 4.3 kPa was achieved. The patients were divided into two groups. In group 1 (n=7), 1% enflurane was used throughout the anaesthesia, and CBF and CMRo2 measured about 70 min after induction averaged 30.1 ml 100 g-1 min-1 and 1.98 ml O2 100 g-1 min-1, respectively. During the second CBF study 1 h later, CBF and CMRo2 were unchanged (P>0.05). In group 2 (n=7), the inspiratory enflurane concentration was increased from 1 to 2% after the first CBF measurement. In this group a significant decrease in CMRo2 was observed, while CBF was unchanged. In six patients EEG was recorded simultaneously with the CBF measurements. In patients subjected to increasing enflurane concentration (Group 2), a suppression in the EEG activity was observed without spike waves. It is concluded that enflurane induces a dose-related decrease in CMRo2 and suppression in the EEG activity, whereas CBF was unchanged (author)

  1. Tuberculoma cerebral Cerebral tuberculoma

    OpenAIRE

    ELIZABETH CLARA BARROSO; TÂNIA REGINA BRÍGIDO DE OLIVEIRA; ANA MARIA DANTAS DO AMARAL; VALÉRIA GÓES FERREIRA PINHEIRO; ANA LÚCIA DE OLIVEIRA SOUSA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  2. Evolving Treatments for Acute Ischemic Stroke.

    Science.gov (United States)

    Zerna, Charlotte; Hegedus, Janka; Hill, Michael D

    2016-04-29

    The purpose of this article is to review advances in stroke treatment in the hyperacute period. With recent evolutions of technology in the fields of imaging, thrombectomy devices, and emergency room workflow management, as well as improvement in statistical methods and study design, there have been ground breaking changes in the treatment of acute ischemic stroke. We describe how stroke presents as a clinical syndrome and how imaging as the most important biomarker will help differentiate between stroke subtypes and treatment eligibility. The evolution of hyperacute treatment has led to the current standard of care: intravenous thrombolysis with tissue-type plasminogen activator and endovascular treatment for proximal vessel occlusion in the anterior cerebral circulation. All patients with acute ischemic stroke are in need of hyperacute secondary prevention because the risk of recurrence is highest closest to the index event. The dominant themes of modern stroke care are the use of neurovascular imaging and speed of diagnosis and treatment. PMID:27126651

  3. Temporal delta wave and ischemic lesions on MRI

    International Nuclear Information System (INIS)

    The present study was designed to determine the clinical significance of a temporal low-voltage irregular delta wave (TLID) on EEG. Among 808 EEG records examined during one year at our hospital, the TLID was commonly detected in patients with clinically diagnosed ischemic brain diseases such as multiple infarction. Subsequently, a relation of the TLID to ischemic lesions on MRI was examined in 50 elderly depressive patients. It was found that there was a close correlation between the occurrence of the TLID and small ischemic lesions on MRI (p<0.001). These results suggest that the TLID is a valuable indicator of minor ischemic changes of the brain. (author)

  4. Progesterone is neuroprotective by inhibiting cerebral edema after ischemia

    Institute of Scientific and Technical Information of China (English)

    Yuan-zheng Zhao; Min Zhang; Heng-fang Liu; Jian-ping Wang

    2015-01-01

    Ischemic edema can alter the structure and permeability of the blood-brain barrier. Recent stud-ies have reported that progesterone reduces cerebral edema after cerebral ischemia. However, the underlying mechanism of this effect has not yet been elucidated. In the present study, pro-gesterone effectively reduced Evans blue extravasation in the ischemic penumbra, but not in the ischemic core, 48 hours after cerebral ischemia in rats. Progesterone also inhibited the down-reg-ulation of gene and protein levels of occludin and zonula occludens-1 in the penumbra. These results indicate that progesterone may effectively inhibit the down-regulation of tight junctions, thereby maintaining the integrity of the blood-brain barrier and reducing cerebral edema.

  5. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Tohru; Sasamori, Yumiko; Takahashi, Hachisaburou; Mikami, Juniti; Ishii, Yuuko; Okada, Kinya; Shirafuji, Naoko; Kashiwakura, Takeshi [Takahashi Neurosurgical Hospital, Sapporo (Japan)

    2000-09-01

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  6. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    International Nuclear Information System (INIS)

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  7. Educational levels and the functional dependence of ischemic stroke survivors Nível de escolaridade e dependência funcional em sobreviventes de acidente vascular cerebral isquêmico

    OpenAIRE

    Tiótrefis G. Fernandes; Goulart, Alessandra C.; Waldyr R. Santos-Junior; Airlane P Alencar; Benseñor, Isabela M.; Lotufo, Paulo A.

    2012-01-01

    We evaluated the functional dependence of stroke survivors from the Study of Stroke Mortality and Morbidity, using the Rankin Scale. Out of 355 ischemic stroke survivors (with a mean age of 67.9 years), 40% had some functional dependence at 28 days and 34.4% had some functional dependence at 6 months. Most predictors of physical dependence were identified at 28 days. These predictors were: low levels of education [illiterate vs. > 8 years of education, multivariate odds ratio (OR) = 3.7; ...

  8. Obstruction of cerebral arteries in childhood stroke

    International Nuclear Information System (INIS)

    Middle cerebral artery obstruction in children is reviewed by our two cases. Ischemic childhood stroke was caused by moyamoya disease in the first, and by fibromuscular dysplasia in the second patient. In both cases transcranial Doppler sonography and cranial CT were performed, but the final diagnosis was made by angiography. The importance of angiography in childhood stroke is emphasized. (orig.)

  9. Effects of treadmill training on matrix metalloproteinases-2 and vascular endotheliar growth factor in ischemic brain of rats after cerebral ischemia-reperfusion%跑台训练对大鼠脑缺血再灌注后脑组织基质金属蛋白酶-2和血管内皮生长因子表达的影响

    Institute of Scientific and Technical Information of China (English)

    马跃文; 强琳

    2012-01-01

    Objective: To study the effects of treadmill training on the recovery of neurological function and the expression of MMP-2 and VEGF in ischemic brain of rats after cerebral ischemia-reperfusion. Method: A total of thirty-five male adult Wistar rats were given cerebral ischemia-reperfusion and were randomly divided into sham-operated group, control group and exercise group, with treadmill running. Neurological function was measured at the 24h after the operation, the 3rd, the 7th and the 14th day after the beginning of exercise respectively. RT-PCR was used to detect the expression of MMP-2 and VEGF in the ischemic brain at the 3rd, 7th and 14th day. Result: Compared with those in the control group, the behavior scores in exercise group was much lower at the 7th and 14th day (P < 0.05). MMP-2 expression in exercises group was higher than in the control group at the 7th and 14th day (P<0.05). The expression of VEGF in the exercise group was greater than that in the control group at all points (P < 0.05). Conclusion: The expression of MMP-2 and VEGF in the brain ischemic area can be improved through treadmill training. It can promote recovery of neurological function by developing neurogenesis and promoting vascularization after cerebral infarction.%目的:探讨跑台训练对大鼠脑缺血再灌注神经功能恢复和缺血脑组织中MMP-2和VEGF表达的影响.方法:用线栓法制作Wistar大鼠大脑中动脉梗死再灌注模型,35只大鼠随机分为假手术组、跑台训练组和手术对照组.跑台训练和手术对照组又分为跑3天、跑7天、跑14天3个亚组,各业组及假手术组每组5只大鼠.跑台组于术后第3天开始给予跑台训练,假手术组及手术对照组不予跑台训练.于跑3天、跑7天、跑14天3个时间点进行神经功能评估后处死大鼠.采用RT-PCR技术测定缺血区脑组织中MMP-2及VEGF的水平.结果:跑台训练组在跑7天、跑14天神经功能评分明显低于对照组(P<0.05).

  10. 12 hours after cerebral ischemia is the optimal time for bone marrow mesenchymal stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    Seyed Mojtaba Hosseini; Mohammad Farahmandnia; Zahra Razi; Somayeh Delavarifar; Benafsheh Shakibajahromi

    2015-01-01

    Cell therapy using stem cell transplantation against cerebral ischemia has been reported. However, it remains controversial regarding the optimal time for cell transplantation and the transplantation route. Rat models of cerebral ischemia were established by occlusion of the middle cerebral artery. At 1, 12 hours, 1, 3, 5 and 7 days after cerebral ischemia, bone marrow mesenchymal stem cells were injected via the tail vein. At 28 days after cerebral ischemia, rat neurological function was evaluated using a 6-point grading scale and the pathological change of ischemic cerebral tissue was observed by hematoxylin-eosin staining. Under the lfuorescence microscope, the migration of bone marrow mesenchymal stem cells was examined by PKH labeling. Caspase-3 activity was measured using spectrophotometry. The optimal neurological function recovery, lowest degree of ischemic cerebral damage, greatest number of bone marrow mesenchymal stem cells migrating to peri-ischemic area, and lowest caspase-3 activity in the ischemic cerebral tissue were observed in rats that underwent bone marrow mesenchymal stem cell transplantation at 12 hours after cerebral ischemia. These ifndings suggest that 12 hours after cerebral ischemia is the optimal time for tail vein injection of bone marrow mesenchymal stem cell transplantation against cerebral ischemia, and the strongest neuroprotective effect of this cell therapy appears at this time.

  11. Cerebral angiographic findings in thromboangiitis obliterans

    Energy Technology Data Exchange (ETDEWEB)

    No, Young J.; Lee, Eun M.; Kim, Jong S. [University of Ulsan, Department of Neurology, Asan Medical Center, Song Pa, PO Pox 145, Seoul (Korea); Lee, Deok H. [University of Ulsan, Department of Neuroradiology, Asan Medical Center, Song Pa, PO Pox 145, Seoul (Korea)

    2005-12-01

    Transient ischemic attacks (TIAs) or ischemic stroke may complicate thromboangiitis obliterans (TAO). However, there has been debate regarding the mechanism of ischemic stroke in TAO. We report the case of a patient with TAO who developed repeated TIAs. An angiogram showed multiple alternative areas of arterial occlusions in the distal segments of both middle cerebral arteries. Extensive collateral vessels around the occluded segment were also observed, which resembled the ''tree root'' or ''corkscrew'' vessels described in the peripheral arteries in TAO. Our patient illustrates that cerebral manifestations of TAO may occur with vascular changes that are identical with those encountered in the limb arteries in TAO. (orig.)

  12. Preliminary study on the effect of chronic nicotine intake on cerebral edema induced by ischemic reperfusion in rats%慢性摄入尼古丁加重大鼠脑缺血再灌注损伤性脑水肿的初步研究

    Institute of Scientific and Technical Information of China (English)

    陈晓; 赵津京; 蒋功达; 徐烈钧; 段喜森; 佘志峰; 陈炜炜; 潘树义

    2014-01-01

    Objective To observe the effect of chronic nicotine intake on cerebral edema induced by ischemic reperfusion in rats and also to investigate the mechanism involved.Methods Ninety male SD rats,with an age of 10 weeks,were randomly divided into the normal saline group (n =45),and the nicotine group (n =45).The animals in the 2 groups were respectively given physiological saline (0.5 ml/kg · d) and nicotine (subcutaneous injection with nicotine at a dosage of 3mg/kg · d) for 6 weeks.After 6 weeks,models of cerebral injury induced by ischemic reperfusion were developed,and occurrence and seriousness of cerebral edema were observed at 5 different time points (there were 9 animals in each group at each different time point).Endothelial cell strains from cerebral micro vessels,bEnd.3,were collected for culture from the animals of the control group and the nicotine group.The animals in the nicotine group were further divided into zthe nicotine group (1μmol/L) and the nicotine + α-bungarotoxin group (nicotine 1 μmol/L,α-bungarotoxin 0.1μmol/L).Changes in cell permeability and the expressions of aquaporin 1 (AQP1) were detected in the animals of the 3 groups.Results Three hours after ischemic reperfusion,cerebral edema in the animals of the nicotine group obviously worsened,as compared with that of the animals in the control group.Cerebral water contents of the 2 groups came to peak levels at 12.0 h after ischemic reperfusion,reaching the levels of(86.53 ± 2.26) % and(90.47 ± 1.94) % respectively,with statistical significance (P < 0.01).Detection of bEnd.3 in the cerebral micro-vessel endothelial cell strains revealed that cell permeability in the nicotine group [(114 ± 15)%] was significantly higher than that of the control group [(100 ± 13)%],with statistical significance (P <0.01).Cell permeability in the nicotine + α-bungarotoxin group significantly improved,as compared with that of the nicotine group,also with statistical significance(P < 0

  13. Protective effect of extract of Cordyceps sinensis in middle cerebral artery occlusion-induced focal cerebral ischemia in rats

    Directory of Open Access Journals (Sweden)

    Tang Huiling

    2010-10-01

    Full Text Available Abstract Background Ischemic hypoxic brain injury often causes irreversible brain damage. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines. From the point of view of "self-medication" or "preventive medicine," Cordyceps sinensis was used in the prevention of cerebral ischemia in this paper. Methods The right middle cerebral artery occlusion model was used in the study. The effects of Cordyceps sinensis (Caterpillar fungus extract on mortality rate, neurobehavior, grip strength, lactate dehydrogenase, glutathione content, Lipid Peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na+K+ATPase activity and glutathione S transferase activity in a rat model were studied respectively. Results Cordyceps sinensis extract significantly improved the outcome in rats after cerebral ischemia and reperfusion in terms of neurobehavioral function. At the same time, supplementation of Cordyceps sinensis extract significantly boosted the defense mechanism against cerebral ischemia by increasing antioxidants activity related to lesion pathogenesis. Restoration of the antioxidant homeostasis in the brain after reperfusion may have helped the brain recover from ischemic injury. Conclusions These experimental results suggest that complement Cordyceps sinensis extract is protective after cerebral ischemia in specific way. The administration of Cordyceps sinensis extract significantly reduced focal cerebral ischemic/reperfusion injury. The defense mechanism against cerebral ischemia was by increasing antioxidants activity related to lesion pathogenesis.

  14. Determination of cerebral metabolic patterns in dementia using positron emission tomography

    International Nuclear Information System (INIS)

    With the introduction of the Kety-Schmidt method whole brain measurements of blood flow and metabolism were first applied to normal aged and demented patients. Chronically demented patients were consistently found to have marked reductions in cerebral blood flow, oxygen utilization, and glucose utilization when dementia was severe, and lesser reductions when it was mild. Others found that cerebral blood flow, oxygen utilization, and glucose utilization were decreased in parallel in late stages of Alzheimer's disease (AD) and multiple infarct dementia (MID). The intraarterial /sup 133/Xe method has been used to determine abnormalities in regional cerebral blood flow that correlate with cognitive deficits in patients with organic dementia, mostly Alzheimer's cases. Positron emission tomography (PET) and the /sup 18/F fluorodeoxyglycose (FDG) method have been applied to small numbers of demented patients with advanced AD. In general, decreases were found in global cerebral glucose utilization, but especially in temporal and parietal cortex. Others, using PET and the /sup 15/O/sub 2/ steady-state method, found a coupled decline in global cerebral blood flow and oxygen utilization that was correlated with increasing severity of dementia in both AD and MID, but there was no increase in oxygen extraction ratio, and therefore no evidence to support the existence of a chronic ischemic brain process. In this chapter, the author reviews some of the recent findings at UCLA using PET and the method in the study of normal aging and dementing disorders

  15. Effects of Semelil (ANGIPARS™ on focal cerebral ischemia in male rats

    Directory of Open Access Journals (Sweden)

    M Asadi-Shekaari

    2010-12-01

    Full Text Available "n  Background and the purpose of the study: Cerebral ischemia is one of the main causes of long term disability and death in aged populations. Many herbal drugs and extracts have been used for the treatment of cerebral ischemia induced insults. This study was designed to investigate the protective effect of Semelil (ANGIPARSTM, a new herbal drug, on focal cerebral ischemia in male rats. Material and methods: Male rats were divided into five groups: sham-operated, ischemic animals treated with distilled water as vehicle, ischemic animals treated with 1, 10 and 100 mg/kg of Semilil respectively. Middle cerebral artery occlusion (MCAO model was used in NMRI rats and neuronal injury analyzed in hippocampal CA1 sector after 48 hrs of Middle Cerebral Artery (MCAO. Results: Results of this study showed that treatment with semelil attenuated ischemic damages and has positive effects on focal cerebral ischemia.

  16. Imaging of the ischemic penumbra in acute stroke

    International Nuclear Information System (INIS)

    One of the main reasons for the soaring interest in acute ischemic stroke among radiologists is the advent of new magnetic resonance techniques such as diffusion-weighted imaging. This new modality has prompted us to seek a better understanding of the pathophysiologic mechanisms of cerebral ischemia/infarction. The ischemic penumbra is an important concept and tissue region because this is the target of various recanalization treatments during the acute phase of stroke. In this context, it is high time for a thorough review of the concept, especially from the imaging point of view

  17. Protective effect of extract of Cordyceps sinensis in middle cerebral artery occlusion-induced focal cerebral ischemia in rats

    OpenAIRE

    Tang Huiling; Zhao Dan; Li Pengtao; Liu Zhenquan; Guo Jianyou

    2010-01-01

    Abstract Background Ischemic hypoxic brain injury often causes irreversible brain damage. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines. From the point of view of "self-medication" or "preventive medicine," Cordyceps sinensis was used in the prevention of cerebral ischemia in this paper. Methods The right middle cerebral artery occlusion model was used in the study. The effects of Cor...

  18. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  19. In-vivo optical imaging and spectroscopy of cerebral hemodynamics

    Science.gov (United States)

    Zhou, Chao

    Functional optical imaging techniques, such as diffuse optical imaging and spectroscopy and laser speckle imaging (LSI), were used in research and clinical settings to measure cerebral hemodynamics. In this thesis, theoretical and experimental developments of the techniques and their in-vivo applications ranging from small animals to adult humans are demonstrated. Near infrared diffuse optical techniques non-invasively measure hemoglobin concentrations, blood oxygen saturation (diffuse reflectance spectroscopy, DRS) and blood flow (diffuse correlation spectroscopy, DCS) in deep tissues, e.g. brain. A noise model was derived for DCS measurements. Cerebral blood flow (CBF) measured with DCS was validated with arterial-spin-labeling MRI. Three-dimensional CBF tomography was obtained during cortical spreading depression from a rat using the optimized diffuse correlation tomographic method. Cerebral hemodynamics in newborn piglets after traumatic brain injury were continuously monitored optically for six hours to demonstrate the feasibility of using diffuse optical techniques as bedside patient monitors. Cerebral autoregulation in piglets and human stroke patients was demonstrated to be non-invasively assessable via the continuous DCS measurement. Significant differences of CBF responses to head-of-bead maneuvers were observed between the peri- and contra-infarct hemispheres in human stroke patients. A significant portion of patient population showed paradoxical CBF responses, indicating the importance of individualized stroke management. The development of a speckle noise model revealed the source of noise for LSI. LSI was then applied to study the acute functional recovery of the rat brain following transient brain ischemia. The spatial and temporal cerebral blood flow responses to functional stimulation were statistically quantified. The area of activation, and the temporal response to stimulation were found significantly altered by the ischemic insult, while the

  20. Brain protection therapy in acute cerebral infarction.

    Science.gov (United States)

    Katsura, Ken-ichiro; Suda, Satoshi; Abe, Arata; Kanamaru, Takuya; Toda, Yusuke; Katayama, Yasuo

    2012-01-01

    Many drugs for cerebral infarction that were shown to be effective in animal experiments have shown negative results in human clinical trials. For this reason, a completely new approach is needed to develop brain protection therapies against cerebral infarction. Brain protection therapies can be categorized into 3 types: 1) lengthening the therapeutic time window for thrombolytic therapy, 2) reducing the side effects of thrombolytic therapy, and 3) brain protection drug therapy for patients with contraindications for thrombolytic therapy (including combination therapy). Here, we show our recent results of brain protection therapy. First, combination therapy with 2 effective drugs was tried, and time-lag administration was performed. Combination therapy was effective and lengthened the therapeutic time window. Next, a completely new approach to improve cerebral ischemic damage, namely, H2 gas inhalation therapy, was tried. This therapy was also effective, even in the ischemic core. PMID:22687352

  1. Cerebral Atrophy

    Science.gov (United States)

    ... Alzheimer’s disease, Pick’s disease, and fronto-temporal dementia cerebral palsy , in which lesions (damaged areas) may impair motor ... lead to cerebral atrophy. NIH Patient Recruitment for Cerebral Atrophy Clinical Trials ... by: Office of Communications and Public Liaison National Institute of Neurological Disorders ...

  2. Transient Ischemic Attack

    Medline Plus

    Full Text Available ... TIA , or transient ischemic attack, is a "mini stroke" that occurs when a blood clot blocks an ... a short time. The only difference between a stroke and TIA is that with TIA the blockage ...

  3. Adrenergic-induced enhancement of brain barrier system permeability to small nonelectrolytes: choroid plexus versus cerebral capillaries

    International Nuclear Information System (INIS)

    Acute hypertension induced by adrenergic agents opens up the blood-CSF barrier (choroid plexus) to nonelectrolyte and protein tracers. Sprague-Dawley adult rats anesthetized with ketamine were given an intravenous bolus of either epinephrine (10 micrograms/kg), phenylephrine (100 micrograms/kg), isoproterenol (10 micrograms/kg), or D,L-amphetamine (2 mg/kg). Tracers were injected simultaneously with test agents, and the animals killed 10 min later. Epinephrine raised MABP by 57 mm Hg, to a peak pressure of 160 mm Hg; and it increased the volume of distribution (Vd) of urea, mannitol, and 125I-bovine serum albumin in CSF by 1.5-, 2.7-, and 30-fold, respectively. There was enhanced uptake by lateral and fourth ventricle choroid plexuses, cerebral cortex, cerebellum, medulla, and thalamus. Phenylephrine also elevated MABP to 160 mm Hg, but it increased permeation of tracers into CSF (and several brain regions) to a lesser extent than epinephrine, attributable to protective vasoconstriction associated with alpha-agonist activity. Ratio analysis of Vd data provides evidence that augmented permeation of nonelectrolyte tracers in acute hypertension occurs predominantly by diffusion rather than vesicular transport. It is postulated that elevated MABP distends the central cores of choroid plexus villi and cerebral capillaries, with resultant stretching and opening of tight junctions in both barrier systems; with less hindrance to diffusion, urea and mannitol are cleared at rates closer to free diffusion. Neither isoproterenol (decreased MABP by 40 mm Hg) nor amphetamine (did not alter MABP) significantly opened the choroid plexus or blood-brain barrier to tracers

  4. Human-derived physiological heat shock protein 27 complex protects brain after focal cerebral ischemia in mice.

    Directory of Open Access Journals (Sweden)

    Shinichiro Teramoto

    Full Text Available Although challenging, neuroprotective therapies for ischemic stroke remain an interesting strategy for countering ischemic injury and suppressing brain tissue damage. Among potential neuroprotective molecules, heat shock protein 27 (HSP27 is a strong cell death suppressor. To assess the neuroprotective effects of HSP27 in a mouse model of transient middle cerebral artery occlusion, we purified a "physiological" HSP27 (hHSP27 from normal human lymphocytes. hHSP27 differed from recombinant HSP27 in that it formed dimeric, tetrameric, and multimeric complexes, was phosphorylated, and contained small amounts of αβ-crystallin and HSP20. Mice received intravenous injections of hHSP27 following focal cerebral ischemia. Infarct volume, neurological deficit scores, physiological parameters, and immunohistochemical analyses were evaluated 24 h after reperfusion. Intravenous injections of hHSP27 1 h after reperfusion significantly reduced infarct size and improved neurological deficits. Injected hHSP27 was localized in neurons on the ischemic side of the brain. hHSP27 suppressed neuronal cell death resulting from cytochrome c-mediated caspase activation, oxidative stress, and inflammatory responses. Recombinant HSP27 (rHSP27, which was artificially expressed and purified from Escherichia coli, and dephosphorylated hHSP27 did not have brain protective effects, suggesting that the phosphorylation of hHSP27 may be important for neuroprotection after ischemic insults. The present study suggests that hHSP27 with posttranslational modifications provided neuroprotection against ischemia/reperfusion injury and that the protection was mediated through the inhibition of apoptosis, oxidative stress, and inflammation. Intravenously injected human HSP27 should be explored for the treatment of acute ischemic strokes.

  5. Mesenchymal Stromal Cell-Derived Factors Promote Tissue Repair in a Small-for-Size Ischemic Liver Model but Do Not Protect against Early Effects of Ischemia and Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Suomi M. G. Fouraschen

    2015-01-01

    Full Text Available Loss of liver mass and ischemia/reperfusion injury (IRI are major contributors to postresectional liver failure and small-for-size syndrome. Mesenchymal stromal cell- (MSC- secreted factors are described to stimulate regeneration after partial hepatectomy. This study investigates if liver-derived MSC-secreted factors also promote liver regeneration after resection in the presence of IRI. C57BL/6 mice underwent IRI of 70% of their liver mass, alone or combined with 50% partial hepatectomy (PH. Mice were treated with MSC-conditioned medium (MSC-CM or unconditioned medium (UM and sacrificed after 6 or 24 hours (IRI group or after 48 hours (IRI + PH group. Blood and liver tissue were analyzed for tissue injury, hepatocyte proliferation, and gene expression. In the IRI alone model, serum ALT and AST levels, hepatic tissue damage, and inflammatory cytokine gene expression showed no significant differences between both treatment groups. In the IRI + PH model, significant reduction in hepatic tissue damage as well as a significant increase in hepatocyte proliferation was observed after MSC-CM treatment. Conclusion. Mesenchymal stromal cell-derived factors promote tissue regeneration of small-for-size livers exposed to ischemic conditions but do not protect against early ischemia and reperfusion injury itself. MSC-derived factors therefore represent a promising treatment strategy for small-for-size syndrome and postresectional liver failure.

  6. Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

    Directory of Open Access Journals (Sweden)

    Almeida Leila Azevedo de

    2006-01-01

    Full Text Available Cerebral infarctions of cardiac etiology are observed in around 20% of patients with ischemic stroke. Cerebral ischemia is the first clinical manifestation in 1/3 of cases of atrial myxomas. Although almost half of patients with atrial myxoma show changes at neurological exam, non-hemorrhagic cerebral infarction is seen in computed tomography in practically all cases. We present the case of a 40 year-old woman whose first clinical manifestation of atrial myxoma was an ischemic stroke. We point out to the possibility of silent cerebral infarction in atrial myxoma patients.

  7. Longitudinal cognitive decline in subcortical ischemic vascular disease--the LADIS Study

    DEFF Research Database (Denmark)

    Jokinen, Hanna; Kalska, Hely; Ylikoski, Raija;

    2009-01-01

    BACKGROUND: Cross-sectional studies have indicated that subcortical ischemic vascular disease (SIVD), as defined according to imaging criteria, is associated with a specific clinical and cognitive profile. Much less is known about the long-term cognitive consequences of SIVD. The aim of the study...... was to investigate the longitudinal cognitive performance and incident dementia in subjects with and without SIVD in a sample of older adults with white matter lesions. METHODS: In the Leukoaraiosis and Disability (LADIS) study, 639 participants were examined with annual clinical and......-up independently of age, sex, education and medial temporal lobe atrophy. CONCLUSIONS: SIVD, as a manifestation of cerebral small vessel disease, is related to progressive cognitive impairment and a considerable risk of developing dementia. SIVD seems to specifically contribute to the deterioration of psychomotor...

  8. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    OpenAIRE

    Sueli Luciano Pires; Rubens José Gagliardi; Milton Luiz Gorzoni

    2004-01-01

    Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi) permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é s...

  9. Revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo: opinião nacional Clinical and interventional revascularization in the acute ischemic stroke: national opinion

    OpenAIRE

    Cesar N. Raffin; Jefferson Gomes Fernandes; Eli Faria Evaristo; José Ibiapina Siqueira Neto; Maurício Friedrich; Paulo Puglia; Rogério Darwich

    2006-01-01

    Este artigo apresenta as conclusões sobre revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo, um dos temas discutidos na reunião "Opinião Nacional sobre o Tratamento do AVC". Tratou-se de reunião promovida e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados em doenças cerebrovasculares, que analisaram e discutiram as evidências e experiências atuais sobre o uso de trombólise e técnicas intervencionistas e...

  10. Gene expression profiling in the human middle cerebral artery after cerebral ischemia.

    Science.gov (United States)

    Vikman, P; Edvinsson, L

    2006-12-01

    We have investigated the gene expression in human middle cerebral artery (MCA) after ischemia. Ischemic stroke affects the perfusion in the affected area and experimental cerebral ischemia results in upregulation of vasopressor receptors in the MCA leading to the ischemic area. We obtained human MCA samples distributing to the ischemic area, 7-10 days post-stroke. The gene expression was examined with real-time polymerase chain reaction (PCR) and microarray, proteins were studied with immunohistochemistry. We investigated genes previously shown to be upregulated in animal models of cerebral ischemia (e.g. ET(A), ET(B), AT1, AT2, and 5-HT(2A/1B/1D)). Their mRNA expression was increased compared with controls, consistent with findings in experimental stroke. Immunohistochemistry showed upregulation of the receptors localized on the smooth muscle cells. The gene expression was profiled with microarray and seven genes chosen for further investigation with real-time PCR; ELK3, LY64, Metallothionin IG, POU3F4, Actin alpha2, RhoA and smoothelin. Six of these were regulated the same way when confirming array expression with real-time PCR. Gene expression studies in the human MCA leading to the ischemic region is similar to that seen after MCA occlusion in rats. We found new genes that support the dynamic changes that occur in the MCA distributing to the ischemic region. PMID:17116215

  11. Risk factors for progressive ischemic stroke A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke, thc potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome.OBJECTIVE: To analyze the possible related risk factors in patients with progressive ishcemic stroke, so as to provide reference for the prevention and treatment of progressive ishcemic stroke.DESIGN: A retrospective analysis.SETTING: Department of Neurology, General Hospital of Beijing Coal Mining Group.PARTICIPANTS: Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology, General Hospital of Beijing Coal Mining Group from March 2002 to June 2006, including 192 males and 88 females, with a mean age of (62±7) years old. They were all accorded with the diagnostic standards for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995, and confired by CT or MRI, admitted within 24 hours after attack, and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack, and the aggravation of neurological defect was defined as the neurological deficit score decreased by more than 2 points. Meanwhile,200 inpatients with non-progressive ischemic stroke (135 males and 65 females) were selected as the control group.METHODS: After admission, a univariate analysis of variance was conducted using the factors of blood pressure, history of diabetes mellitus, fever, leukocytosis, levels of blood lipids, fibrinogen, blood glucose and plasma homocysteine, cerebral arterial stenosis, and CT symptoms of early infarction, and the significant factors were involved in the multivariate non-conditional Logistic regression analysis.MAIN OUTCOME MEASURES

  12. Central nervous system hypoxic-ischemic injuries in newborns and infants: Initiation of membrane destructive process

    OpenAIRE

    Gulomjan Khalimbetov

    2012-01-01

    Comparison of S100 protein and MDA concentrations in blood of newborns and infants with hypoxic-ischemic encephalopathy demonstrated difference in the parameters by a type of cerebral ischemic syndrome. Follow-up study of serum S100 protein concentrations demonstrated absence of normalization in the parameter in patients with psychomotor retardation and paroxysmal syndrome, no normalization of MDA level found in examinees with emotional and behavioral disorders and psychomotor retardation.

  13. CT Perfusion ASPECTS in the Evaluation of Acute Ischemic Stroke: Thrombolytic Therapy Perspective

    OpenAIRE

    Sillanpaa, Niko; Saarinen, Jukka T.; Rusanen, Harri; Hakomaki, Jari; Lahteela, Arto; Numminen, Heikki; Elovaara, Irina; Dastidar, Prasun; Soimakallio, Seppo

    2011-01-01

    Background and Purpose Advances in the management of acute ischemic stroke and medical imaging are creating pressure to replace the rigid one-third middle cerebral artery (MCA) and non-contrast-enhanced CT (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) thresholds used for the selection of patients eligible for intravenous thrombolytic therapy. The identification of potentially salvageable ischemic brain tissue lies at the core of this issue. In this study, the role of CT perfusion ASP...

  14. Noninvasive Ventilatory Correction as an Adjunct to an Experimental Systemic Reperfusion Therapy in Acute Ischemic Stroke

    OpenAIRE

    April Sisson; Alexandrov, Andrei V; Paola Palazzo; Kristian Barlinn; Limin Zhao; Clotilde Balucani

    2010-01-01

    Background. Obstructive sleep apnea (OSA) is a common condition in patients with acute ischemic stroke and associated with early clinical deterioration and poor functional outcome. However, noninvasive ventilatory correction is hardly considered as a complementary treatment option during the treatment phase of acute ischemic stroke. Summary of Case. A 55-year-old woman with an acute middle cerebral artery (MCA) occlusion received intravenous tissue plasminogen activator (tPA) and enrolled int...

  15. Effect of glibenclamide on the prevention of secondary brain injury following ischemic stroke in humans

    OpenAIRE

    Khanna, Arjun; Walcott, Brian P.; Kahle, Kristopher T.; Simard, J. Marc

    2014-01-01

    Cerebral edema and hemorrhagic conversion are common, potentially devastating complications of ischemic stroke and are associated with high rates of mortality and poor functional outcomes. Recent work exploring the molecular pathophysiology of the neurogliovascular unit in ischemic stroke suggests that deranged cellular ion homeostasis due to altered function and regulation of ion pumps, channels, and secondary active transporters plays an integral role in the development of cytotoxic and vas...

  16. Ischemic Stroke, Aortic Dissection, and Thrombolytic Therapy—the Importance of Basic Clinical Skills

    OpenAIRE

    Grupper, Moti; Eran, Ayelet; Shifrin, Alla

    2007-01-01

    Aortic dissection masquerading as ischemic stroke is particularly challenging in the era of thrombolysis as a result of narrow diagnostic time window and severe hemorrhagic potential. We describe a case of a 77-year-old patient with a presumed ischemic cerebral infarct, in whom planned treatment with tissue plasminogen activator therapy (TPA) was withheld because of partial spontaneous improvement in his condition. Shortly afterwards, newly elicited clues in the medical history and physical e...

  17. Macrophage depletion reduced brain injury following middle cerebral artery occlusion in mice

    OpenAIRE

    Ma, Yuanyuan; Li, Yaning; Jiang, Lu; Wang, Liping; Jiang, Zhen; Wang, Yongting; Zhang, Zhijun; Yang, Guo-Yuan

    2016-01-01

    Background Macrophages are involved in demyelination in many brain diseases. However, the role of macrophages in the recovery phase of the ischemic brain is unknown. The present study aims to explore the role of macrophages in the ischemic brain injury and tissue repair following a 90-min transient middle cerebral artery occlusion in mice. Methods Clodronate liposomes were injected into mice to deplete periphery macrophages. These mice subsequently underwent middle cerebral artery occlusion. ...

  18. Acute embolic cerebral ischemia as an initial presentation of polycythemia vera: a case report

    OpenAIRE

    Zoraster, Richard M; Rison, Richard A

    2013-01-01

    Introduction Patients with polycythemia vera are at high risk for vaso-occlusive events including cerebral ischemia. Although unusual, acute ischemic stroke may be an initial presentation of polycythemia vera. It had been previously assumed that cerebral ischemic events were due to increased blood viscosity and platelet activation within the central nervous system arterial vessels. However, there are now a few isolated case reports of probable micro-embolic events originating from outside of ...

  19. Vascular endothelial growth factor:an attractive target in the treatment of hypoxic/ischemic brain injury

    Institute of Scientific and Technical Information of China (English)

    Hui Guo; Hui Zhou; Jie Lu; Yi Qu; Dan Yu; Yu Tong

    2016-01-01

    Cerebral hypoxia or ischemia results in cell death and cerebral edema, as well as other cellular reactions such as angiogenesis and the reestablishment of functional microvasculature to promote recovery from brain injury. Vascular endothelial growth factor is expressed in the central nervous system after hypoxic/ischemic brain injury, and is involved in the process of brain repairvia the regulation of angiogenesis, neurogenesis, neurite outgrowth, and cerebral edema, which all require vascular endothelial growth factor signaling. In this review, we focus on the role of the vascular endothelial growth factor signaling pathway in the response to hypoxic/ischemic brain injury, and discuss potential therapeutic interventions.

  20. Shear Stress Inhibits Apoptosis of Ischemic Brain Microvascular Endothelial Cells

    Directory of Open Access Journals (Sweden)

    Xiafeng Shen

    2013-01-01

    Full Text Available As a therapeutic strategy for ischemic stroke, to restore or increase cerebral blood flow (CBF is the most fundamental option. Laminar shear stress (LS, as an important force generated by CBF, mainly acts on brain microvascular endothelial cells (BMECs. In order to study whether LS was a protective factor in stroke, we investigated LS-intervented ischemic apoptosis of rat BMECs (rBMECs through PE Annexin V/7-AAD, JC-1 and Hoechst 33258 staining to observe the membranous, mitochondrial and nuclear dysfunction. Real-time PCR and western blot were also used to test the gene and protein expressions of Tie-2, Bcl-2 and Akt, which were respectively related to maintain membranous, mitochondrial and nuclear norm. The results showed that LS could be a helpful stimulus for ischemic rBMECs survival. Simultaneously, membranous, mitochondrial and nuclear regulation played an important role in this process.

  1. Cortical myoclonus during IV thrombolysis for ischemic stroke

    OpenAIRE

    Carla Bentes; Rita Peralta; Pedro Viana; Carlos Morgado; Melo, Teresa P; José M. Ferro

    2014-01-01

    We describe a patient with an acute middle cerebral artery ischemic stroke developing subtle involuntary movements of the paretic upper limb with cortical origin during rt-PA perfusion. Despite the multiple potential pathophysiological mechanisms for the relationship between thrombolysis and epileptic activity, seizures during this procedure are scarcely reported. Our hypothesis is that subtle and transient clinical seizures, like those described in our patient, may not be detected or are mis...

  2. Stroke and Drug Delivery—In Vitro Models of the Ischemic Blood-Brain Barrier

    DEFF Research Database (Denmark)

    Tornabene, Erica; Brodin, Birger

    2016-01-01

    Stroke is a major cause of death and disability worldwide. Both cerebral hypoperfusion and focal cerebral infarcts are caused by a reduction of blood flow to the brain, leading to stroke and subsequent brain damage. At present, only few medical treatments of stroke are available, with the Food and...... permeation pathways across the barrier in ischemic and postischemic brain endothelium is important for development of new medical treatments. The blood-brain barrier, that is, the endothelial monolayer lining the brain capillaries, changes properties during an ischemic event. In vitro models of the blood...

  3. Metalloproteinase-2 Associated with Cerebral Ischemic Injury and Recovery (review)%基质金属蛋白酶-2与脑缺血损伤及修复

    Institute of Scientific and Technical Information of China (English)

    马跃文; 强琳

    2011-01-01

    Matrix metalloproteinase-2 (MMP-2), which is a member of MMP family, can degrade extracellular matrix. During the early stage of cerebral ischemia, MMP-2 degrades endothelial tight junction and basal lamina resulting in the opening of blood-brain barrier. During the late stage, MMP-2 promotes neurovascular regeneration and the recovery of the damaged brain tissue.%基质金属蛋白-2(MMP-2)是MMP家族中的一员,可降解细胞外基质.在脑缺血早期,MMP-2可通过破坏内皮细胞紧密连接和基底膜,使血脑屏障开放;脑缺血后期,MMP-2则能促进神经血管再生,有利于损伤脑组织的修复.

  4. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebral blood volume ASPECTS, and two novel imaging parameters in the prediction of clinical outcome of ischemic stroke patients receiving intravenous thrombolytic therapy

    International Nuclear Information System (INIS)

    Recently two classification methods based on the location and the extent of thrombosis detected with CT angiography have been introduced: the Boston Acute Stroke Imaging Scale (BASIS) and the clot burden score (CBS). We studied the performance of BASIS and CBS in predicting good clinical outcome (mRS ≤2 at 90 days) in an acute (<3 h) stroke cohort treated with intravenous thrombolytic therapy. Eighty-three consecutive patients who underwent multimodal CT were analyzed. Binary logistic regression model was used to assess how BASIS, CBS, and cerebral blood volume (CBV) ASPECTS predict favorable clinical outcome. Diagnostic sensitivities and specificities were calculated and compared. Patients with low CBS and CBV ASPECTS scores and major strokes according to BASIS had significantly higher admission NIHSS scores, larger perfusion defects, and more often poor clinical outcome. In logistic regression analysis, CBV ASPECTS, CBS and BASIS were significantly associated with the clinical outcome. The performance of BASIS improved when patients with thrombosis of the M2 segment of the middle cerebral artery were classified as having minor stroke (M1-BASIS). In the anterior circulation, the sum of CBS and CBV ASPECTS (CBSV) proved to be the most robust predictor of favorable outcome. CBV ASPECTS and CBS had high sensitivity but moderate to poor specificity while BASIS was only moderately sensitive and specific. CBS, BASIS, and CBV ASPECTS are statistically robust and sensitive but unspecific predictors of good clinical outcome. Two new derived imaging parameters, CBSV and M1-BASIS, share these properties and may have increased prognostic value. (orig.)

  5. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebral blood volume ASPECTS, and two novel imaging parameters in the prediction of clinical outcome of ischemic stroke patients receiving intravenous thrombolytic therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sillanpaa, Niko; Hakomaki, Jari; Lahteela, Arto; Dastidar, Prasun; Soimakallio, Seppo [Tampere University Hospital, Medical Imaging Center, Tampere (Finland); Saarinen, Jukka T.; Numminen, Heikki; Elovaara, Irina [Tampere University Hospital, Department of Neurology, Tampere (Finland); Rusanen, Harri [Oulu University Hospital, Department of Neurology, Oulu (Finland)

    2012-07-15

    Recently two classification methods based on the location and the extent of thrombosis detected with CT angiography have been introduced: the Boston Acute Stroke Imaging Scale (BASIS) and the clot burden score (CBS). We studied the performance of BASIS and CBS in predicting good clinical outcome (mRS {<=}2 at 90 days) in an acute (<3 h) stroke cohort treated with intravenous thrombolytic therapy. Eighty-three consecutive patients who underwent multimodal CT were analyzed. Binary logistic regression model was used to assess how BASIS, CBS, and cerebral blood volume (CBV) ASPECTS predict favorable clinical outcome. Diagnostic sensitivities and specificities were calculated and compared. Patients with low CBS and CBV ASPECTS scores and major strokes according to BASIS had significantly higher admission NIHSS scores, larger perfusion defects, and more often poor clinical outcome. In logistic regression analysis, CBV ASPECTS, CBS and BASIS were significantly associated with the clinical outcome. The performance of BASIS improved when patients with thrombosis of the M2 segment of the middle cerebral artery were classified as having minor stroke (M1-BASIS). In the anterior circulation, the sum of CBS and CBV ASPECTS (CBSV) proved to be the most robust predictor of favorable outcome. CBV ASPECTS and CBS had high sensitivity but moderate to poor specificity while BASIS was only moderately sensitive and specific. CBS, BASIS, and CBV ASPECTS are statistically robust and sensitive but unspecific predictors of good clinical outcome. Two new derived imaging parameters, CBSV and M1-BASIS, share these properties and may have increased prognostic value. (orig.)

  6. [NDT-Bobath method used in the rehabilitation of patients with a history of ischemic stroke].

    Science.gov (United States)

    Klimkiewicz, Paulina; Kubsik, Anna; Woldańska-Okońska, Marta

    2012-01-01

    Ischemic stroke is the third leading cause of death and disability in human. The vitally important problem after ischemic stroke is hemiparesis of the body. The most common methods used in improving the mobility of patients after ischemic stroke is a Bobath-NDT (Neuro-Developmental Treatment - Bobath), which initiated the Berta and Karel Bobath for children with cerebral palsy. It is a method designed to neurophysiological recovery of these vital functions that the patient was lost due to illness, and wants it back. PMID:23289255

  7. Effects of estradiol on ischemic factor-induced astrocyte swelling and AQP4 protein abundance

    OpenAIRE

    Rutkowsky, Jennifer M.; Wallace, Breanna K.; Wise, Phyllis M.; O'Donnell, Martha E.

    2011-01-01

    In the early hours of ischemic stroke, cerebral edema forms as Na, Cl, and water are secreted across the blood-brain barrier (BBB) and astrocytes swell. We have shown previously that ischemic factors, including hypoxia, aglycemia, and arginine vasopressin (AVP), stimulate BBB Na-K-Cl cotransporter (NKCC) and Na/H exchanger (NHE) activities and that inhibiting NKCC and/or NHE by intravenous bumetanide and/or HOE-642 reduces edema and infarct in a rat model of ischemic stroke. Estradiol also re...

  8. Dual targeted nanocarrier for brain ischemic stroke treatment.

    Science.gov (United States)

    Zhao, Yue; Jiang, Yan; Lv, Wei; Wang, Zhongyuan; Lv, Lingyan; Wang, Baoyan; Liu, Xin; Liu, Yang; Hu, Quanyin; Sun, Wujin; Xu, Qunwei; Xin, Hongliang; Gu, Zhen

    2016-07-10

    Focal cerebral ischemia, known as stroke, causes serious long-term disabilities globally. Effective therapy for cerebral ischemia demands a carrier that can penetrate the blood-brain barrier (BBB) and subsequently target the ischemia area in brain. Here, we designed a novel neuroprotectant (ZL006) loaded dual targeted nanocarrier based on liposome (T7&SHp-P-LPs/ZL006) conjugated with T7 peptide (T7) and stroke homing peptide (SHp) for penetrating BBB and targeting ischemia area, respectively. Compared with non-targeting liposomes, T7&SHp-P-LPs/ZL006 could transport across BCEC cells and significantly enhance cellular uptake and reduce cells apoptosis of excitatory amino acid stimulated PC-12 cells. However, there was no significant difference in cellular uptake between SHp-modified and plain liposomes when PC-12 cells were incubated without excitatory amino acid. Besides, ex vivo fluorescent images indicated that DiR labeled T7&SHp-P-LPs could efficiently transport across BBB and mostly accumulated in ischemic region rather than normal cerebral hemisphere of MCAO rats. Furthermore, T7&SHp-P-LPs/ZL006 could enhance the ability of in vivo anti-ischemic stroke of MCAO rats. These results demonstrated that T7&SHp-P-LPs could be used as a safe and effective dual targeted nanocarrier for ischemic stroke treatment. PMID:27142584

  9. In-111-labeled leukocyte brain SPECT imaging in acute ischemic stroke in man

    International Nuclear Information System (INIS)

    This study was performed to investigate the role of leukocyte accumulation in human cerebral infarction and its association with neurological functional outcome. A total of 42 patients diagnosed as acute ischemic stroke (22 embolism, 17 thrombosis, 3 TIA) were examined. Leukocyte accumulation was studied using indium-111-labeled leukocyte brain SPECT. Volume of brain infarction was evaluated by CT and/or MRI. The data were compared with the cerebral blood flow (CBF) imaging. Immediately after CBF study by SPECT using either Tc-99m-HMPAO or Tc-99m-ECD, In-111-labeled autologous leukocytes were injected intravenously. Brain scan for leukocytes was performed after 48 hours. The European Stroke Scale was used for neurological assessment. Thirteen patients with cerebral embolism and three patients with cerebral thrombosis showed intensive accumulation of leukocytes in the region of low flow Leukocyte's accumulation was not seen in patients with TIA. The accumulation of leukocytes was more noticeable in the central zone of the ischemia. Patients who showed negative leukocyte accumulation revealed clinically mild functional outcome and the size of infarction on CT and/or MRI was small. The regional accumulation of leukocytes was seen in all the patients with hemorrhagic infarction, but the degree of hemorrhage on CT did not have significant influence on the amount of leukocyte accumulation. Abnormal accumulation of leukocytes was associated with reduced CBF during the acute embolic stroke. The present clinical study revealed that leukocyte accumulation correlated with the poor neurological functional outcome in patients with acute embolic stroke. (K.H.)

  10. In-111-labeled leukocyte brain SPECT imaging in acute ischemic stroke in man

    Energy Technology Data Exchange (ETDEWEB)

    Fujinuma, Kunihiko; Sakai, Fumihiko; Iizuka, Takahiro; Kitai, Norio [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine

    1997-01-01

    This study was performed to investigate the role of leukocyte accumulation in human cerebral infarction and its association with neurological functional outcome. A total of 42 patients diagnosed as acute ischemic stroke (22 embolism, 17 thrombosis, 3 TIA) were examined. Leukocyte accumulation was studied using indium-111-labeled leukocyte brain SPECT. Volume of brain infarction was evaluated by CT and/or MRI. The data were compared with the cerebral blood flow (CBF) imaging. Immediately after CBF study by SPECT using either Tc-99m-HMPAO or Tc-99m-ECD, In-111-labeled autologous leukocytes were injected intravenously. Brain scan for leukocytes was performed after 48 hours. The European Stroke Scale was used for neurological assessment. Thirteen patients with cerebral embolism and three patients with cerebral thrombosis showed intensive accumulation of leukocytes in the region of low flow Leukocyte`s accumulation was not seen in patients with TIA. The accumulation of leukocytes was more noticeable in the central zone of the ischemia. Patients who showed negative leukocyte accumulation revealed clinically mild functional outcome and the size of infarction on CT and/or MRI was small. The regional accumulation of leukocytes was seen in all the patients with hemorrhagic infarction, but the degree of hemorrhage on CT did not have significant influence on the amount of leukocyte accumulation. Abnormal accumulation of leukocytes was associated with reduced CBF during the acute embolic stroke. The present clinical study revealed that leukocyte accumulation correlated with the poor neurological functional outcome in patients with acute embolic stroke. (K.H.)

  11. Effects of estrogen on cerebrovascular function: age-dependent shifts from beneficial to detrimental in small cerebral arteries of the rat.

    Science.gov (United States)

    Deer, Rachel R; Stallone, John N

    2016-05-15

    In the present study, interactions of age and estrogen in the modulation of cerebrovascular function were examined in small arteries vasoconstriction was attenuated in ovariectomized + estrogen-replaced, multigravid adult rats (5-6 mo; MAE) but potentiated in older ovariectomized + estrogen-replaced, reproductively senescent rats (12-14 mo; RSE). SC560 and NS398 reduced reactivity similarly in ovariectomized multigravid adult rats (5-6 mo; MAO) and ovariectomized reproductively senescent rat (12-14 mo; RSO). In MAE, reactivity to VP was reduced to a greater extent by SC560 than by NS398; however, in RSE, this effect was reversed. VP-stimulated PGI2 was increased by estrogen, yet reduced by age. VP-stimulated TXA2 was increased by estrogen and age in RSE but did not differ in MAO and RSO. Taken together, these data reveal that the vascular effects of estrogen are distinctly age-dependent in F rats. In younger MA, beneficial and protective effects of estrogen are evident (decreased vasoconstriction, increased dilator prostanoid function). Conversely, in older RS, detrimental effects of estrogen begin to be manifested (enhanced vasoconstriction and CP function). These findings may lead to age-specific estrogen replacement therapies that maximize beneficial and minimize detrimental effects of this hormone on small cerebral arteries that regulate blood flow. PMID:26993224

  12. Tuberculoma cerebral Cerebral tuberculoma

    Directory of Open Access Journals (Sweden)

    ELIZABETH CLARA BARROSO

    2002-01-01

    Full Text Available Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa 5-15% das formas extrapulmonares e é reconhecida como de alta letalidade. Apresentação tumoral como a relatada é rara, particularmente em imunocompetentes. Quando tratada, pode ter bom prognóstico e deve entrar sempre no diagnóstico diferencial de massas cerebrais.It is reported a case of a previously healthy man with seizures of sudden onset. A contrast head computerized tomogram (CT showed a right frontoparietal expanding lesion suggesting to be metastatic. No prior disease was found on investigation. The histologic exam of the brain revealed tuberculoma. The seizures were controlled with Hidantoin 300 mg/day and antituberculosis chemotherapy for 18 months. Central nervous system tuberculosis (5-15% of the extrapulmonary forms is highly lethal. The case reported herein is specially rare in immunocompetent patients. It may have good prognosis and should be considered in the differential diagnosis of brain tumours.

  13. The effect of herbs on cerebral energy metabolism in cerebral ischemia-reperfusion mice

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Vascular dementia is one of the most familiar types of senile dementia. Over the past few years, the research on the damage of cerebral tissues after ischemia has become a focus. The factors and mechanism of cerebral tissue damage after ischemia are very complex. The handicap of energy metabolism is regarded as the beginning factor which leads to the damage of neurons, but its dynamic changes in ischemic area and its role during the process of neuronal damage are not very clear. There are few civil reports on using 31 P nuclear magnetic resonance instrument to explore the changes of cerebral energy metabolism in intravital animals. After exploring the influence of herbs on cerebral energy metabolism in ischemia-reperfusion mice, we came to the conclusion that herbs can improve the cerebral energy metabolism in ischemia-reperfusion mice.

  14. No evidence for increased brain iron deposition in patients with ischemic white matter disease.

    Science.gov (United States)

    Gattringer, Thomas; Khalil, Michael; Langkammer, Christian; Jehna, Margit; Pichler, Alexander; Pinter, Daniela; Kneihsl, Markus; Petrovic, Katja; Ropele, Stefan; Fazekas, Franz; Enzinger, Christian

    2016-09-01

    Besides specific iron accumulation in some neurodegenerative disorders, increased iron deposition in cerebral deep gray matter (DGM) is found in multiple sclerosis. As this is considered largely a white matter (WM) disease, we speculated that patients with more severe ischemic WM hyperintensities (WMH) might also have an increased iron concentration in DGM structures and tested this assumption by using magnetic resonance imaging-based quantitative R2* relaxometry. WMH severity was measured in 61 patients with acute transient neurological symptoms (mean age: 71.5 ± 8.3 years) undergoing 3-Tesla magnetic resonance imaging. Despite a 6-year higher age of patients with more severe (i.e., early confluent or confluent) WMH, their DGM R2* rates did not differ from patients with punctate or no WMH. In the globus pallidum, R2* rates were even lower in patients with severe WMH. WMH volume was not correlated with R2* levels in any of the analyzed DGM structures. These findings argue against WM damage per se causing increased DGM iron deposition in multiple sclerosis and suggest no role of iron accumulation in ischemic small vessel disease. PMID:27459926

  15. Cerebral Palsy

    Science.gov (United States)

    ... 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Cerebral Palsy: Keith's Story Physical Therapy I Have Cerebral Palsy. Can I Babysit? Body Image and Self-Esteem Contact Us Print Resources Send to a friend ...

  16. Electro-acupuncture could be an effective pretreatment for cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Feng Zhang

    2010-10-01

    Full Text Available "nElectroacupuncture, the integration of traditional Chinese acupuncture and modern electrotherapy, has been used for clinical treatment of cerebral ischemic disease in both eastern and western countries; however, the mechanism underlying its effects is still unknown. It is well known that excessive glutamate results in neuronal excitotoxicity after ischemic stroke. Previous studies have indicated that electro-acupuncture may downregulate the overactivation of glutamate after ischemia, and a recent study implied that electro-acupuncture prior to ischemia could induce brain ischemic tolerance. Based on the present information, we hypothesize that electro-acupuncture could be an effective pretreatment for cerebral ischemia by regulating the glutamatergic system.

  17. Diffusion tensor imaging patients with major cerebral artery occlusive disease

    International Nuclear Information System (INIS)

    Diffusion tensor (DT) imaging provides quantitative information about the magnitude and the directionality (anisotropy) of water diffusion in vivo and can detect pathologic changes in brain ischemia. This study tried to detect ischemic brain damage using DT imaging in patients with symptomatic chronic major cerebral artery occlusive disease. DT imaging was performed using a 3.0 Tesla magnetic resonance (MR) scanner in 50 patients with unilateral internal carotid artery or middle cerebral artery stenosis or occlusion, who had no obvious infarct lesions on conventional MR imaging. Thirty-three patients underwent DT imaging before and after vascular reconstruction surgery. Fractional anisotropy (FA) was calculated in the middle cerebral artery territory. Preoperative FA values in the ipsilateral side were significantly lower than those in the contralateral side. After surgery, the FA value was significantly increased. DT imaging may indicate ischemic brain damage, not visualized by conventional MR imaging, in patients with major cerebral artery occlusive disease. (author)

  18. Early detection of cerebral infarction by 31P spectroscopic imaging

    International Nuclear Information System (INIS)

    Recent advances in magnetic resonance spectroscopy permit noninvasive study of brain metabolism in vivo, 31P spectroscopic imaging being the method for evaluation of localized phosphorous metabolism. Experimentally, an ischemic-hypoxic brain insult is characterized by depletion of high energy metabolites. These changes are seen immediately after an ischemic insult. We had the opportunity of carrying out 31P spectroscopic imaging of hyperacute cerebral infarction, while MRI and CT were negative. Cerebral infarction of the middle cerebral artery territory was suggested by 31P spectroscopic imaging, which was closely consistent with a later-developing region of low density on CT. In cerebral infarction, early detection of the lesion is a useful pointer to the patient's prognosis, making 31P spectroscopic imaging a potential tool. (orig.)

  19. Increased Expression of mir-34a-5p and Clinical Association in Acute Ischemic Stroke Patients and in a Rat Model

    Science.gov (United States)

    Liang, Ting-ying; Lou, Ji-yu

    2016-01-01

    Background MiRNA is widely recognized as the most important regulator in various diseases. However, there has been little research regarding miRNA expression and its involvement in ischemic stroke. Material/Methods In this study, we investigated the pattern of miRNA-34a-5p expression along with its clinical application in human ischemic stroke and in an in vivo rat model. We recruited 102 cerebral ischemia patients and 97 health controls for this study. Clinical data were gathered and recorded with the help of questionnaires. Blood samples were obtained from patients within 72 h after cerebral ischemia. National Institutes of Health Stroke Scale (NIHSS), Acute Stroke Treatment (TOAST), and infarct volume were used to analyze the correlation of miRNA-34a-5p expression and clinical information. In addition, blood samples and brain tissues were collected from an established middle cerebral artery occlusion (MCAO) model consisting of 20 adult male mice at 24 h after the MCAO. Expression level of miRNA-34a-5p was detected by real-time polymerase chain reactions. Results Results showed overexpression of miRNA-34a-5p in acute ischemic stroke patients blood samples compared to the controls (p<0.05). Also, large and small arterial strokes types demonstrated elevated miRNA-34a-5p expression levels. Further correlation analysis revealed a negative association between miRNA-34a-5p and NIHSS scores (r=−0.692 p<0.05) and infarct volume (r=−0.719, p<0.05). Moreover, in vivo experiment results showed significant up-regulated expression of miRNA-34a-5p in middle cerebral artery occlusion compared to controls, along with a positive correlation between miRNA-34a-5p in blood and brain (r=0.742, p<0.05). Conclusions Our results suggest there is a potential regulatory role of miRNA-34a-5p in acute ischemic stroke, which could serve as a therapeutic target or biomarker in stroke prognosis. PMID:27545688

  20. Infarto cerebral isquémico en el postoperatorio inmediato de una transposición de grandes vasos en una niña de 5 meses y medio Ischemic stroke in the early postoperative period of a transposition of great arteries in a 5 and a half months female infant

    Directory of Open Access Journals (Sweden)

    A. Rico

    2009-07-01

    Full Text Available La Transposición de los Grandes Vasos con septum íntegro (TGV con SI es una cardiopatía congénita caracterizada por la existencia de una discordancia aislada ventrículo-arterial con concordancia aurículo-ventricular. Al no existir mezcla entre las circulaciones sistémica y pulmonar a través de una comunicación interventricular se trata de una cardiopatía cianosante severa, ya que no es posible la oxigenación a nivel sistémico. Presentamos el caso de una niña diagnosticada de TGV con SI a los 5 meses y 15 días de edad. Se intervino mediante atriseptostomía de urgencia y posterior cirugía de "recuperación" (banding de la arteria pulmonar y shunt subclavia-pulmonar previa a la corrección anatómica mediante switch arterial. Falleció a los 8 días del ingreso como consecuencia de un infarto cerebral isquémico.Transposition of the Great Arteries (TGA with intact ventricular septum is a congenital heart disease characterized by ventricle-arterial discordance and atria-ventricle concordance. Cyanosis is common in patients with TGA because there is no mixing between systemic and pulmonary circulations through a ventricular septal defect and systemic oxygenation is not possible. We report the case of a 5 months and 15 days old female infant who was diagnosed with TGA with intact septum. Balloon atrial septostomy and "retraining" of left ventricle by pulmonary artery banding and subclavian-pulmonary artery shunt were necessary to be performed before anatomical correction by arterial switch. Nevertheless, she died 8 days after admission due to an ischemic stroke.

  1. Small molecule-mediated up-regulation of microRNA targeting a key cell death modulator BNIP3 improves cardiac function following ischemic injury.

    Science.gov (United States)

    Lee, Se-Yeon; Lee, Seahyoung; Choi, Eunhyun; Ham, Onju; Lee, Chang Youn; Lee, Jiyun; Seo, Hyang-Hee; Cha, Min-Ji; Mun, Bohyun; Lee, Yunmi; Yoon, Cheesoon; Hwang, Ki-Chul

    2016-01-01

    Genetic ablation of BCL2/adenovirus E1B 19 kDa protein-interacting protein 3 (BNIP3), an essential regulator of cardiac cell death, is an effective way to prevent cardiac cell death triggered by pathologic conditions. However, currently there exists no known means, such as inhibitors, to down-regulate BNIP3 in mature heart. Here, we report that a small molecule inducer of microRNA-182 (miR-182) suppressed ischemia/reperfusion (I/R)-induced cardiac cell death by down-regulating BNIP3. We first selected miR-182 as a potent BNIP3-targeting miRNA based on miRNA-target prediction databases and empirical data. The subsequent screening of small molecules for inducing miR-182 expression identified Kenpaullone as a hit compound. Both exogenous miR-182 and Kenpaullone significantly suppressed hypoxia-induced cardiomyocyte death in vitro. To investigate the effect of changing substituents of Kenpaullone on miR-182 expression, we synthesized 9 derivatives of Kenpaullone. Among these derivatives, compound 5 showed significantly improved ability to induce miR-182 expression. The results of the in vivo study showed that compound 5 significantly improved heart function following I/R-injury in rats. Our study provides strong evidence that the small molecule-mediated up-regulation of miRNAs is a viable strategy to down-regulate target proteins with no known chemical inhibitor and that compound 5 may have potential to prevent I/R-inflicted cardiac cell death. PMID:27008992

  2. Ischemic preconditioning acts upstream of GluR2 down-regulation to afford neuroprotection in the hippocampal CA1

    OpenAIRE

    Tanaka, Hidenobu; Calderone, Agata; Jover, Teresa; Grooms, Sonja Y.; Yokota, Hidenori; Zukin, R. Suzanne; Bennett, Michael V. L.

    2002-01-01

    Animals subjected to sublethal transient global ischemia (ischemic preconditioning) exhibit neuroprotection against subsequent global ischemia-induced neuronal death in the hippocampal CA1 (ischemic tolerance). The molecular mechanisms underlying ischemic tolerance are unclear. Here we report that ischemic preconditioning induced a small, transient down-regulation of GluR2 mRNA expression and greatly attenuated subsequent ischemia-induced GluR2 mRNA and protein down-regulation and neuronal de...

  3. Cerebral ischemia in rabbit: a new experimental model with immunohistochemical investigation.

    Science.gov (United States)

    Yamamoto, K; Yoshimine, T; Yanagihara, T

    1985-12-01

    Regional cerebral ischemia was produced in the rabbit by unilateral transorbital occlusion of the middle cerebral artery (procedure I); the middle cerebral and azygos anterior cerebral or anterior communicating artery (procedure II); or the middle cerebral, azygos anterior cerebral or anterior communicating, and internal carotid artery (procedure III). Evolution of ischemic lesions was examined with the immunohistochemical reaction for tubulin. With procedure I, ischemic lesions did not become constantly visible for 6 h in the basal ganglia and for 8 h in the frontoparietal region of the cerebral cortex. With procedure II, it was shortened to 3 h in the basal ganglia and to 6 h in the cerebral cortex. With procedure III, the ischemic lesions were observed in 1 h both in the basal ganglia and in the cerebral cortex as loss of the reaction for tubulin in the neuropil, nerve cell bodies, and dendrites. The evidence of neuronal damage became apparent in the same areas later by staining with hematoxylin-eosin. The experimental model presented here may be suitable for investigation of the mechanism that shifts reversible ischemia to cerebral infarction and for evaluation of the effectiveness of pharmacological intervention. PMID:3932374

  4. Cerebral Air Embolism from Angioinvasive Cavitary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Chen Lin

    2014-01-01

    Full Text Available Background. Nontraumatic cerebral air embolism cases are rare. We report a case of an air embolism resulting in cerebral infarction related to angioinvasive cavitary aspergillosis. To our knowledge, there have been no previous reports associating these two conditions together. Case Presentation. A 32-year-old female was admitted for treatment of acute lymphoblastic leukemia (ALL. Her hospital course was complicated by pulmonary aspergillosis. On hospital day 55, she acutely developed severe global aphasia with right hemiplegia. A CT and CT-angiogram of her head and neck were obtained demonstrating intravascular air emboli within the left middle cerebral artery (MCA branches. She was emergently taken for hyperbaric oxygen therapy (HBOT. Evaluation for origin of the air embolus revealed an air focus along the left lower pulmonary vein. Over the course of 48 hours, her symptoms significantly improved. Conclusion. This unique case details an immunocompromised patient with pulmonary aspergillosis cavitary lesions that invaded into a pulmonary vein and caused a cerebral air embolism. With cerebral air embolisms, the acute treatment option differs from the typical ischemic stroke pathway and the provider should consider emergent HBOT. This case highlights the importance of considering atypical causes of acute ischemic stroke.

  5. Acute Chagas Disease Induces Cerebral Microvasculopathy in Mice

    OpenAIRE

    Nisimura, Lindice Mitie; Estato, Vanessa; de Souza, Elen Mello; Reis, Patricia A.; Lessa, Marcos Adriano; de Castro-Faria-Neto, Hugo Caire; Pereira, Mirian Claudia de Souza; Tibiriçá, Eduardo; Garzoni, Luciana Ribeiro

    2014-01-01

    Cardiomyopathy is the main clinical form of Chagas disease (CD); however, cerebral manifestations, such as meningoencephalitis, ischemic stroke and cognitive impairment, can also occur. The aim of the present study was to investigate functional microvascular alterations and oxidative stress in the brain of mice in acute CD. Acute CD was induced in Swiss Webster mice (SWM) with the Y strain of Trypanosoma cruzi (T. cruzi). Cerebral functional capillary density (the number of spontaneously perf...

  6. Diffusion and Perfusion MRI in Acute Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    Tchoyoson CC Lim; Chong-Tin Tan

    2001-01-01

    Reeent advances in magnetic resonance imaging (MRI), in particular diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI), have allowed clinicians to have the ability to differentiate between irreversible cerebral infarction and the potentially reversible ischemic penumbra. This article examines the principles and practice of DWI and PWI. With continued advances in thrombolysis and other therapy for acute cerebral ischemia, neuroimaging is poised to play an increasingly important role in decisionmaking in aeute stroke.

  7. Detection of small human cerebral cortical lesions with MRI under different levels of Gaussian smoothing: applications in epilepsy

    Science.gov (United States)

    Cantor-Rivera, Diego; Goubran, Maged; Kraguljac, Alan; Bartha, Robert; Peters, Terry

    2010-03-01

    The main objective of this study was to assess the effect of smoothing filter selection in Voxel-Based Morphometry studies on structural T1-weighted magnetic resonance images. Gaussian filters of 4 mm, 8 mm or 10 mm Full Width at High Maximum are commonly used, based on the assumption that the filter size should be at least twice the voxel size to obtain robust statistical results. The hypothesis of the presented work was that the selection of the smoothing filter influenced the detectability of small lesions in the brain. Mesial Temporal Sclerosis associated to Epilepsy was used as the case to demonstrate this effect. Twenty T1-weighted MRIs from the BrainWeb database were selected. A small phantom lesion was placed in the amygdala, hippocampus, or parahippocampal gyrus of ten of the images. Subsequently the images were registered to the ICBM/MNI space. After grey matter segmentation, a T-test was carried out to compare each image containing a phantom lesion with the rest of the images in the set. For each lesion the T-test was repeated with different Gaussian filter sizes. Voxel-Based Morphometry detected some of the phantom lesions. Of the three parameters considered: location,size, and intensity; it was shown that location is the dominant factor for the detection of the lesions.

  8. Locations of cerebral infarctions in tuberculous meningitis

    International Nuclear Information System (INIS)

    The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.)

  9. Cerebral palsy.

    Science.gov (United States)

    Graham, H Kerr; Rosenbaum, Peter; Paneth, Nigel; Dan, Bernard; Lin, Jean-Pierre; Damiano, Diane L; Becher, Jules G; Gaebler-Spira, Deborah; Colver, Allan; Reddihough, Dinah S; Crompton, Kylie E; Lieber, Richard L

    2016-01-01

    Cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. Cerebral palsy is not a disease entity in the traditional sense but a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. There is currently no cure, but progress is being made in both the prevention and the amelioration of the brain injury. For example, administration of magnesium sulfate during premature labour and cooling of high-risk infants can reduce the rate and severity of cerebral palsy. Although the disorder affects individuals throughout their lifetime, most cerebral palsy research efforts and management strategies currently focus on the needs of children. Clinical management of children with cerebral palsy is directed towards maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation and scoliosis. These management strategies include enhancing neurological function during early development; managing medical co-morbidities, weakness and hypertonia; using rehabilitation technologies to enhance motor function; and preventing secondary musculoskeletal problems. Meeting the needs of people with cerebral palsy in resource-poor settings is particularly challenging. PMID:27188686

  10. Is longer sevoflurane preconditioning neuroprotective in permanent focal cerebral ischemia?

    Science.gov (United States)

    Qiu, Caiwei; Sheng, Bo; Wang, Shurong; Liu, Jin

    2013-08-15

    Sevoflurane preconditioning has neuroprotective effects in the cerebral ischemia/reperfusion model. However, its influence on permanent cerebral ischemia remains unclear. In the present study, the rats were exposed to sevoflurane for 15, 30, 60, and 120 minutes, followed by induction of permanent cerebral ischemia. Results demonstrated that 30- and 60-minute sevoflurane preconditioning significantly reduced the infarct volume at 24 hours after cerebral ischemia, and 60-minute lurane preconditioning additionally reduced the number of TUNEL- and caspase-3-positive cells in the ischemic penumbra. However, 120-minute sevoflurane preconditioning did not show evident neuroprotective effects. Moreover, 60-minute sevoflurane preconditioning significantly attenuated neurological deficits and infarct volume in rats at 4 days after cerebral ischemia. These findings indicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis. PMID:25206521

  11. Angiotensinogen gene polymorphism and ischemic stroke in East Asians A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Sheng Wang; Rong Zeng; Limin Lei; Jinsong Huang

    2013-01-01

    OBJECTIVE: To investigate the association between angiotensinogen gene M235T polymorphism and ischemic stroke in East Asians. DATA RETRIEVAL: A computer-based online search was conducted in PubMed, Google scholar, China National Knowledge lnfrastructure database between January 1990 and April 2012 for relevant studies. The key words were angiotensinogen or AGT, polymorphism or genetic and ischemic stroke or cerebral infarction. SELECTION CRITERIA: Case-controlled studies addressing the correlation between angiotensinogen gene M235T polymorphism and ischemic stroke in East Asians were included. The distribution of genotypes in the included studies was tested for Hardy-Weinberg equilibrium. Quality evaluation of the included studies was conducted by two physicians. Statistical analyses were carried out using Stata 12.0 software for meta-analysis. Heterogeneity tests, sensitivity analysis and publication bias were also conducted. MAIN OUTCOME MEASURES: The association between angiotensinogen gene M235T polymorphism and ischemic stroke risk in East Asians was assessed. RESULTS: Six relevant studies involving 891 patients with ischemic stroke and 727 controls were included in this meta-analysis. Results showed that there was a significant association between angiotensinogen gene M235T polymorphism and the risk of ischemic stroke in East Asians (T vs. M: publication bias. CONCLUSION: The angiotensinogen gene M235T polymorphism is associated with ischemic stroke in East Asians, and the TT genotype and T allele are risk factors for ischemic stroke.

  12. Factors causing prolonged hypoperfusion after transient ischemic attack

    International Nuclear Information System (INIS)

    Even during the symptom-free stages, patients with a transient ischemic attack (TIA) often experience cerebral blood flow disturbances. In order to evaluate the factors which cause this abnormality, we studied the cerebral blood flow disturbance, anatomy and clinical status in 21 patients after TIAs. The results of 99mTc-hexamethyl-propylene-amine oxime SPECT were compared with CT, cerebral angiogram, cerebrovascular risk factors and clinical findings to determine which factor is most responsible for the hypoperfusion of brain after TIA. The overall sensitivity rates in detecting a lesion were 67% in SPECT and 19% in CT. The hypoperfused area tended to be large in patients who had intracranial, severe stenotic, multiple, or hemodynamically significant arterial lesions on the ipsilateral side. No such relationships were found between other examinations. We conclude that hypoperfusion after TIA essentially reflects a continuous cerebral blood flow disturbance that can be attributed to atherosclerosis of the cerebral arteries, with subsequent embolic and/or hemodynamic cerebral ischemia, although there may be a variety of processes. (author)

  13. Chronic conditions in adults with cerebral palsy

    OpenAIRE

    Peterson, MD; Ryan, JM; Hurvitz, EA; E Mahmoudi

    2015-01-01

    Adults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP;2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP.

  14. THE EFFECT OF LIGUSTRAZINE ON NEUROGENESIS IN CORTEX AFTER FOCAL CEREBRAL ISCHEMIA IN RATS

    Institute of Scientific and Technical Information of China (English)

    邱芬; 刘勇; 张蓬勃; 康前雁; 田英芳; 陈新林; 赵建军; 祁存芳

    2006-01-01

    It has been demonstrated that there are neuralstemcells that can self-renewand differentiate intomultiple cell types[1-3]in central nervous system ofadult mammals.After cerebral ischemia,these cellscan proliferate,migrate,differentiate and partici-pate in the repair of ischemic cerebral injuries[4-6].Neural stemcells play a very i mportant role in alle-viating ischemic cerebral injuries and promotingfunctional recovery.Ligustrazine,an active ingre-dient of Ligustici,can help dilate blood vessels,i m-prove m...

  15. Effects of lateral ventricle transplantation of bone marrow stromal cells on the movement and cognitive function of cerebral ischemic reperfusion rats%侧脑室移植骨髓基质细胞对脑缺血再灌注大鼠运动及认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    顾平; 张忠霞; 张宝华; 王彦永; 张振清; 崔冬生; 耿媛; 王铭维

    2011-01-01

    of infarction area. BrdU staining showed that on the 1st day after transplantation, the positive cells were gathered in the transplanted lateral cerebral ventricle, resided in the wall of the cerebral ventricle in the style of tigh disposed cell clump. On the 3rd day, the most positive cells passed through the cerebral ventricle parietes directily migrated to the ischemic zone in the form of single cell. On the 14th day, the most positive cells were found in the striatum and cortex of the ischemia hemisphere.Results indicated that BMSCs lateral ventricle transplantation 24 hours after MCAO operation can significantly improve the motor coordination ability and the function of space learning and memory of MCAO rats. The infarction size of MCAO rats was not diminished, while the BMSCs with lateral ventricle transplantation can survive and migrate to the striatum and cortical area of cerebral ischemia zone directily.%背景:将骨髓基质细胞经侧脑室移植治疗大脑中动脉阻断缺血所致脑梗死模型鼠已取得一定效果,但尚未见对其认知功能的影响.目的:观察骨髓基质细胞侧脑室移植对大脑中动脉阻断缺血模型大鼠行为认知功能的影响,并观察脑梗死灶大小的变化和植入骨髓基质细胞的迁移路径.方法:制作SD大鼠大脑中动脉阻断缺血2 h再灌注模型后随机分为3组,骨髓基质细胞组及磷酸缓冲液组分别于梗死侧侧脑室注射骨髓基质细胞悬液5 μL(含约1.0×106个细胞)或等量的磷酸缓冲液,模型组和不造模的正常组不作任何处理.应用平衡木实验观察大鼠运动协调能力,水迷宫实验观察其游泳速度及空间学习记忆能力;苏木精-伊红染色观察梗死灶大小的变化,免疫组化观察BrdU阳性细胞的迁移路径.结果与结论:骨髓基质细胞组在移植后第3,7,14天平衡木评分均有显著改善(P < 0.05).移植后第7~10天,骨髓基质细胞组大鼠的游泳速度均快于磷酸缓冲液组(P < 0

  16. A simplified technique for producing an ischemic wound model.

    Science.gov (United States)

    Chien, Sufan; Wilhelmi, Bradon J

    2012-01-01

    One major obstacle in current diabetic wound research is a lack of an ischemic wound model that can be safely used in diabetic animals. Drugs that work well in non-ischemic wounds may not work in human diabetic wounds because vasculopathy is one major factor that hinders healing of these wounds. We published an article in 2007 describing a rabbit ear ischemic wound model created by a minimally invasive surgical technique. Since then, we have further simplified the procedure for easier operation. On one ear, three small skin incisions were made on the vascular pedicles, 1-2 cm from the ear base. The central artery was ligated and cut along with the nerve. The whole cranial bundle was cut and ligated, leaving only the caudal branch intact. A circumferential subcutaneous tunnel was made through the incisions, to cut subcutaneous tissues, muscles, nerves, and small vessels. The other ear was used as a non-ischemic control. Four wounds were made on the ventral side of each ear. This technique produces 4 ischemic wounds and 4 non-ischemic wounds in one animal for paired comparisons. After surgery, the ischemic ear was cool and cyanotic, and showed reduced movement and a lack of pulse in the ear artery. Skin temperature of the ischemic ear was 1-10 °C lower than that on the normal ear and this difference was maintained for more than one month. Ear tissue high-energy phosphate contents were lower in the ischemic ear than the control ear. Wound healing times were longer in the ischemic ear than in the non-ischemic ear when the same treatment was used. The technique has now been used on more than 80 rabbits in which 23 were diabetic (diabetes time ranging from 2 weeks to 2 years). No single rabbit has developed any surgical complications such as bleeding, infection, or rupture in the skin incisions. The model has many advantages, such as little skin disruption, longer ischemic time, and higher success rate, when compared to many other models. It can be safely used in

  17. Cerebral hemodynamic status evaluated with PET and long term prognosis in major cerebral arterial occlusive diseases

    International Nuclear Information System (INIS)

    In major cerebral arterial occlusive diseases, patients with increased oxygen extraction fraction (OEF), which is measured with positron emission tomography (PET), may be at increased risk for cerebral ischemia. The purpose of the first study was to determine whether increased OEF is a predictor of long-term risk of subsequent stroke. We prospectively evaluated the relationship between the regional hemodynamic status of cerebral circulation and the subsequent risk of stroke in 40 patients with symptomatic internal carotid artery (ICA) or middle cerebral artery occlusive diseases who underwent PET. Patients were divided into 2 hemodynamic categories according to the mean hemispheric value of OEF in the hemisphere supplied by the artery with symptomatic disease: patients with increased OEF and those with normal OEF. All patients were followed for 5 years with medical treatment until death or the recurrence of stroke. During 5 years, 11 strokes, 9 of which were ipsilateral ischemic, occurred. Five of 7 patients with increased OEF had ischemic strokes, and 6 of 33 patients with normal OEF had ischemic strokes. There were 4 ipsilateral ischemic strokes in patients with increased OEF and 5 in those with normal OEF. Kaplan-Meier analysis revealed that the risks of all stroke and ipsilateral ischemic stroke in patients with increased OEF were significantly higher than in those with normal OEF (long-rank test; p<0.0002 and p<0.0018, respectively). Multivariate analysis with the Cox proportional hazards model demonstrated that increased OEF significantly increased stroke recurrence: the relative risk was 7.2 (95% confidence interval [CI], 2.0-25.5; p<0.005) for all stroke and 6.4 (95% CI, 1.6-26.1; p<0.01) for ipsilateral stroke. These findings suggest that an increased OEF is an independent predictor of 5-year risk of subsequent stroke. The purpose of the second study was to determine whether in patients with ICA occlusion and initially normal OEF, subsequent deterioration

  18. Effects of Semelil (ANGIPARS™) on focal cerebral ischemia in male rats

    OpenAIRE

    Asadi-Shekaari, M; H Eftekhar Vaghefi; Talakoub, A; HR Khorram Khorshid

    2010-01-01

    "n  Background and the purpose of the study: Cerebral ischemia is one of the main causes of long term disability and death in aged populations. Many herbal drugs and extracts have been used for the treatment of cerebral ischemia induced insults. This study was designed to investigate the protective effect of Semelil (ANGIPARSTM), a new herbal drug, on focal cerebral ischemia in male rats. Material and methods: Male rats were divided into five groups: sham-operated, ischemic anim...

  19. Cerebral hypoxia

    Science.gov (United States)

    ... the veins ( deep vein thrombosis ) Lung infections (pneumonia) Malnutrition When to Contact a Medical Professional Cerebral hypoxia ... References Bernat JL. Coma, vegetative state, and brain death. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  20. A case of cerebral infarction showing interesting SPECT images

    International Nuclear Information System (INIS)

    A case of cerebral infarction showing interesting SPECT images was reported. One month after stroke, 81mKr and 99mTc-HMPAO-SPECT were showed post ischemic high flow area as hot lesion, but 123I-IMP-SPECT was showed as cold lesion in early scan. Two months after stroke, all SPECT images showed infarction as cold area. (author)

  1. Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients.

    Directory of Open Access Journals (Sweden)

    Marjolein Huijts

    2013-11-01

    Full Text Available Background – White matter lesions (WMLs, asymptomatic lacunar infarcts, brain microbleeds (BMBs and enlarged perivascular spaces (EPVS have been identified as silent lesions due to cerebral small vessel disease (cSVD. All these markers have been individually linked to cognitive functioning, but are also strongly correlated with each other. The combined effect of these markers on cognitive function has never been studied and would possibly provide more useful information on the effect on cognitive function. Methods – Brain MRI and extensive neuropsychological assessment were performed in 189 patients at risk for cSVD (112 hypertensive patients and 77 first-ever lacunar stroke patients. We rated the presence of any asymptomatic lacunar infarct, extensive WMLs, any deep BMB, and moderate to extensive EPVS in the basal ganglia. The presence of each marker was summed to an ordinal score between 0 and 4. Associations with domains of cognitive function (memory, executive function, information processing speed and overall cognition were analyzed with correlation analyses. Results – Correlation analyses revealed significant associations between accumulating cSVD burden and decreased performance on all cognitive domains (all p≤.001. Results remained significant for information processing speed (r=-.181, p=.013 and overall cognition (r=-.178, p=.017, after correction for age and sex. Testing of trend using linear regression analyses revealed the same results. Discussion – We tested a new approach to capture total brain damage resulting from cSVD and found that accumulation of MRI burden of cSVD is associated with decreased performance on tests of information processing speed and overall cognition, implying that accumulating brain damage is accompanied by worse cognitive functioning.

  2. The distribution of N-isopropyl-p-iodoamphetamine in experimental ischemic brain of the mongolian gerbil

    International Nuclear Information System (INIS)

    We studied the distribution of N-isopropyl-p-[I-131]-iodoamphetamine (IMP) in permanent and temporary ischemic brains of mongolian gerbils. For the permanent ischemic brain model, the right common carotid artery was ligated under ether anesthesia. For the temporary ischemic brain model, the right common carotid artery was clamped by a clip and recirculated at 3 hours thereafter. After given time intervals, 1.35 MBq (50 μCi) of IMP was injected intravenously into 17 gerbils (permanent ischemic brain model), 18 gerbils (temporary ischemic brain model) which had severe neurological symptoms, and 3 normal gerbils for controls. One minute, 10 minutes, 1 hour and 6 hours after the injection, gerbils were sacrified and autoradiography of the brain was performed. The activity of IMP in various parts of the brain was calculated from each autoradiogram. In permanent ischemic brains, low perfusion areas were observed in the right cerebral hemisphere, the brain stem (5 ∼ 20 % of normal value), and in the left hemisphere (40 ∼ 60 % of normal value). In temporary ischemic brains, focal areas of increased activity were observed in the right cerebral hemisphere and the thalamus from 10 minutes to 24 hours after recirculation. The high activity disappeared rapidly at 10 minutes after the injection. It seemed that this high activity represented luxury perfusion in the region with severe tissue damage. In the left hemisphere, almost complete recovery of perfusion occurred at 1 ∼ 3 days after recirculation. These results suggested the possibility of IMP to demonstrate cerebral ischemia, luxury perfusion and diaschisis. (author)

  3. The usefulness of deconvolution perfusion CT in patients with acute cerebral infarction: comparison with diffusion MRI

    International Nuclear Information System (INIS)

    This study was performed to evaluate the usefulness of Deconvolution perfusion CT in patients with acute cerebral infarction. Nine patients with acute cerebral infarction underwent conventional CT and cerebral perfusion CT within 23 hours of the onset of symptoms. The perfusion CT scan for each patient was obtained at the levels of basal ganglia and 1 cm caudal to the basal ganglia. By special imaging software, perfusion images including cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps were created. The infarcted lesions were evaluated on each perfusion maps by 3 radiolocical technician. MTT delay time was measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size were measured on each perfusion map and compared with the value obtained by diffusion weighted MR imaging (DWMRI). All perfusion CT maps showed the perfusion defect lesion in all patients. There were remarkable MTT delay in perfusion defect lesion. In comparison of lesion size between each perfusion map and DWMRI, the lesion on CBF map was the most closely correlated with the lesion on DWMRI (7/9). The size of perfusion defect lesion on MTT map was larger than that of lesion on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Deconvolution Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra but also hemodynamic status in perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction

  4. The usefulness of deconvolution perfusion CT in patients with acute cerebral infarction: comparison with diffusion MRI

    Energy Technology Data Exchange (ETDEWEB)

    Eun, Sung Jong [Chonnam National University Graduate School, Gwangju (Korea, Republic of); Kim, Young Keun [Kwangju Health College, Gwangju (Korea, Republic of)

    2003-06-15

    This study was performed to evaluate the usefulness of Deconvolution perfusion CT in patients with acute cerebral infarction. Nine patients with acute cerebral infarction underwent conventional CT and cerebral perfusion CT within 23 hours of the onset of symptoms. The perfusion CT scan for each patient was obtained at the levels of basal ganglia and 1 cm caudal to the basal ganglia. By special imaging software, perfusion images including cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps were created. The infarcted lesions were evaluated on each perfusion maps by 3 radiolocical technician. MTT delay time was measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size were measured on each perfusion map and compared with the value obtained by diffusion weighted MR imaging (DWMRI). All perfusion CT maps showed the perfusion defect lesion in all patients. There were remarkable MTT delay in perfusion defect lesion. In comparison of lesion size between each perfusion map and DWMRI, the lesion on CBF map was the most closely correlated with the lesion on DWMRI (7/9). The size of perfusion defect lesion on MTT map was larger than that of lesion on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Deconvolution Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra but also hemodynamic status in perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

  5. Blood biomarkers in the early stage of cerebral ischemia.

    Science.gov (United States)

    Maestrini, I; Ducroquet, A; Moulin, S; Leys, D; Cordonnier, C; Bordet, R

    2016-03-01

    In ischemic stroke patients, blood-based biomarkers may be applied for the diagnosis of ischemic origin and subtype, prediction of outcomes and targeted treatment in selected patients. Knowledge of the pathophysiology of cerebral ischemia has led to the evaluation of proteins, neurotransmitters, nucleic acids and lipids as potential biomarkers. The present report focuses on the role of blood-based biomarkers in the early stage of ischemic stroke-within 72h of its onset-as gleaned from studies published in English in such patients. Despite growing interest in their potential role in clinical practice, the application of biomarkers for the management of cerebral ischemia is not currently recommended by guidelines. However, there are some promising clinical biomarkers, as well as the N-methyl-d-aspartate (NMDA) peptide and NMDA-receptor (R) autoantibodies that appear to identify the ischemic nature of stroke, and the glial fibrillary acidic protein (GFAP) that might be able to discriminate between acute ischemic and hemorrhagic strokes. Moreover, genomics and proteomics allow the characterization of differences in gene expression, and protein and metabolite production, in ischemic stroke patients compared with controls and, thus, may help to identify novel markers with sufficient sensitivity and specificity. Additional studies to validate promising biomarkers and to identify novel biomarkers are needed. PMID:26988891

  6. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Cerebral Palsy KidsHealth > For Parents > Cerebral Palsy Print A A ... kids who are living with the condition. About Cerebral Palsy Cerebral palsy is one of the most common ...

  7. Developing drug strategies for the neuroprotective treatment of acute ischemic stroke.

    Science.gov (United States)

    Tuttolomondo, Antonino; Pecoraro, Rosaria; Arnao, Valentina; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

    2015-01-01

    Developing new treatment strategies for acute ischemic stroke in the last twenty years has offered some important successes, but also several failures. Most trials of neuroprotective therapies have been uniformly negative to date. Recent research has reported how excitatory amino acids act as the major excitatory neurotransmitters in the cerebral cortex and hippocampus. Furthermore, other therapeutic targets such as free radical scavenger strategies and the anti-inflammatory neuroprotective strategy have been evaluated with conflicting data in animal models and human subjects with acute ischemic stroke. Whereas promising combinations of neuroprotection and neurorecovery, such as citicoline, albumin and cerebrolysin have been tested with findings worthy of further evaluation in larger randomized clinical trials. Understanding the complexities of the ischemic cascade is essential to developing pharmacological targets for acute ischemic stroke in neuroprotective or flow restoration therapeutic strategies. PMID:26469760

  8. 扩散加权成像与短暂性脑缺血发作后认知功能损害的相关性研究%Study of Cognitive Impairment and Cerebral DWI in Patients with Transient Ischemic Attacks

    Institute of Scientific and Technical Information of China (English)

    倪建明; 张追阳; 张威江; 施琴

    2012-01-01

    Objective To examine the association between the cognitive functioning and cerebral abnormalities identified on diffusion weighted imaging (DWI) in transient ischemic attacks (TIA). Materials and Methods 49 TIA patients underwent brain diffusion MR scanning within 3 days after the last episode. Subjects were tested using Montreal Cognitive Assessment (MoCA) during the first week. Another 25 healthy people who had matched age, gender and education level were also recruited as a normal control group. Sores of neuropsychologjcal scale were compared between each of the three groups. Results DWI detected abnormalities were present in 21 of 49 cases (42. 86% ). Prolonged TIA duration ( ≥30 minutes) was observed more frequently in the abnormal group than in the normal group. Patients with TIA had cognitive impairment, prominently in spaces executive function, execute, memory and attention function, patients with DWI abnormal had more severe cognitive decline than that of patients with normal DWI(P<0.001). Conclusion TIA patients have extent frontal and temporal lobe related cognition impairments and patients with DWI abnormal have more severe cognitive decline than that of patients with normal DWI.%目的 初步探讨短暂性脑缺血发作(transient ischemic attacks,TIA)患者认知功能损伤与扩散加权成像(DWI)异常改变之间的关系.资料与方法 49例TIA患者在发病3天内行DWI检查,发病7天内采用中文版蒙特利尔认知评估量表(MoCA)进行认知功能测试.根据是否存在DWI异常,将49例TIA患者分为DWI异常组和DWI正常组,同时选取25名正常健康志愿者作为对照组,比较两组患者神经认知功能评分的差异性.结果 TIA患者的视空间与执行功能、注意、延迟记忆评分及MoCA总分显著低于对照组(P<0.001),且DWI阳性的TIA患者的各项评分均显著低于DWI阴性患者;DWI阳性及DWI阴性组的命名、语言、抽象思维及定向力评分无显著差异,与对照组

  9. Ischemic stroke: carotid and vertebral artery disease.

    Science.gov (United States)

    Vilela, P; Goulão, A

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. PMID:15657789

  10. Ischemic stroke: carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  11. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  12. Perfusion Angiography in Acute Ischemic Stroke.

    Science.gov (United States)

    Scalzo, Fabien; Liebeskind, David S

    2016-01-01

    Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA) remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF) and cerebral blood volume (CBV), mean transit time (MTT), time-to-peak (TTP), and T max, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA) and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely. PMID:27446232

  13. Delayed reflow of an ischemic infarct after spontaneous thrombolysis studied by CBF tomography using SPECT and Tc-99m HMPAO

    DEFF Research Database (Denmark)

    Companioni, J M; Lassen, N A; Tfelt-Hansen, P;

    1991-01-01

    A patient with a large ischemic infarct in the left middle cerebral artery territory was studied six times in the acute/subacute phase by cerebral blood flow (CBF) tomography using Tc-99m-HMPAO. The SPECT instrument used was a brain dedicated highly sensitive four-camera system (TOMOMATIC 232) that...... of the occlusion with flows reaching levels above that of the opposite non-affected side ("Luxury Perfusion"). The delayed reflow implies, that SPECT may not constitute a reliable tool for evaluating the success or failure of thrombolytic treatment in ischemic stroke....

  14. Glibenclamide for the Treatment of Ischemic and Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    Nicholas Caffes

    2015-03-01

    Full Text Available Ischemic and hemorrhagic strokes are associated with severe functional disability and high mortality. Except for recombinant tissue plasminogen activator, therapies targeting the underlying pathophysiology of central nervous system (CNS ischemia and hemorrhage are strikingly lacking. Sur1-regulated channels play essential roles in necrotic cell death and cerebral edema following ischemic insults, and in neuroinflammation after hemorrhagic injuries. Inhibiting endothelial, neuronal, astrocytic and oligodendroglial sulfonylurea receptor 1–transient receptor potential melastatin 4 (Sur1–Trpm4 channels and, in some cases, microglial KATP (Sur1–Kir6.2 channels, with glibenclamide is protective in a variety of contexts. Robust preclinical studies have shown that glibenclamide and other sulfonylurea agents reduce infarct volumes, edema and hemorrhagic conversion, and improve outcomes in rodent models of ischemic stroke. Retrospective studies suggest that diabetic patients on sulfonylurea drugs at stroke presentation fare better if they continue on drug. Additional laboratory investigations have implicated Sur1 in the pathophysiology of hemorrhagic CNS insults. In clinically relevant models of subarachnoid hemorrhage, glibenclamide reduces adverse neuroinflammatory and behavioral outcomes. Here, we provide an overview of the preclinical studies of glibenclamide therapy for CNS ischemia and hemorrhage, discuss the available data from clinical investigations, and conclude with promising preclinical results that suggest glibenclamide may be an effective therapeutic option for ischemic and hemorrhagic stroke.

  15. Changes of cognitive function and its correlated factors in patients with first acute cerebral ischemic stroke%首发急性缺血性脑卒中患者认知功能变化及其与相关因素关系的分析

    Institute of Scientific and Technical Information of China (English)

    袁大华; 张虹桥; 章成国; 林碧清; 曾桄伦; 王玉凯; 杜朴; 彭伟英

    2012-01-01

    、画钟测验方面比较差异存在统计学意义(P<0.05),但在其他认知领域方面组别之间差异无统计学意义(P>0.05).高水平HDL-C组视空间结构能力评分显著高于正常组,差异有统计学意义(P<0.05),而高水平HDL-C组执行功能评分则低于正常组,差异也有统计学意义(P<0.05).(4)Logistic回归分析发现发现MMSE总体评分与性别、年龄、空腹血糖、餐后2h血糖有关;而年龄、性别和HDL-C是执行功能独立危险因素;记忆力与年龄有关,其中即刻听觉记忆力还与HDL-C相关;空间结构能力与年龄、性别及改良Rankin量表(mRS)评分均呈显著相关关系;信息处理能力则仅与HDL-C水平相关.结论 (1)首发急性缺血性脑卒中患者中约75%可存在认知功能障碍,主要以记忆力、执行力、视空间结构能力损害为主.(2)血糖水平尤其空腹血糖受损状况对患者认知功能的损害最为明显.(3)高水平的HDL-C有助于提高患者认知功能.(4)年龄、性别、HDL-C与患者认知功能水平的关系最密切.%Objective To investigate the changes of cognitive impairment and its correlated factors in patients with first acute cerebral ischemic stroke.Methods Five hundred and sixty-eighty patients,admitted to our hospital from July 2010 to June 2011 and met the diagnostic criteria of first acute cerebral ischemic stroke,were chosen in our study; neuropsychological evaluation was conducted within 1 week of acute cerebral ischemic stroke.The comprehensive neuropsychological evaluation battery included mini-mental state examination (MMSE),Digit span,Mattis dementia scale,Rey complex figure test,stroop test,World Health Organization and University of California-Los Angeles auditory verbal learning test,semantic category verbal fluency test and clock drawing test,which contained tests for memory,attention,executive function,information processing capability,visuospatial and visuo constructive functions

  16. Endothelial progenitor cells in acute ischemic stroke

    Science.gov (United States)

    Martí-Fàbregas, Joan; Crespo, Javier; Delgado-Mederos, Raquel; Martínez-Ramírez, Sergi; Peña, Esther; Marín, Rebeca; Dinia, Lavinia; Jiménez-Xarrié, Elena; Fernández-Arcos, Ana; Pérez-Pérez, Jesús; Querol, Luis; Suárez-Calvet, Marc; Badimon, Lina

    2013-01-01

    Objectives The levels of circulating endothelial progenitor cells (EPCs) in ischemic stroke have not been studied extensively and reported results are inconsistent. We aimed to investigate the time course, the prognostic relevance, and the variables associated with EPC counts in patients with ischemic stroke at different time points. Material and methods We studied prospectively 146 consecutive patients with ischemic stroke within the first 48 h from the onset of symptoms (baseline). We evaluated demographic data, classical vascular risk factors, treatment with thrombolysis and statins, stroke etiology, National Institute of Health and Stroke Scale score and outcome (favorable when Rankin scale score 0–2). Blood samples were collected at baseline, at day 7 after stroke (n = 121) and at 3 months (n = 92). The EPC were measured by flow cytometry. Results We included 146 patients with a mean age of 70.8 ± 12.2 years. The circulating EPC levels were higher on day 7 than at baseline or at 3 months (P = 0.045). Pretreatment with statins (odds ratio [OR] 3.11, P = 0.008) and stroke etiology (P = 0.032) were predictive of EPC counts in the baseline sample. EPC counts were not associated with stroke severity or functional outcome in all the patients. However, using multivariate analyses, a better functional outcome was found in patients with higher EPC counts in large-artery atherosclerosis and small-vessel disease etiologic subtypes. Conclusions After acute ischemic stroke, circulating EPC counts peaked at day 7. Pretreatment with statins increased the levels of EPC. In patients with large-artery atherosclerosis and small-vessel disease subtypes, higher counts were related to better outcome at 3 months. PMID:24363968

  17. Cerebral perfusion reserve indexes determined by fluoromethane positron emission scanning

    International Nuclear Information System (INIS)

    An index of cerebral perfusion reserve (RES%), defined as the percent change of regional cerebral blood flow over baseline per mm Hg of end-tidal CO2 tension, was determined for each middle cerebral artery (MCA) territory in patients with unilateral carotid distribution transient ischemic attacks or minor cerebrovascular accidents and was compared with that of age-matched, neurologically normal volunteers. Vasodilator responses to induced hypercapnia were tested during inhalation of 5% CO2 in 95% O2 while regional cerebral blood flow was measured by fluoromethane inhalation positron emission tomography. Mean RES% for 24 normal MCA territories was 5.2 +/- 0.8%. Mean RES% for 15 patient nonischemic MCA territories was 3.8 +/- 1.3% and for 15 ischemic MCA territories was 2.8 +/- 1.9% (both p less than 0.001). Individual RES% values and symmetry ratios between ischemic and nonischemic regions were also determined and compared with angiographic data. Areas of diminished, asymmetric, or paradoxical (two patients) CO2 reactivity appear to correspond to areas of compensatory vasodilation. We found this technique to be a safe and reproducible method for defining and recording localized areas of cerebral tissue at apparent risk for hemodynamically related damage

  18. Study on the clinical usefulness of magnetic resonance imaging in cases of multiple cerebral infarction

    International Nuclear Information System (INIS)

    The clinical significance of MRI in thrombotic multiple cerebral infarction was examined in 9 patients having recent lacunar stroke. Recent infarct was identified on Gd-enhanced MRI in 4 patients. For patients multiple small infarction, Gd-enhanced MRI made it possible to differentiate recent from other lesions. To clarify the significance of periventricular high intensity lesion (PVH) on T2-weighted MRI, hemodynamic and neuropsychologic examinations were carried out in 41 patients with multiple cerebral infarction. All the patients had PVH, which was classified into three grades as follows: grade I (n=16) showing only a thin high intensity band along the body of lateral ventricles; grade 2 (n=15) showing a definite high intensity area around the lateral ventricles; grade 3 (n=10) showing diffuse thick and irregular foci around the whole ventricle. In these patients, rCBF was measured by 133Xe inhalation methods. Initial slope index was significantly higher in patients with grade 3 than those with grade I. Mini-mental state test score was significantly higher in patients with grade l than those with grade 2 and 3. Progression of PVH may be related with the reduction of the cerebral circulation and mental function in cases of multiple cerebral infarction. Ischemic and hemorrhagic lesions can be distinguished by MRI, because old intracerebral hemorrhage appear as hypointensity areas with or without hyperintensity area on T2w images. In 92 patients with multiple infarction, MRI was used to evaluate the incidence and distribution of coexisting old intracerebral hemorrhage. Old hemorrhage were found in 15 patients (16.3%). locating the site where hypertensive hemorrhage commonly occurred. High-field MRI is useful for assessing the coexistence of hemorrhage in hypertensive patients with multiple cerebral infarction. (N.K.)

  19. Study on the clinical usefulness of magnetic resonance imaging in cases of multiple cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Miyashita, Kotaro (Niigata Univ. (Japan). Brain Research Inst.)

    1991-09-01

    The clinical significance of MRI in thrombotic multiple cerebral infarction was examined in 9 patients having recent lacunar stroke. Recent infarct was identified on Gd-enhanced MRI in 4 patients. For patients multiple small infarction, Gd-enhanced MRI made it possible to differentiate recent from other lesions. To clarify the significance of periventricular high intensity lesion (PVH) on T2-weighted MRI, hemodynamic and neuropsychologic examinations were carried out in 41 patients with multiple cerebral infarction. All the patients had PVH, which was classified into three grades as follows: grade I (n=16) showing only a thin high intensity band along the body of lateral ventricles; grade 2 (n=15) showing a definite high intensity area around the lateral ventricles; grade 3 (n=10) showing diffuse thick and irregular foci around the whole ventricle. In these patients, rCBF was measured by {sup 133}Xe inhalation methods. Initial slope index was significantly higher in patients with grade 3 than those with grade I. Mini-mental state test score was significantly higher in patients with grade l than those with grade 2 and 3. Progression of PVH may be related with the reduction of the cerebral circulation and mental function in cases of multiple cerebral infarction. Ischemic and hemorrhagic lesions can be distinguished by MRI, because old intracerebral hemorrhage appear as hypointensity areas with or without hyperintensity area on T2w images. In 92 patients with multiple infarction, MRI was used to evaluate the incidence and distribution of coexisting old intracerebral hemorrhage. Old hemorrhage were found in 15 patients (16.3%). locating the site where hypertensive hemorrhage commonly occurred. High-field MRI is useful for assessing the coexistence of hemorrhage in hypertensive patients with multiple cerebral infarction. (N.K.).

  20. Study on the effect and mechanism of agmatine on blood brain barrier with cerebral ischemic reperfusion injury rats%胍丁胺对脑缺血再灌注损伤大鼠血脑屏障的作用机制研究

    Institute of Scientific and Technical Information of China (English)

    郑立霞; 徐鑫淼; 郎现波; 张秀丽; 杨美子

    2015-01-01

    目的:研究胍丁胺对血脑屏障( BBB )通透性的影响及其与水通道蛋白( AQP)的相关性。方法将大鼠随机分为假手术组、实验组和模型组。大脑中动脉栓塞2 h后,实验组和模型组分别腹腔注射胍丁胺(50 mg · kg-1)和等量0.9%NaCl。通过测定脑水含量、BBB通透性,考察BBB的损害程度,用2,3,5-氯化三苯基四氮唑(TTC)染色法比较梗死灶大小,苏木精-伊红(HE)染色和电镜观察神经元形态学变化,Western-blotting法检测AQP4、AQP9的表达。结果实验组BBB通透性显著下降,变性神经元数明显减少,同时, AQP4与AQP9的表达较模型组显著降低。结论胍丁胺通过降低AQP4、AQP9的表达来改善BBB通透性,从而减轻脑水肿引起的神经元损伤。%Objective To observe the effect of agmatine on brain ede-ma and examine the relation between blood brain barrier ( BBB) per-meability and aquaporin 4 ( AQP4 ) and aquaporin 9 ( AQP9 ) in rats with cerebral ischemic reperfusion.Methods Health male Sprague-Dawley rats were randomly divided into sham group , model group and test ( agmatine ) group.And 2 h after middle cerebral artery occlusion, giving agmatine ( 50 mg · kg -1 ) in test group or 0.9%NaCl in sham and model groups by intraperitoneal injection, respec-tively.Brain edema and the size of the brain infarct were assayed by brain water content and BBB permeability and 2,3,5 -triphenyltet-razoliumchloridstaining( TTC).The morphological changes of neurons were observed by hematoxylin and eosin staining and transmission electron microscopy.And the expression of AQP4 and AQP9 were assessed by Western -blotting.Results The BBB permeability de-creased significantly and the morphological changes of neurons were reduced significantly and the expression of AQP4 and AQP9 decreased significantly in rats with agmatine.Conclusion Agmatine reduce the injury of the BBB by decreasing the expression of AQP4 and

  1. Etiologic Classification in Ischemic Stroke

    OpenAIRE

    Hakan Ay

    2011-01-01

    Ischemic stroke is an etiologically heterogenous disorder. Classification of ischemic stroke etiology into categories with discrete phenotypic, therapeutic, and prognostic features is indispensible to generate consistent information from stroke research. In addition, a functional classification of stroke etiology is critical to ensure unity among physicians and comparability among studies. There are two major approaches to etiologic classification in stroke. Phenotypic systems define subtypes...

  2. Ischemic Stroke: Risk Stratification, Warfarin Teatment and Outcome Measure

    Directory of Open Access Journals (Sweden)

    Srikanth Kaithoju

    2015-12-01

    Full Text Available Stroke is a focal neurological syndrome of vascular basis, which may be due to ischemic thrombo-embolism or intra-cerebral haemorrhage. This condition has to be treated on emergency basis as it may cause an irreversible neurological damage. Warfarin has been a widely used oral anti-coagulant in treating ischemic stroke patients. This review highlights the benefits and challenges of warfarin treatment in stroke patients and discusses about the importance of risk stratification scores & bleeding scores in estimating the bleeding risk associated with warfarin treatment. This review also highlights the use of stroke outcome measures in identifying the patients with post-stroke disabilities to provide patient specific treatment.

  3. Targeting reactive nitrogen species: a promising therapeutic strategy for cerebral ischemia-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Xing-miao CHEN; Han-sen CHEN; Ming-jing XU; Jian-gang SHEN

    2013-01-01

    Ischemic stroke accounts for nearly 80% of stroke cases.Recanalization with thrombolysis is a currently crucial therapeutic strategy for re-building blood supply,but the thrombolytic therapy often companies with cerebral ischemia-reperfusion injury,which are mediated by free radicals.As an important component of free radicals,reactive nitrogen species (RNS),including nitric oxide (NO) and peroxynitrite (ONO0ˉ),play important roles in the process of cerebral ischemia-reperfusion injury.Ischemia-reperfusion results in the production of nitric oxide (NO) and peroxynitrite (ONOOˉ) in ischemic brain,which trigger numerous molecular cascades and lead to disruption of the blood brain barrier and exacerbate brain damage.There are few therapeutic strategies available for saving ischemic brains and preventing the subsequent brain damage.Recent evidence suggests that RNS could be a therapeutic target for the treatment of cerebral ischemia-reperfusion injury.Herein,we reviewed the recent progress regarding the roles of RNS in the process of cerebral ischemic-reperfusion injury and discussed the potentials of drug development that target NO and ONO0ˉ to treat ischemic stroke.We conclude that modulation for RNS level could be an important therapeutic strategy for preventing cerebral ischemiareperfusion injury.

  4. Brain-derived neurotrophic factor inhibits glucose intolerance after cerebral ischemia

    Science.gov (United States)

    Shu, Xiaoliang; Zhang, Yongsheng; Xu, Han; Kang, Kai; Cai, Donglian

    2013-01-01

    Brain-derived neurotrophic factor is associated with the insulin signaling pathway and glucose tabolism. We hypothesized that expression of brain-derived neurotrophic factor and its receptor may be involved in glucose intolerance following ischemic stress. To verify this hypothesis, this study aimed to observe the changes in brain-derived neurotrophic factor and tyrosine kinase B receptor expression in glucose metabolism-associated regions following cerebral ischemic stress in mice. At day 1 after middle cerebral artery occlusion, the expression levels of brain-derived neurotrophic factor were significantly decreased in the ischemic cortex, hypothalamus, liver, skeletal muscle, and pancreas. The expression levels of tyrosine kinase B receptor were decreased in the hypothalamus and liver, and increased in the skeletal muscle and pancreas, but remained unchanged in the cortex. Intrahypothalamic administration of brain-derived neurotrophic factor (40 ng) suppressed the decrease in insulin receptor and tyrosine-phosphorylated insulin receptor expression in the liver and skeletal muscle, and inhibited the overexpression of gluconeogenesis-associated phosphoenolpyruvate carboxykinase and glucose-6-phosphatase in the liver of cerebral ischemic mice. However, serum insulin levels remained unchanged. Our experimental findings indicate that brain-derived neurotrophic factor can promote glucose metabolism, reduce gluconeogenesis, and decrease blood glucose levels after cerebral ischemic stress. The low expression of brain-derived neurotrophic factor following cerebral ischemia may be involved in the development of glucose intolerance. PMID:25206547

  5. Brain-derived neurotrophic factor inhibits glucose intolerance after cerebral ischemia***

    Institute of Scientific and Technical Information of China (English)

    Xiaoliang Shu; Yongsheng Zhang; Han Xu; Kai Kang; Donglian Cai

    2013-01-01

    Brain-derived neurotrophic factor is associated with the insulin signaling pathway and glucose tabolism. We hypothesized that expression of brain-derived neurotrophic factor and its receptor may be involved in glucose intolerance fol owing ischemic stress. To verify this hypothesis, this study aimed to observe the changes in brain-derived neurotrophic factor and tyrosine kinase B receptor expression in glucose metabolism-associated regions fol owing cerebral ischemic stress in mice. At day 1 after middle cerebral artery occlusion, the expression levels of brain-derived neurotrophic factor were significantly decreased in the ischemic cortex, hypothalamus, liver, skeletal muscle, and pancreas. The expression levels of tyrosine kinase B receptor were decreased in the hypothalamus and liver, and increased in the skeletal muscle and pancreas, but remained unchanged in the cortex. Intrahypothalamic administration of brain-derived neurotrophic factor (40 ng) suppressed the de-crease in insulin receptor and tyrosine-phosphorylated insulin receptor expression in the liver and skeletal muscle, and inhibited the overexpression of gluconeogenesis-associated phosphoenolpy-ruvate carboxykinase and glucose-6-phosphatase in the liver of cerebral ischemic mice. However, serum insulin levels remained unchanged. Our experimental findings indicate that brain-derived neurotrophic factor can promote glucose metabolism, reduce gluconeogenesis, and decrease blood glucose levels after cerebral ischemic stress. The low expression of brain-derived neurotrophic factor fol owing cerebral ischemia may be involved in the development of glucose intolerance.

  6. Tuberculoma cerebral

    OpenAIRE

    BARROSO ELIZABETH CLARA; OLIVEIRA TÂNIA REGINA BRÍGIDO DE; AMARAL ANA MARIA DANTAS DO; PINHEIRO VALÉRIA GÓES FERREIRA; SOUSA ANA LÚCIA DE OLIVEIRA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  7. [Platelets, atherothrombosis, antiplatelet drugs and cerebral ischemia].

    Science.gov (United States)

    Bousser, Marie-Germaine

    2013-02-01

    Platelets play a much more important role in myocardial ischemia than in cerebral ischemia, because atherothrombosis - the underlying cause of the vast majority of myocardial infarcts - is responsible for only 25-30% of cerebral infarcts. Aspirin is the only effective antiplatelet drug for primary prevention of ischemic events, especially those affecting the heart. For secondary prevention of cerebral infarction, clopidogrel and the combination of aspirin with extended-release dipyridamole are both marginally better than aspirin alone, but aspirin remains the gold standard worldwide because of its remarkable cost/benefit/tolerability ratio. The clopidogrel-aspirin combination is to be avoided because of the risk of hemorrhage, particularly in the brain and gastrointestinal tract. Revascularization strategies and the choice of antiplatelet drugs for the acute phase of myocardial and cerebral ischemia are very different, consisting of endovascular treatment and aggressive platelet inhibition for coronary infarcts, versus intravenous thrombolysis and / or aspirin for cerebral infarcts. None of the new antiplatelet drugs used in acute coronary syndromes has so far been studied in acute cerebral ischemia. PMID:24919368

  8. A schizophrenic patient with cerebral infarctions after hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Youichi Yanagawa

    2013-01-01

    Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

  9. Development of functional in vivo imaging of cerebral lenticulostriate artery using novel synchrotron radiation angiography

    International Nuclear Information System (INIS)

    The lenticulostriate artery plays a vital role in the onset and development of cerebral ischemia. However, current imaging techniques cannot assess the in vivo functioning of small arteries such as the lenticulostriate artery in the brain of rats. Here, we report a novel method to achieve a high resolution multi-functional imaging of the cerebrovascular system using synchrotron radiation angiography, which is based on spatio-temporal analysis of contrast density in the arterial cross section. This method provides a unique tool for studying the sub-cortical vascular elasticity after cerebral ischemia in rats. Using this technique, we demonstrated that the vascular elasticity of the lenticulostriate artery decreased from day 1 to day 7 after transient middle cerebral artery occlusion in rats and recovered from day 7 to day 28 compared to the controls (p < 0.001), which paralleled with brain edema formation and inversely correlated with blood flow velocity (p < 0.05). Our results demonstrated that the change of vascular elasticity was related to the levels of brain edema and the velocity of focal blood flow, suggesting that reducing brain edema is important for the improvement of the function of the lenticulostriate artery in the ischemic brain. (paper)

  10. Diazoxide and dimethyl sulphoxide alleviate experimental cerebral hypoperfusion-induced white matter injury in the rat brain

    NARCIS (Netherlands)

    Farkas, E; Annahazi, A; Institoris, A; Mihaly, A; Luiten, PGM; Bari, F

    2005-01-01

    Aging and dementia are accompanied by cerebral white matter (WM) injury. which is considered to be of ischemic origin. A causal link between cerebral ischemia and WM damage has been demonstrated in rats: however. few attempts appear to have, been made to test potential drugs for the alleviation of i

  11. Clinical and radiological of acute ischemic stroke patients without angiographic occlusion on digital subtraction angiogram. A pooled analysis of case series

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Qaisar A.; Memon Zeeshan, Muhammad; Vazquez, Gabriela; Suri, M. Fareed K.; Hussein, Haitham M.; Qureshi, Adnan I. [Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, MN (United States); Mohammad, Yousef M. [Department of Neurology, Ohio State University, Columbus, OH (United States)

    2008-11-15

    Approximately 20-30% of the patients with acute ischemic stroke do not have any occlusion demonstrated on initial digital subtraction angiography (DSA). We sought to determine the risk and rates of cerebral infarction and favorable neurological outcome in this group of acute ischemic stroke patients. Patients were identified from a prospectively maintained stroke database and from literature search of MEDLINE, PubMed, and Cochrane databases. All patients had initial neurological assessment on National Institutes of Health Stroke Scale (NIHSS). Patients then underwent DSA after initial head computed tomography (CT) scans. Follow-up radiological assessment at 24-72 h was performed with CT and magnetic resonance imaging scans. Association of stroke risk factors with clinical and radiological outcomes was estimated. A total of 81 patients was analyzed (mean age 63 years; 28 were women). The median NIHSS score was 8 (range 2-25). None of the patients received either intravenous or intra-arterial thrombolytic. Cerebral infarction was detected in 62 (76%) of the 81 patients. Twenty-four to 48-h NIHSS was available for 51 patients only. Neurological improvement was observed in 22 (43%) of the 51 patients. Favorable outcome ascertained at 3-month follow-up was seen in 48 (59%) of the 81 patients. After adjusting for age, sex, and baseline NIHSS, male patients [odds ratio (OR) 4.5 (1.4-14.3), p value=0.01] and patients with age{>=} =65 [OR 4.3 (1.2-16.2), p value=0.03] have a higher risk of cerebral infarcts on the follow-up imaging. Similarly, patients who presented with <10 NIHSS had a better 3-month outcome than those with >10 NIHSS [OR 0.21 (0.08-0.61), p value=0.004]. Ischemic stroke patients without arterial occlusion on DSA have a higher risk of cerebral infarction and disability particularly in men, patients over 65 years of age and with NIHSS{>=}=10. The cause of infarction may have been arterial obstruction with spontaneous recanalization or small vessel occlusion

  12. Computed tomographic and Doppler sonographic correlations in patients with ischemic strokes

    International Nuclear Information System (INIS)

    Full text: Introduction: Ischemic strokes (cerebral infarctions) constitute 80% of the acute disorders of the brain circulation. They most frequently occur in atherosclerosis of the extra- and intracranial vessels and/or arterial hypertension heart diseases (ischemic heart disease, rhythm and conductive disorders), cerebral vasculitis, blood diseases originating from hypercoagulability (thrombocytosis), etc. One of the well studied and adequately supported by documents risk factors for cerebral vascular disease (RF for CVD) are the asymptomatic carotid stenosis (ACS) and the symptomatic stenosis, especially the haemodynamically significant ones. Materials and methods: Two hundred twenty two patients with ischemic brain strokes originating from carotid stenosis, hypertension and heart diseases were studied. The correlation between the size and localization of the brain stroke was studied through computer tomography, while the grade of the carotid stenosis was determined with the help of Doppler sonography. Results and discussion: Significant correlations between the size and localization of the ischemic foci and the grade of the carotid stenosis in patients with brain stroke were found in a considerable number of patients. In most of the patients the electrocardiography tests showed the presence of heart diseases, a fact which gives evidence for the generalization of the vessel disorders in these patients. Conclusion: Our study confirmed the high diagnostic value of the combination of these two methods, on the one hand is sufficiently informative, on the other hand are generally available

  13. Histone acetylation and CREB binding protein are required for neuronal resistance against ischemic injury.

    Directory of Open Access Journals (Sweden)

    Ferah Yildirim

    Full Text Available Epigenetic transcriptional regulation by histone acetylation depends on the balance between histone acetyltransferase (HAT and deacetylase activities (HDAC. Inhibition of HDAC activity provides neuroprotection, indicating that the outcome of cerebral ischemia depends crucially on the acetylation status of histones. In the present study, we characterized the changes in histone acetylation levels in ischemia models of focal cerebral ischemia and identified cAMP-response element binding protein (CREB-binding protein (CBP as a crucial factor in the susceptibility of neurons to ischemic stress. Both neuron-specific RNA interference and neurons derived from CBP heterozygous knockout mice showed increased damage after oxygen-glucose deprivation (OGD in vitro. Furthermore, we demonstrated that ischemic preconditioning by a short (5 min subthreshold occlusion of the middle cerebral artery (MCA, followed 24 h afterwards by a 30 min occlusion of the MCA, increased histone acetylation levels in vivo. Ischemic preconditioning enhanced CBP recruitment and histone acetylation at the promoter of the neuroprotective gene gelsolin leading to increased gelsolin expression in neurons. Inhibition of CBP's HAT activity attenuated neuronal ischemic preconditioning. Taken together, our findings suggest that the levels of CBP and histone acetylation determine stroke outcome and are crucially associated with the induction of an ischemia-resistant state in neurons.

  14. Cerebral hypoxia and ischemia in preterm infants

    Directory of Open Access Journals (Sweden)

    Alberto Ravarino

    2014-06-01

    Full Text Available Premature birth is a major public health issue internationally affecting 13 million babies worldwide. Hypoxia and ischemia is probably the commonest type of acquired brain damage in preterm infants. The clinical manifestations of hypoxic-ischemic injury in survivors of premature birth include a spectrum of cerebral palsy and intellectual disabilities. Until recently, the extensive brain abnormalities in preterm neonates appeared to be related mostly to destructive processes that lead to substantial deletion of neurons, axons, and glia from necrotic lesions in the developing brain. Advances in neonatal care coincide with a growing body of evidence that the preterm gray and white matter frequently sustain less severe insults, where tissue destruction is the minor component. Periventricular leukomalacia (PVL is the major form of white matter injury and consists classically of focal necrotic lesions, with subsequent cyst formation, and a less severe but more diffuse injury to cerebral white mater, with prominent astrogliosis and microgliosis but without overt necrosis. With PVL a concomitant injury occurs to subplate neurons, located in the subcortical white matter. Severe hypoxic-ischemic insults that trigger significant white matter necrosis are accompanied by neuronal degeneration in cerebral gray and white matter. This review aims to illustrate signs of cerebral embryology of the second half of fetal life and correlate hypoxic-ischemic brain injury in the premature infant. This should help us better understand the symptoms early and late and facilitate new therapeutic strategies. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  15. Cortical myoclonus during IV thrombolysis for ischemic stroke

    Science.gov (United States)

    Bentes, Carla; Peralta, Rita; Viana, Pedro; Morgado, Carlos; Melo, Teresa P.; Ferro, José M.

    2014-01-01

    We describe a patient with an acute middle cerebral artery ischemic stroke developing subtle involuntary movements of the paretic upper limb with cortical origin during rt-PA perfusion. Despite the multiple potential pathophysiological mechanisms for the relationship between thrombolysis and epileptic activity, seizures during this procedure are scarcely reported. Our hypothesis is that subtle and transient clinical seizures, like those described in our patient, may not be detected or are misdiagnosed as nonepileptic involuntary movements. We aimed to draw attention to the recognition challenge of this paroxysmal motor behavior, highlighting this clinical and neurophysiological identification using video recording and back-average analysis of the EEG. PMID:25667903

  16. Cortical myoclonus during IV thrombolysis for ischemic stroke

    Directory of Open Access Journals (Sweden)

    Carla Bentes

    2014-01-01

    Full Text Available We describe a patient with an acute middle cerebral artery ischemic stroke developing subtle involuntary movements of the paretic upper limb with cortical origin during rt-PA perfusion. Despite the multiple potential pathophysiological mechanisms for the relationship between thrombolysis and epileptic activity, seizures during this procedure are scarcely reported. Our hypothesis is that subtle and transient clinical seizures, like those described in our patient, may not be detected or are misdiagnosed as nonepileptic involuntary movements. We aimed to draw attention to the recognition challenge of this paroxysmal motor behavior, highlighting this clinical and neurophysiological identification using video recording and back-average analysis of the EEG.

  17. Pathways to ischemic neuronal cell death: are sex differences relevant?

    OpenAIRE

    McCullough Louise D; Lang Jesse T

    2008-01-01

    Abstract We have known for some time that the epidemiology of human stroke is sexually dimorphic until late in life, well beyond the years of reproductive senescence and menopause. Now, a new concept is emerging: the mechanisms and outcome of cerebral ischemic injury are influenced strongly by biological sex as well as the availability of sex steroids to the brain. The principal mammalian estrogen (17 β estradiol or E2) is neuroprotective in many types of brain injury and has been the major f...

  18. Exercise preconditioning exhibits neuroprotective effects on hippocampal CA1 neuronal damage after cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Nabi Shamsaei

    2015-01-01

    Full Text Available Recent evidence has suggested the neuroprotective effects of physical exercise on cerebral ischemic injury. However, the role of physical exercise in cerebral ischemia-induced hippocampal damage remains controversial. The aim of the present study was to evaluate the effects of pre-ischemia treadmill training on hippocampal CA1 neuronal damage after cerebral ischemia. Male adult rats were randomly divided into control, ischemia and exercise + ischemia groups. In the exercise + ischemia group, rats were subjected to running on a treadmill in a designated time schedule (5 days per week for 4 weeks. Then rats underwent cerebral ischemia induction through occlusion of common carotids followed by reperfusion. At 4 days after cerebral ischemia, rat learning and memory abilities were evaluated using passive avoidance memory test and rat hippocampal neuronal damage was detected using Nissl and TUNEL staining. Pre-ischemic exercise significantly reduced the number of TUNEL-positive cells and necrotic cell death in the hippocampal CA1 region as compared to the ischemia group. Moreover, pre-ischemic exercise significantly prevented ischemia-induced memory dysfunction. Pre-ischemic exercise mighct prevent memory deficits after cerebral ischemia through rescuing hippocampal CA1 neurons from ischemia-induced degeneration.

  19. Exercise preconditioning exhibits neuroprotective effects on hippocampal CA1 neuronal damage after cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Nabi Shamsaei; Mehdi Khaksari; Sohaila Erfani; Hamid Rajabi; Nahid Aboutaleb

    2015-01-01

    Recent evidence has suggested the neuroprotective effects of physical exercise on cerebral isch-emic injury. However, the role of physical exercise in cerebral ischemia-induced hippocampal damage remains controversial. The aim of the present study was to evaluate the effects of pre-ischemia treadmill training on hippocampal CA1 neuronal damage after cerebral ischemia. Male adult rats were randomly divided into control, ischemia and exercise + ischemia groups. In the exercise + ischemia group, rats were subjected to running on a treadmill in a designated time schedule (5 days per week for 4 weeks). Then rats underwent cerebral ischemia induction th rough occlusion of common carotids followed by reperfusion. At 4 days after cerebral ischemia, rat learning and memory abilities were evaluated using passive avoidance memory test and rat hippocampal neuronal damage was detected using Nissl and TUNEL staining. Pre-ischemic ex-ercise signiifcantly reduced the number of TUNEL-positive cells and necrotic cell death in the hippocampal CA1 region as compared to the ischemia group. Moreover, pre-ischemic exercise significantly prevented ischemia-induced memory dysfunction. Pre-ischemic exercise mighct prevent memory deficits after cerebral ischemia through rescuing hippocampal CA1 neurons from ischemia-induced degeneration.

  20. Potential neuroprotective effects of acupuncture stimulation on diabetes mellitus in a global ischemic rat model

    International Nuclear Information System (INIS)

    Acupuncture (ACU) is known to be effective in ischemia treatment, and glutamate (GLU) excitotoxicity is an important factor in neuronal cell death. We observed the effect of ACU on cerebral blood flow (%CBF) and ΔGLU (the changes in GLU release) in the ischemic stroke rat model of diabetic mellitus (DM). A global ischemia was induced using the eleven-vessel occlusion (11-VO) method in 14 Sprague-Dawley rats (DM), which were randomly divided into two groups: the control group and the ACU-treatment group. Extracellular ΔGLU was assessed using an intra-cerebral biosensor system measuring 256 samples per second, simultaneously with %CBF and electroencephalogram. ACU stimulation was applied to ACU points GB34 and GB39 during the ischemic period. Twenty-three diagnostic parameters were proposed first for a detailed analysis of changes in %CBF and GLU release during ischemia/reperfusion. ACU rats showed a significant decrease in ischemic (p < 0.05) and reperfusion %CBF (p < 0.0001) than control rats, and a significantly larger decrease in ischemic ΔGLU (p < 0.05) and peak level of reperfusion ΔGLU (p < 0.005) than control rats. From these results, we suggest that ACU stimulation is responsible for the potential protection of neurons through suppression of %CBF response in the increased plasma osmolality and extracellular ΔGLU in diabetic rats under ischemic conditions

  1. CURRENT REPERFUSION THERAPY POSSIBILITIES IN MYOCARDIAL INFARCTION AND ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    E. V. Konstantinova

    2015-01-01

    Full Text Available Myocardial infarction and ischemic stroke remain to be of the greatest medical and social importance because of their high prevalence, disability, and mortality rates. Intractable thrombotic occlusion of the respective artery leads to the formation of an ischemic lesion focus in the tissue of the heart or brain. Emergency reperfusion serves to decrease a necrotic focus, makes its formation reversible, and reduces patient death rates. The paper considers main reperfusion therapy lines: medical (with thrombolytic drugs and mechanical (with primary interventions one and their combination in treating patients with acute myocardial and cerebral ischemia. Each reperfusion procedure is discussed in view of its advantages, disadvantages, available guidelines, and possibilities of real clinical practice. Tenecteplase is assessed in terms of its efficacy, safety, and capacities for bolus administration, which allows its use at any hospital and at the pre-hospital stage. Prehospital thrombolysis permits reperfusion therapy to bring much closer to the patient and therefore aids in reducing time to reperfusion and in salvaging as much the myocardial volume as possible. The rapidest recovery of myocardial and cerebral perfusion results in a decreased necrotic area and both improved immediate and late prognosis. The results of randomized clinical trials studying the possibilities of the medical and mechanical methods to restore blood flow are analyzed in the context of evidence-based medicine. The reason why despite the available contraindications, limited efficiency, and the risk of hemorrhagic complications, thrombolytic therapy remains the method of choice for prehospital reperfusion, an alternative to primary percutaneous coronary intervention (PCI if it cannot be carried out in patients with myocardial infarction at the stated time, and the only treatment ischemic stroke treatment that has proven its efficiency and safety in clinical trials is under

  2. Recurrent cerebral thrombosis

    International Nuclear Information System (INIS)

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.)

  3. Ischemic white brain matter lesions in MR imaging

    International Nuclear Information System (INIS)

    In 21 patients suffering from cerebrovascular insufficiency, MR imaging was correlated with positron emission tomographic measurements of regional cerebral blood flow in order to evaluate the functional significance of ischemic white matter lesions (WMLs). In contrast to brain infarcts, WMLs demonstrated no marked reduction of regional cerebral blood flow. It has to be considered, however, that the blood flow within the white matter is reduced by a factor of four as compared with the gray matter. In several cases, cortex adjacent to WMLs revealed reduced blood flow. This finding can probably be explained as an effect of deafferentiation. A statistically significant inverse relation between the mean cortical blood flow and the extent of WMLs could be demonstrated

  4. Contributing Mechanisms of Aortic Atheroma in Ischemic Cerebrovascular Disease.

    Science.gov (United States)

    Kong, Qi; Ma, Xin

    2015-12-01

    In recent years, the correlation between aortic atheroma (AA) and the occurrence and recurrence of ischemic cerebrovascular disease (ICVD) has attracted much attention, but the contributory mechanisms remain controversial. This review analyzes related research on the roles of AA in ICVD, and demonstrates the correlation between the formation and development of AA and abnormal metabolism, inflammation, hemodynamic changes, and other contributory factors. The presence of complex aortic plaque (CAP) in the ascending aorta and aortic arch increases the risk of cerebral embolism and degree of injury, while the association between CAP in the descending aorta and cerebral embolism remains ambiguous. AA also functions as an indicator of atherosclerosis burden as well as hypercoagulability, which may further increase the risk of ICVD. Further study on the relationship of AA to ICVD will improve diagnosis and treatment in clinical practice. PMID:26522269

  5. Physical exercise training and neurovascular unit in ischemic stroke.

    Science.gov (United States)

    Wang, X; Zhang, M; Feng, R; Li, W B; Ren, S Q; Zhang, J; Zhang, F

    2014-06-20

    Physical exercise could exert a neuroprotective effect in both clinical studies and animal experiments. A series of related studies have indicated that physical exercise could reduce infarct volume, alleviate neurological deficits, decrease blood-brain barrier dysfunction, promote angiogenesis in cerebral vascular system and increase the survival rate after ischemic stroke. In this review, we summarized the protective effects of physical exercise on neurovascular unit (NVU), including neurons, astrocytes, pericytes and the extracellular matrix. Furthermore, it was demonstrated that exercise training could decrease the blood-brain barrier dysfunction and promote angiogenesis in cerebral vascular system. An awareness of the exercise intervention benefits pre- and post stroke may lead more stroke patients and people with high-risk factors to accept exercise therapy for the prevention and treatment of stroke. PMID:24780769

  6. An emboligenic pulmonary abscess leading to ischemic stroke and secondary brain abscess

    Directory of Open Access Journals (Sweden)

    Albrecht Philipp

    2012-11-01

    Full Text Available Abstract Background Ischemic stroke by septic embolism occurs primarily in the context of infective endocarditis or in patients with a right-to-left shunt and formation of a secondary cerebral abscess is a rare event. Erosion of pulmonary veins by a pulmonary abscess can lead to transcardiac septic embolism but to our knowledge no case of septic embolic ischemic stroke from a pulmonary abscess with secondary transformation into a brain abscess has been reported to date. Case presentation We report the case of a patient with a pulmonary abscess causing a septic embolic cerebral infarction which then transformed into a cerebral abscess. After antibiotic therapy and drainage of the abscess the patient could be rehabilitated and presented an impressive improvement of symptoms. Conclusion Septic embolism should be considered as cause of ischemic stroke in patients with pulmonary abscess and can be followed by formation of a secondary cerebral abscess. Early antibiotic treatment and repeated cranial CT-scans for detection of a secondary abscess should be performed.

  7. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke. PMID:23805635

  8. Risk factors and prognosis of ischemic stroke in young patients in Uzbekistan

    Directory of Open Access Journals (Sweden)

    Khurshidakhon Rasulova

    2011-03-01

    Full Text Available Between 2004 and 2008, we studied reasons and risk factors of ischemic stroke in 150 young patients (aged between 17-44 years, compared with those in elderly patients (n=70. According to our data, heredity, arterial hypertension, cerebral vasculitis, thyroid diseases, chronic alcoholism, smoking and long-term use of oral contraceptives are main risk factors of ischemic stroke in the young in Uzbekistan. However, relative risk of stroke in this group of patients is less than in elder patients. In 16% cases, usage of standard diagnostic measures does not lead to identification of the disease cause.

  9. Concurrent Ruptured Pseudoaneurysm of the Internal Carotid Artery and Cerebral Infarction as an Initial Manifestation of Polycythemia Vera

    OpenAIRE

    Choi, Kyu-Sun; Kim, Jae-Min; Ryu, Je-il; Oh, Young-Ha

    2015-01-01

    The most common neurologic manifestations of polycythemia vera (PV) are cerebral infarction and transient ischemic attacks, while cerebral hemorrhage or intracranial dissection has been rarely associated with PV. Here we report the first case of a 59-year-old patient with intracranial supraclinoid internal carotid artery (ICA) dissection causing cerebral infarction and concomitant subarachnoid hemorrhage due to pseudoaneurysm rupture as clinical onset of PV. This case report discusses the pos...

  10. Contribution of reactive oxygen species to cerebral amyloid angiopathy, vasomotor dysfunction, and microhemorrhage in aged Tg2576 mice

    OpenAIRE

    Han, Byung Hee; Zhou, Meng-liang; Johnson, Andrew W; Singh, Itender; Liao, Fan; Vellimana, Ananth K.; Nelson, James W.; Milner, Eric; Cirrito, John R.; Basak, Jacob; Yoo, Min; Dietrich, Hans H.; Holtzman, David M.; Zipfel, Gregory Joseph

    2015-01-01

    One of the hallmarks of Alzheimer’s disease (AD) is cerebral amyloid angiopathy (CAA), which is a strong and independent risk factor for cerebral hemorrhage, ischemic stroke, and dementia. However, the mechanisms by which CAA contributes to these conditions are poorly understood. Results from the present study provide strong evidence that vascular oxidative stress plays a causal role in CAA-induced cerebrovascular dysfunction, CAA-induced cerebral hemorrhage, and CAA formation, itself. They a...

  11. Bedside Evaluation of Cerebral Energy Metabolism in Severe Community-Acquired Bacterial Meningitis

    DEFF Research Database (Denmark)

    Rom Poulsen, Frantz; Schulz, Mette; Jacobsen, Anne;

    2015-01-01

    this technique may separate ischemia and non-ischemic mitochondrial dysfunction. The present study is a retrospective interpretation of biochemical data obtained in a series of patients with severe community-acquired meningitis. METHODS: Cerebral energy metabolism was monitored in 15 patients with...... severe community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as lactate/pyruvate (LP) ratio >30 with intracerebral pyruvate level <70 µmol L(-1). Non-ischemic mitochondrial dysfunction was defined...... 5 patients classified as non-ischemic mitochondrial dysfunction, and in 2 patients (3 catheters) classified as ischemia. CONCLUSIONS: In patients with severe community-acquired meningitis, compromised cerebral energy metabolism occurs frequently and was diagnosed in 7 out of 15 cases. A biochemical...

  12. Effects of Electroacupuncture plus Intra-carotid Drug Injection on Rheoencephalogram in Patients with Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    李江明; 胡永均; 童利民; 王大军; 张道敬

    2004-01-01

    Purpose: To investigate the mechanism of electroacupuncture (EA) plus intra-carotid drug injection for treating cerebral infarction. Methods: Rheoencephalogram was recorded with a RG-2B type of bridge rheoencephalograph and findings were compared before and after the treatment. Results: After the treatment, the prolonged rising time was shortened, and the decreased amplitude obviously elevated. Conclusion: The therapy can dilate cerebral blood vessels, increase the cerebral blood flow, and improve the elasticity of cerebral blood vessels, leading to sufficient blood and oxygen supply in the ischemic brain tissues and to restoration of their functions.

  13. Lipocalin-2 as an Infection-Related Biomarker to Predict Clinical Outcome in Ischemic Stroke

    Science.gov (United States)

    Hochmeister, Sonja; Engel, Odilo; Adzemovic, Milena Z.; Pekar, Thomas; Kendlbacher, Paul; Zeitelhofer, Manuel; Haindl, Michaela; Meisel, Andreas; Fazekas, Franz; Seifert-Held, Thomas

    2016-01-01

    Objectives From previous data in animal models of cerebral ischemia, lipocalin-2 (LCN2), a protein related to neutrophil function and cellular iron homeostasis, is supposed to have a value as a biomarker in ischemic stroke patients. Therefore, we examined LCN2 expression in the ischemic brain in an animal model and measured plasma levels of LCN2 in ischemic stroke patients. Methods In the mouse model of transient middle cerebral artery occlusion (tMCAO), LCN2 expression in the brain was analyzed by immunohistochemistry and correlated to cellular nonheme iron deposition up to 42 days after tMCAO. In human stroke patients, plasma levels of LCN2 were determined one week after ischemic stroke. In addition to established predictive parameters such as age, National Institutes of Health Stroke Scale and thrombolytic therapy, LCN2 was included into linear logistic regression modeling to predict clinical outcome at 90 days after stroke. Results Immunohistochemistry revealed expression of LCN2 in the mouse brain already at one day following tMCAO, and the amount of LCN2 subsequently increased with a maximum at 2 weeks after tMCAO. Accumulation of cellular nonheme iron was detectable one week post tMCAO and continued to increase. In ischemic stroke patients, higher plasma levels of LCN2 were associated with a worse clinical outcome at 90 days and with the occurrence of post-stroke infections. Conclusions LCN2 is expressed in the ischemic brain after temporary experimental ischemia and paralleled by the accumulation of cellular nonheme iron. Plasma levels of LCN2 measured in patients one week after ischemic stroke contribute to the prediction of clinical outcome at 90 days and reflect the systemic response to post-stroke infections. PMID:27152948

  14. Cerebral circulation and metabolism in cerebral infarction of middle cerebral artery territory

    International Nuclear Information System (INIS)

    Regional cerebral blood flow (rCBF), oxygen metabolism (rCMRO2), oxygen extraction fraction (rOEF) and blood volume (rCBV) were measured with a high performance positron CT (HEADTOME-III) and the 15O labeled gas steady-state method. Seven normal volunteers and 13 patients with ischemic infarction located in the territory of unilateral middle cerebral artery (MCA) were subjected to the positron CT measurement. In the present study, over estimation of rOEF and rCMRO2 were corrected by rCBV using the principle described by Lammertsma and Jones. From these paremeters we also calculated an rCBV/rCBF which meant regional blood transient time of cerebral vessels (rTT). Early ischemic lesions showed two types of uncoupling between rCBF and rCMRO2. Patients studied within the 5th day of the onset showed high rOEF with low rCBF in the infarcted forcus (misery perfusion). About a week after onset rOEF was changed into low level with decreased rCMRO2 and recovered rCBF, and the change lasted to a month after onset recovered rCBF, and the change lasted to a month after onset (luxury perfusion). Then, about two months later, the lesions gradually went to matched change of rCBF and rCMRO2 (coupled perfusion). These changes of rCBF and rCMRO2 described above will reveal the natural course of ischemic brain tissue with acute onset. It was also proved that there was positive correlation between rTT and rOEF. A parameter of rTT will be important to presume rOEF from a single photon emission CT measurement, which has not been able to study oxygen metabolism but could measure rCBF and rCBV. The threshold levels of rCBF and rCMRO2 for morphological tissue damages assessed as a low density area on a X-ray CT were clinically estimated from the present study. The thresholds evaluated in patients within a day of onset, were 12 ml/100 ml/min, and 1.5 ml/ 100 ml/min for rCBF and rCMRO2, respectively. (J.P.N.)

  15. Photochemically induced ischemic stroke in rats

    Directory of Open Access Journals (Sweden)

    Schmidt Antje

    2012-08-01

    Full Text Available Abstract Background Photothrombosis was introduced as a model of ischemic stroke by Watson et al. in 1985. In the present paper, we describe a protocol to induce photothrombotic infarcts in rats. Findings The photosensitive dye Bengal Rose is intravenously administered and a laser beam is stereotactically positioned onto the skull. Illumination through the intact skull leads to local activation of Bengal Rose, which results in free radical formation, disturbance of endothelial function and thrombus formation in illuminated small cortical vessels. Conclusions Photochemically induced infarcts cause long-term sensorimotor deficits, allow long-term survival and are particularly suitable to assess the effectiveness of neuroregenerative therapies in chronic stroke studies.

  16. Brain-derived neurotrophic factor inhibits glucose intolerance after cerebral ischemia

    OpenAIRE

    Shu, Xiaoliang; Zhang, Yongsheng; Xu, Han; Kang, Kai; Cai, Donglian

    2013-01-01

    Brain-derived neurotrophic factor is associated with the insulin signaling pathway and glucose tabolism. We hypothesized that expression of brain-derived neurotrophic factor and its receptor may be involved in glucose intolerance following ischemic stress. To verify this hypothesis, this study aimed to observe the changes in brain-derived neurotrophic factor and tyrosine kinase B receptor expression in glucose metabolism-associated regions following cerebral ischemic stress in mice. At day 1 ...

  17. Bilateral optic nerve infarction in rhino-cerebral mucormycosis: A rare magnetic resonance imaging finding

    OpenAIRE

    Mandeep Singh Ghuman; Shabdeep Kaur; Samarjit Kaur Bhandal; Archana Ahluwalia; Kavita Saggar

    2015-01-01

    Mucormycosis is an emerging disease in diabetes and immunocompromised patients. Rhino-orbito-cerebral mucormycosis is one of the common forms of the disease. Mucormycosis leading to ischemic optic neuropathy is a rare complication. The role of magnetic resonance imaging (MRI) in the diagnosis of ischemic optic neuropathy is limited and uncommonly reported. We report an unusual case of mucormycosis in which MRI revealed bilateral optic nerve infarction, in addition to perineural extension of t...

  18. Echocardiographic Findings And Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Natalya Gamletovna Dadamyants

    2011-10-01

    Full Text Available In order to study cardiac pathology in different subtypes of ischemic stroke we examined 165 stroke patients. The 1st group included 90 (54.5% patients with hemodynamic stroke, the 2nd one - 75 (45.5% patients with cardioembolic stroke. Control group consisted of 45 individuals without cerebrovascular diseases. Cardiac pathologies with the prevalence of various types of ischemic heart disease were observed in all groups. The parameters of left ventricular stroke volume and ejection fraction were lower in patients with hemodynamic stroke than in other groups, but were within normal limits. Potential sources of cardiogenic embolism were found in all groups: in the 1st group at 74.4%, in the 2nd one at 100%. Thus, most patients with ischemic stroke have different heart defects related to the subtypes of ischemic stroke. 

  19. RANOLAZINE IN ISCHEMIC HEART DISEASE

    OpenAIRE

    V. P. Lupanov

    2015-01-01

    Study results of a new anti-anginal drug (an inhibitor of sodium channels — ranolazine) are presented. Indications, contraindications, major clinical trials of the drug in patients with ischemic heart disease are considered.

  20. RANOLAZINE IN ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    V. P. Lupanov

    2015-12-01

    Full Text Available Study results of a new anti-anginal drug (an inhibitor of sodium channels — ranolazine are presented. Indications, contraindications, major clinical trials of the drug in patients with ischemic heart disease are considered.

  1. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  2. Modulation of NADPH oxidase activation in cerebral ischemia/reperfusion injury in rats.

    Science.gov (United States)

    Genovese, Tiziana; Mazzon, Emanuela; Paterniti, Irene; Esposito, Emanuela; Bramanti, Placido; Cuzzocrea, Salvatore

    2011-02-01

    NADPH oxidase is a major complex that produces reactive oxygen species (ROSs) during the ischemic period and aggravates brain damage and cell death after ischemic injury. Although many approaches have been tested for preventing production of ROSs by NADPH oxidase in ischemic brain injury, the regulatory mechanisms of NADPH oxidase activity after cerebral ischemia are still unclear. The aim of this study is identifying apocynin as a critical modulator of NADPH oxidase and elucidating its role as a neuroprotectant in an experimental model of brain ischemia in rat. Treatment of apocynin 5min before of reperfusion attenuated cerebral ischemia in rats. Administration of apocynin showed marked reduction in infarct size compared with that of control rats. Medial carotid artery occlusion (MCAo)-induced cerebral ischemia was also associated with an increase in, nitrotyrosine formation, as well as IL-1β expression, IκB degradation and ICAM expression in ischemic regions. These expressions were markedly inhibited by the treatment of apocynin. We also demonstrated that apocynin reduces levels of apoptosis (TUNEL, Bax and Bcl-2 expression) resulting in a reduction in the infarct volume in ischemia-reperfusion brain injury. This new understanding of apocynin induced adaptation to ischemic stress and inflammation could suggest novel avenues for clinical intervention during ischemic and inflammatory diseases. PMID:21138737

  3. Avaliação dos níveis de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico Assesment of homocysteine, vitamin E, selenium, copper, ceruloplasmin and ferritin levels in patients with ischemic stroke diagnosis

    Directory of Open Access Journals (Sweden)

    Lillian Harboe-Gonçalves

    2007-02-01

    Full Text Available OBJETIVO: Avaliar níveis sangüíneos de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico (AVCI. CASUÍSTICA, MATERIAIS E MÉTODOS: Estudo transversal analítico de 104 pacientes diagnosticados com AVCI e 98 controles. Dosagem de homocisteína e vitamina E feita por cromatografia líquida de alta performance. O selênio foi dosado por tecnologia de espectrometria de massa por plasma indutivamente acoplado; o cobre o foi por colorimetria; a ceruloplasmina, por nefelometria; e a ferritina, por imunoensaio enzimático conjugado à fluorescência (Elfa. Análise estatística feita com testes t de Student e análise de variância. RESULTADOS: Encontrada hiper-homocisteinemia em 43% dos pacientes e 13% dos controles. Os valores obtidos nas dosagens de vitamina E, cobre, ceruloplasmina e ferritina foram significativamente maiores no grupo paciente do que no grupo controle. Quanto ao selênio, a diferença entre os dois grupos não foi significativa. DISCUSSÃO: Níveis de hiper-homocisteinemia foram maiores que os encontrados na literatura, podendo ser conseqüência da genética ou dos hábitos alimentares da população. Os resultados encontrados para vitamina E, selênio, cobre, ceruloplasmina e ferritina coincidem com os de alguns trabalhos publicados, mas o modelo deste estudo não avalia se os níveis de vitamina E e selênio foram alterados pelo AVCI ou por mudanças nos hábitos dos pacientes. A ferritina e a ceruloplasmina podem ser marcadores de AVCI, e não fator causal da sua patogênese. CONCLUSÃO: A hiper-homocisteinemia é mais prevalente nos pacientes diagnosticados com AVCI. Os níveis de vitamina E, cobre, ceruloplasmina e ferritina mais elevados encontrados nos pacientes não podem ser atribuídos à ocorrência de AVCI.OBJECTIVE: To assess blood levels of hyperhomocysteinaemia, vitamin E, selenium, copper, ceruloplasmin and

  4. Effect of glutamate on inflammatory responses of intestine and brain after focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Lei Xu; Jie Sun; Ran Lu; Qing Ji; Jian-Guo Xu

    2005-01-01

    AIM: To study the modulation of glutamate on post-ischemic intestinal and cerebral inflammatory responses in a ischemic and excitotoxic rat model.METHODS: Adult male rats were subjected to bilateral carotid artery occlusion for 15 min and injection of monosodium glutamate intraperitoneally, to decapitate them at selected time points. Tumor necrosis factor alpha (TNF-α) level and nuclear factor kappa B (NF-κB) activity were determined by enzyme-linked immunosorbant assay (ELISA) and electrophoretic mobility shift assay (EMSA), respectively.Hemodynamic parameters were monitored continuously during the whole process of cerebral ischemia and reperfusion.RESULTS: Monosodium glutamate (MSG) treated rats displayed statistically significant high levels of TNF-α in cerebral and intestinal tissuess within the first 6 h of ischemia. The rats with cerebral ischemia showed a minor decrease of TNF-α production in cerebral and intestinal tissuess. The rats with cerebral ischemia and treated with MSG displayed statistically significant low levels of TNF-α in cerebral and intestinal tissues. These results correlated significantly with NF-κB production calculated at the same intervals. During experiment, the mean blood pressure and heart rates in all groups were stable.CONCLUSION: Glutamate is involved in the mechanism of intestinal and cerebral inflammation responses. The effects of glutamate on cerebral and intestinal inflammatory responses after ischemia are up-regulated at the transcriptional level,through the NF-κB signal transduction pathway.

  5. Perinatal Hypoxic-Ischemic brain injury; MR findings

    International Nuclear Information System (INIS)

    To characterize the MR findings of hypoxic-ischemic brain injury and to assess the value of the MR imaging. SE T1-, T2-weighted, and IR brain MR images of 44 infants and children with the past history of perinatal hypoxic insults were reviewed. Abnormal brain MR findings of 8 patients with birth history of prematurity and 36 patients with birth history of full-term/posterm including 7 with severe anoxic insult history, were compared in regard to the location and the character of the lesions. MRI demonstrated the followings; (1)abnormal signal intensity lesions of subcortical and/or deep cerebral white matter, cortex, and deep gray matter, (2)atrophy of the cerebral white matter, cortex and corpus callosum, with/without ventriculomegaly, and (3)delay in myelination. Periventricular and deep white matter lesions were demonstrated in the prematurity, the deep white matter lesions and/ or subcortical white matter lesions in the term/post-term, and deep gray matter lesions in the 7 patients with severe anoxic insults history. MR imaging was useful in the diagnosis of the hypoxic-ischemic brain injury, and the white and gray matter lesions were correlated with the time of the injury and the severity of hypoxic insult

  6. Pathways to ischemic neuronal cell death: are sex differences relevant?

    Directory of Open Access Journals (Sweden)

    McCullough Louise D

    2008-06-01

    Full Text Available Abstract We have known for some time that the epidemiology of human stroke is sexually dimorphic until late in life, well beyond the years of reproductive senescence and menopause. Now, a new concept is emerging: the mechanisms and outcome of cerebral ischemic injury are influenced strongly by biological sex as well as the availability of sex steroids to the brain. The principal mammalian estrogen (17 β estradiol or E2 is neuroprotective in many types of brain injury and has been the major focus of investigation over the past several decades. However, it is becoming increasingly clear that although hormones are a major contributor to sex-specific outcomes, they do not fully account for sex-specific responses to cerebral ischemia. The purpose of this review is to highlight recent studies in cell culture and animal models that suggest that genetic sex determines experimental stroke outcome and that divergent cell death pathways are activated after an ischemic insult. These sex differences need to be identified if we are to develop efficacious neuroprotective agents for use in stroke patients.

  7. Quantification of convection-enhanced delivery to the ischemic brain

    International Nuclear Information System (INIS)

    Convection-enhanced delivery (CED) could have clinical application in the delivery of neuroprotective agents following ischemic stroke. However, ischemic brain tissue changes such as cytotoxic edema, in which cellular swelling decreases the fractional volume of the extracellular space, would be expected to significantly alter the distribution of neuroprotective agents delivered by CED. We sought to predict and characterize these effects using the magnetic resonance contrast agent gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) as a model therapeutic agent. CED was observed using MRI in a normal rat brain and in a middle cerebral artery (MCA) occlusion rat model of brain ischemia. Gd-DTPA was infused to the caudate putamen in the normal rat (n = 6) and MCA occlusion model (n = 6). In each rat, baseline apparent diffusion coefficient images were acquired prior to infusion, and T1 maps were then acquired 13 times throughout the duration of the experiment. These T1 maps were used to compute Gd-DTPA concentrations throughout each brain. In the MCA occlusion group, CED delivered Gd-DTPA to a comparatively larger volume with lower average tissue concentrations. Following the infusion, the total content of Gd-DTPA decreased more slowly in the MCA occlusion group than in the normal group. This quantitative characterization confirms that edematous ischemic tissue changes alter the distribution of agents by CED. These findings may have important implications for CED in the treatment of brain injury, and will assist in future efforts to model the distribution of therapeutic agents

  8. Thrombolysis in acute ischemic stroke: where and when?

    Directory of Open Access Journals (Sweden)

    Giuseppe Micieli

    2007-12-01

    Full Text Available The therapy of acute ischemic stroke remains an open challenge for the clinicians and is closely connected to the ready acknowledgment of symptoms, to the promptness of the instrumental diagnosis and consequently to the rapidity of the pharmacological intervention. Although several studies have validated the effectiveness and the safety profileof the intravenous fibrinolytic treatment, the number of patients who benefit of such therapeutic opportunity is still too little. This data is partially due to the delay within patients arrive to the hospital and to the doubts of the physicians on the possible collateral effects, but it is also related to logistic and organizational-managerial problematic of the patient with acute stroke.These last ones mainly derive from the deficiency on the national territory of dedicated structures (Stroke Unit, from the absence of operative connections between the 118-service and the Stroke Unit, from the delay of the neurologist calling in the emergency room that does not allow an adapted diagnostic evaluation of the ischemic event. The spread of the intravenous fibrinolysis must therefore necessarily pass through the creation of participation protocols between hospitals with stroke unit and primary aid, and between department of emergency/ urgency and staff of the stroke unit also previewing the creation of professional figures like those of the urgency neurologist that could have the full right of the management and the treatment of cerebral ischemic pathology.

  9. Insulin-regulated aminopeptidase deficiency provides protection against ischemic stroke in mice.

    Science.gov (United States)

    Pham, Vi; Albiston, Anthony L; Downes, Catherine E; Wong, Connie H Y; Diwakarla, Shanti; Ng, Leelee; Lee, Seyoung; Crack, Peter J; Chai, Siew Yeen

    2012-04-10

    Recent studies have demonstrated that angiotensin IV (Ang IV) provides protection against brain injury caused by cerebral ischemia. Ang IV is a potent inhibitor of insulin-regulated aminopeptidase (IRAP). Therefore, we examined the effect of IRAP gene inactivation on neuroprotection following transient middle cerebral artery occlusion (MCAo) in mice. IRAP knockout mice and wild-type controls were subjected to 2 h of transient MCAo using the intraluminal filament technique. Twenty-four hours after reperfusion, neurological deficits of the stroke-induced mice were assessed and infarct volumes were measured by TTC staining. The cerebral infarct volume was significantly reduced in the IRAP knockout mice compared to wild-type littermates with corresponding improvement in neurological performance at 24 h post-ischemia. An increase in compensatory cerebral blood flow during MCAo was observed in the IRAP knockout animals with no differences in cerebral vascular anatomy detected. The current study demonstrates that deletion of the IRAP gene protects the brain from ischemic damage analogous to the effect of the IRAP inhibitor, Ang IV. This study indicates that IRAP is potentially a new therapeutic target for the development of treatment for ischemic stroke. PMID:21895534

  10. Supratentorial arterial ischemic stroke following cerebellar tumor resection in two children.

    Science.gov (United States)

    Catsman-Berrevoets, Coriene E; van Breemen, Melanie; van Veelen, Marie Lise; Appel, Inge M; Lequin, Maarten H

    2005-01-01

    We describe two children who developed ischemic strokes in the territory of the middle cerebral artery, one 7 days and one 11 days after resection of a cerebellar tumor. In the first child, another infarction occurred in the territory of the contralateral middle cerebral artery 5 days after the first stroke. No specific cause or underlying risk factor other than the surgical procedure was found. The subacute clinical course at stroke onset resembled that of the 'posterior fossa syndrome', suggesting a common underlying mechanism. PMID:16088257

  11. Bone marrow mesenchymal stem cell therapy in ischemic stroke: mechanisms of action and treatment optimization strategies

    Science.gov (United States)

    Li, Guihong; Yu, Fengbo; Lei, Ting; Gao, Haijun; Li, Peiwen; Sun, Yuxue; Huang, Haiyan; Mu, Qingchun

    2016-01-01

    Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplantation approaches, directional migration, differentiation, replacement, neural circuit reconstruction, angiogenesis, neurotrophic factor secretion, apoptosis, immunomodulation, multiple mechanisms of action, and optimization strategies for bone marrow mesenchymal stem cells in the treatment of ischemic stroke. We also explore the safety of bone marrow mesenchymal stem cell transplantation and conclude that bone marrow mesenchymal stem cell transplantation is an important direction for future treatment of cerebral ischemia. Determining the optimal timing and dose for the transplantation are important directions for future research.

  12. Acute cerebral infarction: pathophysiology and modern treatment concepts

    International Nuclear Information System (INIS)

    This review focuses on the pathophysiological changes in acute cerebral ischemia, with special emphasis on disturbances of the cerebral blood flow (CBF) and the associated penumbra concept. Alternatively, the model of peri-infarct depolarization is demonstrated. Metabolic and molecular changes caused by cerebral ischemia and reperfusion are discussed, namely energy failure, release of glutamate with an excitatoric burst, calcium influx in neurons, generation of free radicals, activation of different proteases, disturbances of protein synthesis, induction of gene expression and apoptosis, loss of membrane integrity, edema formation and microvascular disturbances. In summary, the pathophysiological changes after focal cerebral ischemia and reperfusion are most adequately described by a network of interacting different mechanisms of tissue alterations. The simple concept of a cascade of ischemic effect which would be easy to block seems to be less applicable. A time window of approximately 6 h for the acute stroke therapy is postulated on the base of the above mentioned pathophysiological changes. (orig./AJ)

  13. Watershed Cerebral Infarction in a Patient with Acute Renal Failure

    Directory of Open Access Journals (Sweden)

    Ruya Ozelsancak

    2016-02-01

    Full Text Available Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl and she was discharged. Dysarthria continued for 20 days.

  14. CBF and CMRo/sub 2/ during craniotomy for small supratentorial cerebral tumours in enflurane anaesthesia. A dose-response study

    Energy Technology Data Exchange (ETDEWEB)

    Madsen, J.B.; Cold, G.E.; Eriksen, H.O.; Eskesen, V.; Blatt-Lyon, B.

    1986-01-01

    In 14 patients with supratentorial cerebral tumors with midline shift less than or equal to 10 mm, cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRo/sub 2/) were measured twice on the contralateral side of the craniotomy, using a modification of the Kety and Schmidt method. For induction of anaesthesia, thiopental, fentanyl and pancuronium were used. The anaesthesia was maintained with enflurane 1% in nitrous oxide 67%. Moderate hypocapnia to a level averaging 4.3 kPa was achieved. The patients were divided into two groups. In group 1 (n=7), 1% enflurane was used throughout the anaesthesia, and CBF and CMRo/sub 2/ measured about 70 min after induction averaged 30.1 ml 100 g/sup -1/ min/sub -1/ and 1.98 ml O/sub 2/ 100 g/sup -1/ min/sup -1/, respectively. During the second CBF study 1 h later, CBF and CMRo/sub 2/ were unchanged (P>0.05). In group 2 (n=7), the inspiratory enflurane concentration was increased from 1 to 2% after the first CBF measurement. In this group a significant decrease in CMRo/sub 2/ was observed, while CBF was unchanged. In six patients EEG was recorded simultaneously with the CBF measurements. In patients subjected to increasing enflurane concentration (Group 2), a suppression in the EEG activity was observed without spike waves. It is concluded that enflurane induces a dose-related decrease in CMRo/sub 2/ and suppression in the EEG activity, whereas CBF was unchanged.

  15. Spatial distribution and evolution of cerebral microbleeds: impact on the clinical therapy

    International Nuclear Information System (INIS)

    Cerebral microbleeds reflect the pathological changes of cerebral small vessel diseases. It has characterized spatial distribution and evolution. The occurrence of microbleeds impacts on clinical treatment. Susceptibility weighted imaging can improve the detection of cerebral microbleeds which could help for the diagnosis and differential diagnosis. We reviewed the pathology, characteristics of spatial and evolution of cerebral microbleeds and its impact on clinical therapy. (authors)

  16. Noninvasive Ventilatory Correction as an Adjunct to an Experimental Systemic Reperfusion Therapy in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Kristian Barlinn

    2010-01-01

    Full Text Available Background. Obstructive sleep apnea (OSA is a common condition in patients with acute ischemic stroke and associated with early clinical deterioration and poor functional outcome. However, noninvasive ventilatory correction is hardly considered as a complementary treatment option during the treatment phase of acute ischemic stroke. Summary of Case. A 55-year-old woman with an acute middle cerebral artery (MCA occlusion received intravenous tissue plasminogen activator (tPA and enrolled into a thrombolytic research study. During tPA infusion, she became drowsy, developed apnea episodes, desaturated and neurologically deteriorated without recanalization, re-occlusion or intracerebral hemorrhage. Urgent noninvasive ventilatory correction with biphasic positive airway pressure (BiPAP reversed neurological fluctuation. Her MCA completely recanalized 24 hours later. Conclusions. Noninvasive ventilatory correction should be considered more aggressively as a complementary treatment option in selected acute stroke patients. Early initiation of BiPAP can stabilize cerebral hemodynamics and may unmask the true potential of other therapies.

  17. [Intervention effect of Tibetan patent medicine Ruyi Zhenbao pills in acute ischemic stroke in rats].

    Science.gov (United States)

    Liu, Rui-ying; Wu, Wei-jie; Tan, Rui; Xie, Bin; Zhong, Zhen-dong; He, Jing-ping; Chen, Yao; Kang, Xin-li

    2015-02-01

    Ischemic stroke is a primary cause of death and long-term disability all over the world. This disease is resulted from ischemia and hypoxia in brain tissues because of insufficient blood supply and causes a series of physiochemical metabolism disorders and physiological dysfunction. Its high disability ratio has bright huge burdens to society, governments and families. However, there is not efficacious medicine to treat it. In this study, a right middle cerebral artery occlusion was established in rats to observe the multi-path and multi-aspect intervention effects of Tibetan patent medicine Ruyi Zhenbao pills in reducing injuries to Nissl bodies, cerebral edema and inflammatory reactions and preventing cellular apoptosis, in order to lay a foundation for defining its therapeutic mechanism in acute ischemic stroke. PMID:26084187

  18. Low dose CT perfusion in acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Amanda; Symons, Sean; Jakubovic, Raphael; Zhang, Liying; Aviv, Richard I. [Sunnybrook Health Sciences Centre, Toronto, ON (Canada); So, Aaron; Lee, Ting-Yim [Robarts Research Institute, London, Ontario (Canada)

    2014-12-15

    The purpose of this investigation is to determine if CT perfusion (CTP) measurements at low doses (LD = 20 or 50 mAs) are similar to those obtained at regular doses (RD = 100 mAs), with and without the addition of adaptive statistical iterative reconstruction (ASIR). A single-center, prospective study was performed in patients with acute ischemic stroke (n = 37; 54 % male; age = 74 ± 15 years). Two CTP scans were performed on each subject: one at 100 mAs (RD) and one at either 50 or 20 mAs (LD). CTP parameters were compared between the RD and LD scans in regions of ischemia, infarction, and normal tissue. Differences were determined using a within-subjects ANOVA (p < 0.05) followed by a paired t test post hoc analysis (p < 0.01). At 50 mAs, there was no significant difference between cerebral blood flow (CBF), cerebral blood volume (CBV), or time to maximum enhancement (Tmax) values for the RD and LD scans in the ischemic, infarcted, or normal contralateral regions (p < 0.05). At 20 mAs, there were significant differences between the RD and LD scans for all parameters in the ischemic and normal tissue regions (p > 0.05). CTP-derived CBF and CBV are not different at 50 mAs compared to 100 mAs, even without the addition of ASIR. Current CTP protocols can be modified to reduce the effective dose by 50 % without altering CTP measurements. (orig.)

  19. A new approach to ischemic brain edema and infarct

    Institute of Scientific and Technical Information of China (English)

    Zhai Yu; Jin Jia Xing; Liu De Ha

    2000-01-01

    Objective: To study the feasibility and efficiency of treatment in the patients with acute moderate and severe ischemic stroke with Neurotropin for its principle of inhibiting cerebral edema and repairing injured neurons. Methods: A randomized controlled trial with Neurotropin was performed in 50 patients admitted within 48h after an acute internal carotid artery infarction, Neurological deficits score ( Europe Stroke Scale-ESS ) <80 marks and the area of infarct and edema>2.25cm2. There were 31 patients in the Neurotropin group and 19 patients in the control group. Basic treatment was Troxerutin 250 mg intravenous drip per day for 21 days in two groups. Additionally, the patients in the Neurotropin group were intravenous injected 106 ampoule Neurotropin (3.6 unit per ampoule), divided into 11 days. We evaluated Neurological deficits score (ESS), ability of daily living (ADL)- Barthel Index, the size and average CT density of infarct and edema area on CT scan during different treatment stage and analyzed.them with statistics. Results: The percentage of improved patients (complete and partial recovery) reaches 64.5% in the Neurotropin group and 31.6% in the control group. The size of the infarct and edema area on CT scan is significantly reduced only in the Neurotropin group after treatment. The average range reduced is 28% on day 11 and 41.5% on day 21, and the average CT density in the Neurotropin group is more advanced than in the control group after onset. Conclusion: Neurotropin can be used as an effective therapy in acute ischemic stroke and ischemic cerebral edema.

  20. Cerebral palsy

    International Nuclear Information System (INIS)

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  1. Comparison Study of Four Kinds of Neurological Function Rating Systems on Focal Cerebral Ischemic Models in Rats%4种神经功能评分法在大鼠局灶性脑缺血模型中的比较研究

    Institute of Scientific and Technical Information of China (English)

    王鹏成; 任长虹; 曾现伟; 吉训明; 李宁; 高志峰; 季泰令

    2014-01-01

    Objective To comparatively study on the application of four kinds of neurological function rating systems including forelimb placing test,Longa 5 scores,Ludmila Belayev 12 scores,and Elevated Body Swing Test at the period of chronic recovery on focal cer -ebral ischemic models in rats .Methods SD rats were randomly divided into MCAO ( middle cerebral artery occlusion ) group and Sham group:suture method was used in MCAO ,reperfusion after 90 minutes.Immediately Pulled out suture while plugging to middle cerebral artery in Sham group.To assess and analyze the outcomes by forelimb placing test ,Longa 5 scores,12 scores,and EBST neurological function rating systems in two groups at 2h,1d,3d,7d,10d,14d,17d,21d,24d,28d.Results The analysis of scores at different time point between the two groups showed:no statistic significance existed at 7d,10d,14d,17d,21d,24d,28d in Longa,no statistic significance existed at 21d,24d,28d in EBST.Conclusion Forelimb placing test and 12 scores neurological function rating systems can well evaluate the neurological condition of rats in chronic convalescence ,Longa 5 scores and EBST not effectively assess the neurological condition of rats in chronic convalescence .%目的:对比研究前肢踩空实验、Longa 5分、Ludmila Belayev 12分及提尾悬空摇摆实验(EBST)4种神经功能评分法在大鼠缺血性卒中模型恢复期的适用情况。方法 SD 大鼠随机分为大脑中动脉栓塞(MCAO)组与假手术组(Sham)。线栓法制作大鼠MCAO缺血90min后再灌注模型,Sham组插栓至大脑中动脉后立即拔出线栓。于造模后2h,1d,3d,7d,10d,14d,17d,21d,24d,28d采用4种神经功能评分法进行神经功能缺损评估,对评分结果进行统计学分析。结果 MCAO组与Sham组间4种行为学评分比较,前肢踩空实验( P<0.05)、Longa 5分(P<0.01)、Ludmila Belayev 12分(P<0.01)3种评分法随时间点变化有统计学差异,EBST随时

  2. Chronic oleoylethanolamide treatment improves spatial cognitive deficits through enhancing hippocampal neurogenesis after transient focal cerebral ischemia.

    Science.gov (United States)

    Yang, Li-Chao; Guo, Han; Zhou, Hao; Suo, Da-Qin; Li, Wen-Jun; Zhou, Yu; Zhao, Yun; Yang, Wu-Shuang; Jin, Xin

    2015-04-15

    Oleoylethanolamide (OEA) has been shown to have neuroprotective effects after acute cerebral ischemic injury. The aim of this study was to investigate the effects of chronic OEA treatment on ischemia-induced spatial cognitive impairments, electrophysiology behavior and hippocampal neurogenesis. Daily treatments of 30 mg/kg OEA significantly ameliorated spatial cognitive deficits and attenuated the inhibition of long-term potentiation (LTP) in the middle cerebral artery occlusion (MCAO) rat model. Moreover, OEA administration improved cognitive function in a manner associated with enhanced neurogenesis in the hippocampus. Further study demonstrated that treatment with OEA markedly increased the expressions of brain-derived neurotrophic factor (BDNF) and peroxisome proliferator-activated receptors α (PPARα). Our data suggest that chronic OEA treatment can exert functional recovery of cognitive impairments and neuroprotective effects against cerebral ischemic insult in rats via triggering of neurogenesis in the hippocampus, which supports the therapeutic use of OEA for cerebral ischemia. PMID:25748831

  3. Isquemia cerebral transitoria y riesgo de infarto cerebral isquémico

    Directory of Open Access Journals (Sweden)

    Luis Guillermo Rosales-Bravo

    2006-03-01

    Full Text Available La enfermedad vascular cerebral es la principal causa de hospitalización neurológica en el mundo. Costa Rica no es la excepción; en nuestros hospitales cada día es más frecuente el número de pacientes que ingresan con infartos cerebrales isquémicos. Esta común enfermedad obedece a la prevalencia de enfermedades crónicas como la hipertensión arterial, diabetes mellitus, dislipidemias, tabaquismo y la alta expectativa de vida de los costarricenses, todos considerados factores de riesgo. Aproximadamente un 80% de los infartos cerebrales son isquémicos secundarios a la oclusión arterial aguda de un territorio vascular específico; el restante 20% corresponde a la variante hemorrágica. Las secuelas neurológicas secundarias a esta entidad son la principal causa de discapacidad crónica en los pacientes y conllevan una alta morbilidad y mortalidad. Aunque muchos sufren el infarto cerebral isquémico en forma aguda, otro grupo de pacientes experimenta uno o varios episodios previos de isquemia cerebral transitoria, lo cual los pone en riesgo de sufrir un infarto cerebral isquémico durante un periodo corto, es decir, son pacientes vulnerables. Esta revisión pretende actualizar los conocimientos médicos, especialmente para aquellos que trabajan en la atención primaria y en los servicios de urgencias hospitalarias, que reconozcan a este grupo de pacientes y les brinden la atención médica necesaria para de prevenir un infarto cerebral isquémico. La isquemia cerebral transitoria debe ser considerada como una emergencia neurológica.Stroke is the first cause of neurological hospitalization in the world. Costa Rica is not the exception, in our hospitals the amount of patients who are admitted with ischemic stroke increases every day. This condition is more common due to the high prevalence of chronic diseases, such as hypertension, diabetes mellitus, and dyslipidemia, besides smoking and the high costarrican life expectancy, are all

  4. A case of cerebral embolism due to cardiac myxoma presenting with multiple cerebral microaneurysms detected on first MRI scans.

    Science.gov (United States)

    Sato, Takahiro; Saji, Naoki; Kobayashi, Kazuto; Shibazaki, Kensaku; Kimura, Kazumi

    2016-03-01

    A 64-year-old man developed right arm weakness and dysarthria, and was admitted to our hospital. Diffusion-weighted magnetic resonance imaging of the brain showed a high intensity area in the frontal lobe. T2*-weighted images showed multiple spotty low intensity lesions in bilateral cerebral hemispheres, mimicking cerebral microbleeds. Cerebral angiography showed multiple aneurysms in the anterior, middle, posterior cerebral arteries and cerebellar arteries. Transthoracic echocardiography revealed a floating structure in the left atrial chamber, indicating cardiac myxoma. We diagnosed cardioembolic ischemic stroke due to left atrial myxoma. Cardiac surgery for excision of a left atrial myxoma was performed on the 3rd hospital day. Multiple aneurysms should be taken into account for differential diagnosis in patients with cardiac myxoma and with atypical spotty low intensity on T2*-weighted images. PMID:26797485

  5. Radiology of ischemic strokes in children

    International Nuclear Information System (INIS)

    Arterial ischemic strokes are a relatively frequent diagnostic occurrence in pediatric neuroradiology. They occur mostly in three main etiologic contexts: 1) congenital heart disease; 2) neonatal distress; 3) infections, focal or general inducing vasculitis, but many cases are considered as idiopathic. The positive diagnosis is made by CT; in neonates, however, ultrasound appears as a promising tool. The CT features are basically similar at that age and in adults, although the site of the infarct may result from pathologies more particular to children (e.g. basal ganglia infarction due to arteritis of the carotid syphon and its branches). Infarcts may be multiple and also more frequently hemorrhagic at that age, the homorrhagic phenomena affecting only the gray matter except in young infants in which the subcortical white matter may be affected also. Anatomical sequels include focal atrophy and asymmetry of the brain. Data regarding the etiology can be gathered from angiography which may show the degree of impairment of the arterial bed, its extent, the collateral blood supply and the morphological type of arterial lesion responsible for the cerebral damage. The most particular picture at that age is that of the often diffuse vasculitis, with its various expressions (segmental narrowing of the lumen, dissecting aneurysm, string-of-beads appearance). (orig.)

  6. Radiology of ischemic strokes in children

    International Nuclear Information System (INIS)

    Arterial ischemic strokes are a relatively frequent diagnostic occurrence in pediatric neuroradiology. They occur mostly in three main etiologic contexts: 1) congenital heart disease; 2) neonatal distress; 3) infections, focal or general inducing vasculitis, but many cases are considered idiopathic. The positive diagnosis is made by CT; in neonates, however, ultrasound appears as a promising tool. The CT features are basically similar at that age and in adults, although the site of the infarct may result from pathologies more particular to children (e.g. basal ganglia infarction due to arteritis of the carotid siphon and its branches). Infarcts may be multiple and also more frequently hemorrhagic at that age, the hemorrhagic phenomena affecting only the gray matter except in young infants in which the subcortical white matter may be affected also. Anatomical sequels include focal atrophy and asymmetry of the brain. Data regarding the etiology can be gathered from angiography which may show the degree of impairment of the arterial bed, its extent, the collateral blood supply and the morphological types of arterial lesion responsible for the cerebral damage. The most particular picture at that age is that of the often diffuse vasculitis, with its various expressions (segmental narrowing of the lumen, dissecting aneurysm, string-of-beads appearance)

  7. The Neuroprotective Effects of Coccomyxa Gloeobotrydiformis on the Ischemic Stroke in a Rat Model

    OpenAIRE

    Sun, Luning; Jin, Ying; Dong, Liming; Sumi, Ryo; Jahan, Rabita; Li, Zhi

    2013-01-01

    Stroke is a major cause of mortality and the leading cause of permanent disability. In this study, we adopted the classic middle cerebral artery occlusion(MCAO) stroke model to observe the therapeutic effects of coccomyxa gloeobotrydiformis(CGD) on ischemic stroke, and discuss the underlying mechanisms. Low dose (50 mg/kg.day) and high dose (100 mg/kg.day) concentrations of the drug CGD were intragastrically administrated separately for 8 weeks. Infarct volumes, neurologic deficits and degree...

  8. Acute ischemic stroke in low-voltage electrical injury: A case report

    OpenAIRE

    Huan-Jui, Yeh; Chih-Yang, Liu; Huei-Yu, Lo; Po-Chih, Chen

    2010-01-01

    Background: Acute stroke is not a common complication of electrical injury, and only a few cases of acute stroke have been reported for lightning or high-voltage injuries. Case Report: We present the case of a man who suffered from a low-voltage electrical injury followed by ischemic stroke. Magnetic resonance angiography showed segmental narrowing of the right internal carotid artery and right middle cerebral artery. The patient underwent thrombolytic therapy and catheter-assisted angioplast...

  9. The Contribution of Mannose Binding Lectin to Reperfusion Injury after Ischemic Stroke

    OpenAIRE

    Morrison, Helena; Frye, Jennifer; Davis-Gorman, Grace; Funk, Janet; McDonagh, Paul; Stahl, Gregory; Ritter, Leslie

    2011-01-01

    After complement system (CS) activation, the sequential production of complement products increases cell injury and death through opsonophagocytosis, cytolysis, adaptive, and inflammatory cell responses. These responses potentiate cerebral ischemia-reperfusion (IR) injury after ischemic stroke and reperfusion. Activation of the CS via mannose binding lectin (MBL)-initiated lectin pathway is known to increase tissue damage in response to IR in muscle, myocardium and intestine tissue. In contra...

  10. Trousseau’s Syndrome, a Previously Unrecognized Condition in Acute Ischemic Stroke Associated With Myocardial Injury

    OpenAIRE

    Thalin, Charlotte; Blomgren, Bo; Mobarrez, Fariborz; Lundstrom, Annika; Laska, Ann Charlotte; von Arbin, Magnus; von Heijne, Anders; Rooth, Elisabeth; Wallen, Hakan; Aspberg, Sara

    2014-01-01

    Trousseau’s syndrome is a well-known malignancy associated hypercoagulative state leading to venous or arterial thrombosis. The pathophysiology is however poorly understood, although multiple mechanisms are believed to be involved. We report a case of Trousseau’s syndrome resulting in concomitant cerebral and myocardial microthrombosis, presenting with acute ischemic stroke and markedly elevated plasma troponin T levels suggesting myocardial injury. Without any previous medical history, the p...

  11. Animal models of ischemic stroke and their application in clinical research

    OpenAIRE

    Fluri F; Schuhmann MK; Kleinschnitz C

    2015-01-01

    Felix Fluri, Michael K Schuhmann, Christoph KleinschnitzDepartment of Neurology, University Clinic Wuerzburg, Wuerzburg, GermanyAbstract: This review outlines the most frequently used rodent stroke models and discusses their strengths and shortcomings. Mimicking all aspects of human stroke in one animal model is not feasible because ischemic stroke in humans is a heterogeneous disorder with a complex pathophysiology. The transient or permanent middle cerebral artery occlusion (MCAo) model is ...

  12. Soluble Epoxide Hydrolase Inhibition: Targeting Multiple Mechanisms of Ischemic Brain Injury with a Single Agent

    OpenAIRE

    Iliff, Jeffrey J.; Alkayed, Nabil J.

    2009-01-01

    Soluble epoxide hydrolase (sEH) is a key enzyme in the metabolic conversion and degradation of P450 eicosanoids called epoxyeicosatrienoic acids (EETs). Genetic variations in the sEH gene, designated EPHX2, are associated with ischemic stroke risk. In experimental studies, sEH inhibition and gene deletion reduce infarct size after focal cerebral ischemia in mice. Although the precise mechanism of protection afforded by sEH inhibition remains under investigation, EETs exhibit a wide array of p...

  13. Juvenile Ischemic Stroke Secondary to Cardiogenic Embolism: A Rare Case Report

    OpenAIRE

    Hassan Soleimanpour; Ali Pashapour; Neda Mohammadi; Samad EJ Golzari; Hossein Khodaverdizadeh

    2014-01-01

    Myxomas, the most common primary cardiac tumors, are known as a source of cardiogenic emboli. The possibility of their early detection has made them of great importance for emergency medicines. Detection of the disease is probable at early stages using echocardiography and associate complications such as syncope, cerebral embolic ischemic strokes, and sudden death. We report experience of a rare case of juvenile acute stroke in a patient with cardiac myxoma affecting all cardiac chambers pres...

  14. Cerebral malaria.

    Science.gov (United States)

    Postels, Douglas G; Birbeck, Gretchen L

    2013-01-01

    Malaria, the most significant parasitic disease of man, kills approximately one million people per year. Half of these deaths occur in those with cerebral malaria (CM). The World Health Organization (WHO) defines CM as an otherwise unexplained coma in a patient with malarial parasitemia. Worldwide, CM occurs primarily in African children and Asian adults, with the vast majority (greater than 90%) of cases occurring in children 5 years old or younger in sub-Saharan Africa. The pathophysiology of the disease is complex and involves infected erythrocyte sequestration, cerebral inflammation, and breakdown of the blood-brain barrier. A recently characterized malarial retinopathy is visual evidence of Plasmodium falciparum's pathophysiological processes occurring in the affected patient. Treatment consists of supportive care and antimalarial administration. Thus far, adjuvant therapies have not been shown to improve mortality rates or neurological outcomes in children with CM. For those who survive CM, residual neurological abnormalities are common. Epilepsy, cognitive impairment, behavioral disorders, and gross neurological deficits which include motor, sensory, and language impairments are frequent sequelae. Primary prevention strategies, including bed nets, vaccine development, and chemoprophylaxis, are in varied states of development and implementation. Continuing efforts to find successful primary prevention options and strategies to decrease neurological sequelae are needed. PMID:23829902

  15. Optimal electroacupuncture frequency for maintaining astrocyte structural integrity in cerebral ischemia★

    OpenAIRE

    Xiao, Yicai; Wu, Xingui; Deng, Xiangfa; Huang, Liping; Zhou, Yuancheng; Yang, Xuejie

    2013-01-01

    The astrocyte is a critical regulator of neuronal survival after ischemic brain injury. Electroacupuncture may be an effective therapy for cerebral ischemia, as electroacupuncture frequency can affect the structural integrity of astrocytes. In this study, a rat model of middle cerebral artery occlusion established using the modified thread embolism method was treated with electroacupuncture of the bilateral Quchi (LI11) and Zusanli (ST36) at 15, 30, and 100 Hz frequencies. Behavioral testing,...

  16. A case of postvaricella cerebral angiopathy with a good outcome in a child

    OpenAIRE

    Maria Cristina Magagnini; Luisa La Spina; Daniela Gioé; G Del Campo; G Belfiore; Smilari, P.; Filippo Greco

    2015-01-01

    Cerebral vasculopathy is a serious but uncommon complication of varicella-zoster-virus (VZV) infection. Diagnosis is based on a recent history of VZV infection, signs and symptoms of transient ischemic attack or stroke, and vascular anomalies on neuroimaging. We report a case of postvaricella cerebral angiopathy in a 5-year-old child, who was admitted after three episodes of transient right hemiplegia, each one lasting a few minutes. He had contracted chicken pox, the month prior to admission...

  17. Ellagic acid improves electrocardiogram waves and blood pressure against global cerebral ischemia rat experimental models

    OpenAIRE

    Nejad, Khojasteh Hoseiny; Dianat, Mahin; Sarkaki, Alireza; Naseri, Mohammad Kazem Gharib; Badavi, Mohammad; Farbood, Yaghoub

    2015-01-01

    Background: Global cerebral ischemia (GCIR) arises in patients that are shown a variety of clinical difficulty including cardiac arrest, asphyxia, and shock. In spite of advances in understanding of the brain, ischemia and protective effects to improve ischemic injury still remain unknown. The aim of our study was to investigate the effect of ellagic acid (EA) pretreatment in the rat models of global cerebral ischemia reperfusion. Methods: This experimental study was conducted in 2014 at the ...

  18. Targeting reactive nitrogen species: a promising therapeutic strategy for cerebral ischemia-reperfusion injury

    OpenAIRE

    Chen, Xing-miao; Chen, Han-sen; Xu, Ming-jing; Shen, Jian-gang

    2012-01-01

    Ischemic stroke accounts for nearly 80% of stroke cases. Recanalization with thrombolysis is a currently crucial therapeutic strategy for re-building blood supply, but the thrombolytic therapy often companies with cerebral ischemia-reperfusion injury, which are mediated by free radicals. As an important component of free radicals, reactive nitrogen species (RNS), including nitric oxide (NO) and peroxynitrite (ONOO(-)), play important roles in the process of cerebral ischemia-reperfusion injur...

  19. Early exercise improves cerebral blood flow through increased angiogenesis in experimental stroke rat model

    OpenAIRE

    Zhang, Pengyue; Yu, Huixian; Zhou, Naiyun; Jie ZHANG; Wu, Yi; Zhang, Yuling; Bai, Yulong; Jia, Jie; Zhang, Qi; Tian, Shan; Wu, Junfa; Hu, Yongshan

    2013-01-01

    Background Early exercise after stroke promoted angiogenesis and increased microvessles density. However, whether these newly formatted vessels indeed give rise to functional vascular and improve the cerebral blood flow (CBF) in impaired brain region is still unclear. The present study aimed to determine the effect of early exercise on angiogenesis and CBF in ischemic region. Methods Adult male Sprague Dawley rats were subjected to 90 min middle cerebral artery occlusion(MCAO)and randomly div...

  20. MicroRNA responses to focal cerebral ischemia in male and female mouse brain

    OpenAIRE

    Lusardi, Theresa A; Murphy, Stephanie J.; Phillips, Jay I.; Chen, Yingxin; Catherine M Davis; Young, Jennifer M.; Thompson, Simon J.; Saugstad, Julie A

    2014-01-01

    Stroke occurs with greater frequency in men than in women across diverse ethnic backgrounds and nationalities. Work from our lab and others have revealed a sex-specific sensitivity to cerebral ischemia whereby males exhibit a larger extent of brain damage resulting from an ischemic event compared to females. Previous studies revealed that microRNA (miRNA) expression is regulated by cerebral ischemia in males; however, no studies to date have examined the effect of ischemia on miRNA responses ...

  1. Autophagy Upregulation and Apoptosis Downregulation in DAHP and Triptolide Treated Cerebral Ischemia

    OpenAIRE

    Yang Yang; Keqiang Gao; Zhiying Hu; Weiyun Li; Henry Davies; Shucai Ling; Rudd, John A.; Marong Fang

    2015-01-01

    It has previously been demonstrated that ischemic stroke activates autophagy pathways; however, the mechanism remains unclear. The aim of this study is to further investigate the role that autophagy plays in cerebral ischemia. 2, 4-diamino-6-hydroxy-pyrimidine (DAHP), for its nitric oxide synthase (NOS) inhibiting neuroprotective effect, and triptolide (TP), for its anti-inflammatory property, were selected to administer pre middle cerebral artery occlusion (MCAO). The drugs were administered...

  2. A comparison study of PET, NMR, and CT imaging in cerebral ischemia

    International Nuclear Information System (INIS)

    Whether ischemia without infarction produces recognizable changes in relaxation times of ischemic but viable brain is an important, unresolved issue. Therefore, a study was initiated of patients with cerebral ischemia, using positron emission tomography (PET), NMR, and computed tomography (CT) to compare and contrast the pathophysiologic information provided by each and to study the issue of whether cerebral ischemia without infarction can be appreciated by proton NMR imaging. Here the initial results are reported. 4 refs.; 2 figs.; 1 table

  3. Neuroprotective actions of taurine on hypoxic-ischemic brain damage in neonatal rats.

    Science.gov (United States)

    Zhu, Xiao-Yun; Ma, Peng-Sheng; Wu, Wei; Zhou, Ru; Hao, Yin-Ju; Niu, Yang; Sun, Tao; Li, Yu-Xiang; Yu, Jian-Qiang

    2016-06-01

    Taurine is an abundant amino acid in the nervous system, which has been proved to possess antioxidation, osmoregulation and membrane stabilization. Previously it has been demonstrated that taurine exerts ischemic brain injury protective effect. This study was designed to investigate whether the protective effect of taurine has the possibility to be applied to treat neonatal hypoxic-ischemic brain damage. Seven-day-old Sprague-Dawley rats were treated with left carotid artery ligation followed by exposure to 8% oxygen to generate the experimental group. The cerebral damage area was measured after taurine post-treatment with 2,3,5-triphenyltetrazolium chloride (TTC) staining, Hematoxyline-Eosin (HE) staining and Nissl staining. The activities of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), total antioxidant capacity (T-AOC), myeloperoxtidase (MPO), ATP and Lactic Acid productions were assayed with ipsilateral hemisphere homogenates. Western-blot and immunofluorescence assay were processed to detect the expressions of AIF, Cyt C, Bax, Bcl-2 in brain. We found that taurine significantly reduced brain infarct volume and ameliorated morphological injury obviously reversed the changes of SOD, MDA, GSH-Px, T-AOC, ATP, MPO, and Lactic Acid levels. Compared with hypoxic-ischemic group, it showed marked reduction of AIF, Cyt C and Bax expressions and increase of Bcl-2 after post-treatment. We conclude that taurine possesses an efficacious neuroprotective effect after cerebral hypoxic-ischemic damage in neonatal rats. PMID:27345710

  4. The role of autophagic and lysosomal pathways in ischemic brain injury******

    Institute of Scientific and Technical Information of China (English)

    Zhaohua Gu; Nan Shi; Qian Zhang; Wei Zhang; Meizhen Zhao; Xiaojiang Sun; Yinyi Sun; Kangyong Liu; Fen Wang; Ting Zhang; Qiang Li; Liwei Shen; Ling Zhou; Liang Dong

    2013-01-01

    Autophagy is involved in neural cel death after cerebral ischemia. Our previous studies showed that rapamycin-induced autophagy decreased the rate of apoptosis, but the rate of apoptosis was creased after the autophagy inhibitor, 3-methyladenine, was used. In this study, a suture-occluded method was performed to generate a rat model of brain ischemia. Under a transmission electron microscope, autophagic bodies and autophagy lysosomes were markedly accumulated in neurons at 4 hours post brain ischemic injury, with their numbers gradual y reducing over time. Western blotting demonstrated that protein levels of light chain 3-II and cathepsin B were significantly in-creased within 4 hours of ischemic injury, but these levels were not persistently upregulated over time. Confocal microscopy showed that autophagy was mainly found in neurons with positive light chain 3 signal. Injection of rapamycin via tail vein promoted the occurrence of autophagy in rat brain tissue after cerebral ischemia and elevated light chain 3 and cathepsin B expression. However, in-jection of 3-methyladenine significantly diminished light chain 3-II and cathepsin B expression. Results verified that autophagic and lysosomal activity is increased in ischemic neurons. Abnormal components in cel s can be eliminated through upregulating cel autophagy or inhibiting autophagy after ischemic brain injury, resulting in a dynamic balance of substances in cel s. Moreover, drugs that interfere with autophagy may be potential therapies for the treatment of brain injury.

  5. Treatment with Isorhamnetin Protects the Brain Against Ischemic Injury in Mice.

    Science.gov (United States)

    Zhao, Jin-Jing; Song, Jin-Qing; Pan, Shu-Yi; Wang, Kai

    2016-08-01

    Ischemic stroke is a major cause of morbidity and mortality, yet lacks effective neuroprotective treatments. The aim of this work was to investigate whether treatment with isorhamnetin protected the brain against ischemic injury in mice. Experimental stroke mice underwent the filament model of middle cerebral artery occlusion with reperfusion. Treatment with isorhamnetin or vehicle was initiated immediately at the onset of reperfusion. It was found that treatment of experimental stroke mice with isorhamnetin reduced infarct volume and caspase-3 activity (a biomarker of apoptosis), and improved neurological function recovery. Treatment of experimental stroke mice with isorhamnetin attenuated cerebral edema, improved blood-brain barrier function, and upregulated gene expression of tight junction proteins including occludin, ZO-1, and claudin-5. Treatment of experimental stroke mice with isorhamnetin activated Nrf2/HO-1, suppressed iNOS/NO, and led to reduced formation of MDA and 3-NT in ipsilateral cortex. In addition, treatment of experimental stroke mice with isorhamnetin suppressed activity of MPO (a biomarker of neutrophil infiltration) and reduced protein levels of IL-1β, IL-6, and TNF-α in ipsilateral cortex. Furthermore, it was found that treatment of experimental stroke mice with isorhamnetin reduced mRNA and protein expression of NMDA receptor subunit NR1 in ipsilateral cortex. In conclusion, treatment with isorhamnetin protected the brain against ischemic injury in mice. Isorhamnetin could thus be envisaged as a countermeasure for ischemic stroke but remains to be tested in humans. PMID:27161367

  6. Cerebral blood flow in asymptomatic individuals

    International Nuclear Information System (INIS)

    We studied the relationship between cortical grey matter flow (CBF) and age, cerebrovascular risk factors and the severity of subcortical hypersignals (HS, hyperintensity score in MRI) in 47 asymptomatic subjects with cerebrovascular risk factors. Multiple regression analysis revealed that HS was most strongly related to CBF, and that hematocrit, age and evidence of ischemic change detected in the electrocardiogram also appeared to be independent determinants of CBF. Both the severity and location of hypersignals were correlated with CBF. The most significant negative correlation observed was that between CBF and HS in the basal ganglia-thalamic region, where the degree of signal abnormality was modest. Decreased CBF in asymptomatic subjects with cerebrovascular risk factors may be related to microcirculatory disturbance associated with elevated hematocrit and an increase in the number of risk factors, and functional suppression of cerebral cortex due to the neuronal disconnection associated with subcortical lesions. In addition, impaired cerebral circulation may be related to MRI signal abnormalities. (author)

  7. State of cerebral hemodynamics in patients with cognitive dysfunction associated with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    S.N. Stadnik

    2014-05-01

    Full Text Available The aim of the study was to cerebral hemodynamics in patients with cognitive dysfunction associated with atrial fibrillation (AF. Patients and methods. Fifty-six patients aged 40–75 years (the mean age was 62.7±6.3 years with nonvalvular AF caused by ischemic heart disease were examined. In 30 (53.6% patients AF was permanent; in 26 (46.4% patients, it was either persistent or paroxysmal. The exclusion criteria were as follows: past transient ischemic attacks, stroke or myocardial infarction, and severe somatic diseases. All patients with AF were evaluated for cognitive functions (using the short scale for assessing the mental status, auditory memory and associative memory (using the Schulte test, and emotional background (using the Hospital Anxiety and Depression Scale. Ultrasonography of the extracranial and intracranial vessels and registration of the average linear blood flow velocity (LBFV was performed. Results. Cognitive impairments (CI were diagnosed in 38 patients who entered the main group; patients with AF without CI comprised the control group. 82.6% of patients of the main group were diagnosed with constrictive lesion of the carotid (CA and vertebral (VA arteries of various severity; the isolated lesion of the CA was observed in 23.7% of patients, the isolated lesion of the VA in 18.4%; multiple lesions of the CA and VA in 69.4%; and the hemodynamically significant lesion, in 30.3%. In patients of the control group, constrictive lesions of the extracranial arteries were observed in 65.5% of cases. Condition of the major arteries of the head (MAH significantly affects the LBFV parameters of the intracranial arteries. In patients with multiple lesions of the CA and VA, the LBFV in the intracranial vessels was much lower than that in patients with isolated lesions of the CA and VA.The relation between the rate and severity of constrictive lesions of the MAH and the presence of AF accompanied with CI was noted in patients. Cerebral

  8. Role of CT perfusion imaging in evaluating the effects of multiple burr hole surgery on adult ischemic Moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Dong Wei; Zhao, Wen Yuan; Yang, Zhi Gang; Li, Qiang; Liu, Jian Min [Second Military Medical University, Department of Neurosurgery, Changhai Hospital, Shanghai (China); Zhang, Yong Wei [Second Military Medical University, Department of Neurology, Changhai Hospital, Shanghai (China); Xu, Bing; Ma, Xiao Long; Tian, Bing [Second Military Medical University, Department of Radiology, Changhai Hospital, Shanghai (China)

    2013-12-15

    To evaluate the effects of the multiple burr hole (MBH) revascularization on ischemic type adult Moyamoya disease (MMD) by computed tomography perfusion (CTP). Eighty-six ischemic MMD patients received CTP 1 week before and 3 weeks after MBH operation. Fifty-seven patients received it again at 6 month and underwent digital subtraction angiography (DSA) and mRS follow-up. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and relative values of ischemic symptomatic hemispheres were measured. Differences in pre- and post-surgery perfusion CT values were assessed. There were significant differences of CBF, TTP, and relative time to peak (rTTP) in ischemic hemisphere between 1 week before and 3 weeks after surgery, and no significant difference in relative cerebral blood flow (rCBF), CBV, relative cerebral blood volume (rCBV), MTT, relative mean transit time (rMTT). According to whether there was symptom improvement or not on 3 weeks after MBH, the rTTP value was not statistically significant in the patients whose symptoms were not improved at all on 3 weeks after operation. Six-month follow-up showed that CBF, rCBF, and rCBV values were significantly higher than those before operation. Postoperative MTT, TTP, rMTT, and rTTP values were significantly lower than those before operation. CTP is a sensitive method to obtain functional imaging of cerebral microcirculation, which can be a noninvasive assessment of the abnormalities of intracranial arteries and cerebral perfusion changes in MMD before and after surgery. CBF and TTP map, especially the relative values of TTP, seems to have the capability of being quite sensitive to the presence of altered brain perfusion at early time after indirect revascularization. (orig.)

  9. Risk factors in various subtypes of ischemic stroke according to toast criteria

    International Nuclear Information System (INIS)

    To identify the frequency of risk factors in various subtypes of acute ischemic stroke according to TOAST criteria. Study Design: Cross-sectional, observational study. Place and Duration of Study: Ziauddin Hospital, Karachi, from January to December 2007. Methodology: Patients with acute ischemic stroke were enrolled. Studied variables included demographic profile, history of risk factors, physical and neurological examination, and investigations relevant with the objectives of the study. Findings were described as frequency percentages. Proportions of risk factors against subtypes was compared using chi-square test with significance at p < 0.05. Results: Out of the 100 patients with acute ischemic stroke, mean age at presentation was 63.5 years. Risk factor distribution was hypertension in 85%, Diabetes mellitus in 49%, ischemic heart disease in 30%, dyslipedemia in 22%, smoking in 9%, atrial fibrillation in 5%, and previous history of stroke in 29%. The various subtypes of acute ischemic stroke were lacunar infarct in 43%, large artery atherosclerosis in 31%, cardioembolic type in 8%, stroke of other determined etiology in 1% and stroke of undetermined etiology in 18%. Hypertension and Diabetes were the most important risk factors in both large and small artery atherosclerosis. In patients with cardio-embolic stroke significant association was found with ischemic heart disease (p=0.01). Conclusion: Importance and relevance of risk factors evaluated for subtypes rather than ischemic stroke as a whole should be reflected in preventive efforts against the burden of ischemic stroke. (author)

  10. Transient Ischemic Attack (Beyond the Basics)

    Science.gov (United States)

    ... and diagnosis (Beyond the Basics)" and "Patient information: Hemorrhagic stroke treatment (Beyond the Basics)" and "Patient information: Ischemic ... symptoms and diagnosis (Beyond the Basics) Patient information: Hemorrhagic stroke treatment (Beyond the Basics) Patient information: Ischemic stroke ...

  11. STATINS IN PREVENTION OF ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2015-09-01

    Full Text Available The evidence base of statin therapy in primary and secondary prevention of ischemic stroke is surveyed. Results of classical trails with statins in ischemic stroke prevention as well as results of meta-analyses are discussed.

  12. Statins in prevention of ischemic stroke

    OpenAIRE

    A.V. Susekov; A. B. Blohin; Z. G. Luginova; E. J. Soloveva; N. V. Maltseva; O.E. Tarasova; V.V. Kuharchuk

    2013-01-01

    The evidence base of statin therapy in primary and secondary prevention of ischemic stroke is surveyed. Results of classical trails with statins in ischemic stroke prevention as well as results of meta-analyses are discussed.

  13. 微小RNA与脑缺血后神经元凋亡%MicroRNAs and neuronal apoptosis after cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    肖璐; 张娴娴; 陈应柱

    2012-01-01

    MicroRNAs (miRNAs) are a class of highly conserved non-coding small RNA molecules.They regulate gene expression by inhibiting transcription or translation.Ischemic stroke is one of the major diseases of resulting in death and disability worldwide.The final outcome of its pathological process is neuronal death.Neuronal apoptosis is mainly seen in ischemic penumbra,and saving the neurons in penumbra are the key to the treatment of ischemic stroke.This article reviews the roles of miRNAs in the neuronal apoptosis during cerebral ischemia.%微小RNA(microRNA,miRNA)是一类高度保守的非编码小RNA分子,通过抑制转录或翻译来调控基因表达.缺血性卒中是导致全球人口死亡和残疾的主要疾病之一,其病理学过程的最终结局为神经元死亡.神经元凋亡主要见于缺血半暗带,而挽救半暗带神经元是缺血性卒中治疗的关键.文章对miRNA在脑缺血时神经元凋亡中的作用进行了综述.

  14. MRI in ischemic heart disease

    International Nuclear Information System (INIS)

    Full text: The role of magnetic resonance imaging in the evaluation of ischemic heart disease has increased over the last years. Cardiac MRI is the only imaging modality that provides 'one stop shop' assessment. Information about ventricular function, myocardial ischemia and myocardial viability can be obtained in a single cardiac MRI session. Additionally, Cardiac MRI has become a gold standard method in evaluation of myocardial viability and in assessment of ventricular mass and function. As a result, cardiac MRI enable radiologist to comprehensively assess ischemic heart disease. The aim of this presentation is to provide the reader a state-of-the art on how the newest cardiac MRI techniques can be used to study ischemic heart disease patients.

  15. 3-N-butylphthalide improves neuronal morphology after chronic cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Wanhong Zhao; Chao Luo; Jue Wang; Jian Gong; Bin Li; Yingxia Gong; Jun Wang; Hanqin Wang

    2014-01-01

    3-N-butylphthalide is an effective drug for acute ischemic stroke. However, its effects on chronic cerebral ischemia-induced neuronal injury remain poorly understood. Therefore, this study li-gated bilateral carotid arteries in 15-month-old rats to simulate chronic cerebral ischemia in aged humans. Aged rats were then intragastrically administered 3-n-butylphthalide. 3-N-butylphtha-lide administration improved the neuronal morphology in the cerebral cortex and hippocampus of rats with chronic cerebral ischemia, increased choline acetyltransferase activity, and decreased malondialdehyde and amyloid beta levels, and greatly improved cognitive function. These findings suggest that 3-n-butylphthalide alleviates oxidative stress caused by chronic cerebral ischemia, improves cholinergic function, and inhibits amyloid beta accumulation, thereby im-proving cerebral neuronal injury and cognitive deifcits.

  16. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  17. Effect of Batroxobin on Neuronal Apoptosis During Focal Cerebral Ischemia and Reperfusion in Rats

    Institute of Scientific and Technical Information of China (English)

    吴卫平; 匡培根; 李振洲

    2001-01-01

    We have found that Batroxobin plays a protactive role in ischemic brain injury, which attracted us to investigate the effect of Batroxobin on apoptosis of neurons during cerebral ischemia and reperfusion. The apoptotic cells in ischemic rat brains at different reperfusion intervals were tested with method of TdT-mediated dUTP-DIG nick end labeling (TUNEL) and the effect of Batroxobin on the apoptosis of neurons was studied in left middle cerebral artery (LMCA) occlusion and reperfusion in rat models (n=18). The results showed that few scattered apoptosis cells were observed in right cerebral hemispheres after LMCA occlusion and reperfusion, and that a lot of apoptosis cells were found in left ischemic cortex and caudoputamen at 12h reperfusion, and they reached peak at 24h~48h reperfusion. However, in the rats pretreated with Batroxobin, the number of apoptosis cells in left cerebral cortex and caudoputamen reduced significantly and the neuronal damage was much milder at 24h reperfusion than that of saline-treated rats. The results indicate that administration of Batroxobin may reduce the apoptosis of neurons induced by cerebral ischemia and reperfusion and afford significant cerebroprotection in the model of focal cerebral ischemia and reperfusion.

  18. Salvia miltiorrhiza and ischemic diseases

    Institute of Scientific and Technical Information of China (English)

    Xin-Yan JI; Benny K-H TAN; Yi-Zhun ZHU

    2000-01-01

    The demonstration of beneficial effects of salvia miltiorrhiza (DanShen) on ischemic diseases has revolutionized the management of angina pectoris, myocardial infarction (MI) or stroke in Chinese society. Experimental studies have shown that DanShen dilated coronary arteries, increased coronary blood flow, and scavenged free radicals in ischemic diseases, so that it reduced the cellular damage from ischemia and improved heart functions. Clinical trials also indicated that DanShen was an effective medicine for angina pectoris, MI, and stroke. This review will focus on DanShen's effects in angina pectoris, MI and stroke.

  19. Aqueous extract of Cordyceps alleviates cerebral ischemia-induced short-term memory impairment in gerbils

    Science.gov (United States)

    Lee, Sang-Hak; Ko, Il-Gyu; Kim, Sung-Eun; Hwang, Lakkyong; Jin, Jun-Jang; Choi, Hyun-Hee; Kim, Chang-Ju

    2016-01-01

    Cerebral ischemia is caused by reduced cerebral blood flow due to a transient or permanent cerebral artery occlusion. Ischemic injury in the brain leads to neuronal cell death, and eventually causes neurological impairments. Cordyceps, the name given to the fungi on insects, has abundant useful natural products with various biological activities. Cordyceps is known to have nephroprotective, hepatoprotective, anti-inflammatory, antioxidative, and antiapoptotic effects. We investigated the effects of Cordyceps on short-term memory, neuronal apoptosis, and cell proliferation in the hippocampal dentate gyrus following transient global ischemia in gerbils. For this study, a step-down avoidance test, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, immunohistochemistry for caspase-3 and 5-bromo-2′-de-oxyuridine, and western blot for Bax, Bcl-2, brain-derived neurotrophic factor (BDNF), and tyrosin kinase B were performed. In the present study, Cordyceps alleviated cerebral ischemia-induced short-term memory impairment. Cordyceps showed therapeutic effects through inhibiting cerebral ischemia-induced apoptosis in the hippocampus. Cordyceps suppressed cerebral ischemia-induced cell proliferation in the hippocampal dentate gyrus due to the reduced apoptotic neuronal cell death. Cordyceps treatment also enhanced BDNF and TrkB expressions in the hippocampus of ischemic gerbils. It can be suggested that Cordyceps overcomes cerebral ischemia-induced neuronal apoptosis, thus facilitates recovery following cerebral ischemia injury. PMID:27162767

  20. Aqueous extract of Cordyceps alleviates cerebral ischemia-induced short-term memory impairment in gerbils.

    Science.gov (United States)

    Lee, Sang-Hak; Ko, Il-Gyu; Kim, Sung-Eun; Hwang, Lakkyong; Jin, Jun-Jang; Choi, Hyun-Hee; Kim, Chang-Ju

    2016-04-01

    Cerebral ischemia is caused by reduced cerebral blood flow due to a transient or permanent cerebral artery occlusion. Ischemic injury in the brain leads to neuronal cell death, and eventually causes neurological impairments. Cordyceps, the name given to the fungi on insects, has abundant useful natural products with various biological activities. Cordyceps is known to have nephroprotective, hepatoprotective, anti-inflammatory, antioxidative, and antiapoptotic effects. We investigated the effects of Cordyceps on short-term memory, neuronal apoptosis, and cell proliferation in the hippocampal dentate gyrus following transient global ischemia in gerbils. For this study, a step-down avoidance test, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, immunohistochemistry for caspase-3 and 5-bromo-2'-de-oxyuridine, and western blot for Bax, Bcl-2, brain-derived neurotrophic factor (BDNF), and tyrosin kinase B were performed. In the present study, Cordyceps alleviated cerebral ischemia-induced short-term memory impairment. Cordyceps showed therapeutic effects through inhibiting cerebral ischemia-induced apoptosis in the hippocampus. Cordyceps suppressed cerebral ischemia-induced cell proliferation in the hippocampal dentate gyrus due to the reduced apoptotic neuronal cell death. Cordyceps treatment also enhanced BDNF and TrkB expressions in the hippocampus of ischemic gerbils. It can be suggested that Cordyceps overcomes cerebral ischemia-induced neuronal apoptosis, thus facilitates recovery following cerebral ischemia injury. PMID:27162767