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Sample records for cerebral ischemic small

  1. Acute ischemic cerebral attack

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    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...

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

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    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.)

  3. Immune mechanisms in cerebral ischemic tolerance

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    Lidia eGarcia-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.

  4. Cerebral perfusion SPECT in transient ischemic attack

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    You, D.-L. E-mail: dlyou@mail.kfcc.org.tw; Shieh, F.-Y.; Tzen, K.-Y.; Tsai, M.-F.; Kao, P.-F

    2000-04-01

    Purpose: The purpose of our study is to evaluate the efficacy of cerebral perfusion single photon emission computerized tomography (SPECT) in patients with transient ischemic attack (TIA). Methods: Thirty-seven patients with TIA were collected for study. All patients had transient focal neurological symptoms or signs with complete recovery within 24 h after onset. The patients underwent cerebral perfusion SPECT between 6 h and 11 days after onset, with 10 cases performed within 24 h (group A), nine cases performed between 1 and 3 days (group B), 11 cases performed between 3 and 5 days (group C), and seven cases performed after more than 5 days (group D). A semi-quantitative method was used for analyzing the SPECT data, and the difference ratios between lesion side and contralateral normal side were calculated on each pair of regions of interest. Results: In total, 78.4% (29/37) of patients had reduced perfusion in the cerebral cortical regions or deep nuclei, and the regions with reduced perfusion corresponded with clinical presentations of the patients. The abnormal rate with reduced perfusion was 90.0% in group A, 77.8% in group B, 72.7% in group C and 71.4% in group D. Cross cerebellar diaschisis (CCD) was present in seven patients, and all of the primary cerebral perfusion defects of these patients were located at the territory of left or right middle cerebral artery. Conclusion: Cerebral perfusion SPECT is a potential tool to detect cerebral perfusion defects and CCD in patients with TIA. Although the perfusion defect may persist more than 5 days after onset, we suggest cerebral perfusion SPECT should be performed as soon as possible.

  5. [Cerebral infarction and transient ischemic attack].

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    Sahara, Noriyuki; Kuwashiro, Takahiro; Okada, Yasushi

    2016-04-01

    Japanese Guidelines for the Management of Stroke 2015 was published. Here, we describe several points revised from the 2009 edition about "Cerebral infarction and transient ischemic attack (TIA)". The revision points are as follows; 1. Extension of possible time window of intravenous recombinant tissue-plasminogen activator treatment (from within 3 hours to within 4.5 hours); 2. Antiplatelet therapy in acute stage (dual antiplatelet therapy (DAPT) for non-cardioembolic ischemic stroke or TIA); 3. Endovascular recanalization therapy in acute stage; 4. Antiplatelet therapy in chronic stage (Cilostazol is recommended similar to aspirin or clopidogrel); 5. Non-vitamin K antagonist oral anticoagulants (NOACs) for non-valvular atrial fibrillation (NVAF) stroke or TIA patients; 6. Management of TIA. We explain the revised points of the guideline in the text.

  6. Influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease

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    Hui Lu; Ning-Ning Cui; Bin-Cheng Wang

    2016-01-01

    Objective:To study the influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease. Methods:A total of 58 patients with ischemic cerebrovascular disease in our hospital from April 2015 to January 2016 were selected as the study object, and 58 patients were randomly divided into two groups, 29 patients in control group were treated with routine treatment, 29 patients in observation group were treated with remote ischemic preconditioning on the basic treatment of control group, then the cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment and at first, third and sixth month after the treatment were respectively detected and compared.Results:The cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment all showed no significant differences (allP>0.05), while the cerebral oxygen metabolism and cerebral blood flow indexes of observation group at first, third and sixth month after the treatment were all significantly better than those before the treatment, and the results were all significantly better than those of control group at the same time too (allP>0.05).Conclusions: The influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease are better, and its application value for the patients with ischemic cerebrovascular disease is higher.

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

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    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

  8. Changes of resting cerebral activities in subacute ischemic stroke patients

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    Ping Wu

    2015-01-01

    Full Text Available This study aimed to detect the difference in resting cerebral activities between ischemic stroke patients and healthy participants, define the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efficacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunction and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks and 15 age-matched healthy participants. A resting-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental findings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely potential targets for the neural regeneration of subacute ischemic stroke patients.

  9. Changes of resting cerebral activities in subacute ischemic stroke patients

    Institute of Scientific and Technical Information of China (English)

    Ping Wu; Fang Zeng; Yong-xin Li; Bai-li Yu; Li-hua Qiu; Wei Qin; Ji Li; Yu-mei Zhou; Fan-rong Liang

    2015-01-01

    This study aimed to detect the difference in resting cerebral activities between ischemic stroke pa-tients and healthy participants, deifne the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efifcacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunc-tion and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks) and 15 age-matched healthy participants. A rest-ing-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental ifndings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely po-tential targets for the neural regeneration of subacute ischemic stroke patients.

  10. Regional cerebral blood flow in acute stage ischemic cerebrovascular disease by xenon-133 inhalation and single photon emission computerized tomography

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    Kurokawa, Hiroyuki (Akita Univ. (Japan). School of Medicine)

    1989-03-01

    During the period from February 1984 through June 1985, single photon emission computerized tomography (SPECT) with xenon-133 inhalation method has been performed for the measurement of regional cerebral blood flow (rCBF) during the first 48 hours of onset of cerebral infarction (n=71) and transient ischemic attack (n=21). X-ray CT (CT) and carotid arteriography were concurrently performed in all the patients. In repeated studies performed for 15 normal volunteers, rCBF measurement by SPECT was found reproducible. Mean values of rCBF for the right and left cerebral hemispheres were 60.3{plus minus}6.52 and 61.8{plus minus}6.91 ml/100 g/min, respectively. For cerebral infarction, ischemic foci corresponding to clinical symptoms were detected more frequently on SPECT than on CT (93% vs 63%). In all of the evaluable 35 patients with cerebral infarction, rCBF within the first 8 hours of onset was decreased: 31.0 ml/100 g/min for the internal carotid artery (ICA) occlusion and 36.0 ml/100 g/min for the middle cerebral artery (MCA) occlusion. Crossed cerebellar diaschisis was observed in 50% (9/18) for ICA occlusion and 37% (14/38) for MCA occlusion. For transient ischemic attack, there was no significant difference in the detection of ischemic foci between SPECT and CT (38% vs 43%). In detecting small foci especially in the deep regions such as the basal ganglia, SPECT was inferior to CT. Mean rCBF for transient ischemic attack tended to be lower than the normal rCBF (50.7 ml/100 g/min for the right cerebral hemisphere and 50.6 ml/100 g/min for the left cerebral hemisphere). SPECT may aid in predicting prognosis and chosing treatment strategy, as well as in determining cerebral hemodynamics. (N.K.).

  11. An unusual cause of ischemic stroke - Cerebral air embolism

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    Vinit Suri

    2014-01-01

    Full Text Available Air embolism is a preventable, often undiagnosed but potentially treatable cause of ischemic stroke with a high morbidity and mortality. It is usually iatrogenic ocurring especially in patients in ICU setting. We describe the case and neuroimaging of a patient with ischaemic stroke due to air embolism during manipulation of central venous line. We also review the literature with respect to aetiology, incidence pathophysiology, diagnosis, and treatment options for venous and air embolism. Cerebral air embolism should be considered in patients with sudden neurological deterioration after central venous or arterial manipulations or certain neurological procedures. Prevention, as well as early diagnosis and management, may reduce morbidity and mortality.

  12. Nitroxyl exacerbates ischemic cerebral injury and oxidative neurotoxicity.

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    Choe, Chi-un; Lewerenz, Jan; Fischer, Gerry; Uliasz, Tracy F; Espey, Michael Graham; Hummel, Friedhelm C; King, Stephen Bruce; Schwedhelm, Edzard; Böger, Rainer H; Gerloff, Christian; Hewett, Sandra J; Magnus, Tim; Donzelli, Sonia

    2009-09-01

    Nitroxyl (HNO) donor compounds function as potent vasorelaxants, improve myocardial contractility and reduce ischemia-reperfusion injury in the cardiovascular system. With respect to the nervous system, HNO donors have been shown to attenuate NMDA receptor activity and neuronal injury, suggesting that its production may be protective against cerebral ischemic damage. Hence, we studied the effect of the classical HNO-donor, Angeli's salt (AS), on a cerebral ischemia/reperfusion injury in a mouse model of experimental stroke and on related in vitro paradigms of neurotoxicity. I.p. injection of AS (40 mumol/kg) in mice prior to middle cerebral artery occlusion exacerbated cortical infarct size and worsened the persistent neurological deficit. AS not only decreased systolic blood pressure, but also induced systemic oxidative stress in vivo indicated by increased isoprostane levels in urine and serum. In vitro, neuronal damage induced by oxygen-glucose-deprivation of mature neuronal cultures was exacerbated by AS, although there was no direct effect on glutamate excitotoxicity. Finally, AS exacerbated oxidative glutamate toxicity - that is, cell death propagated via oxidative stress in immature neurons devoid of ionotropic glutamate receptors. Taken together, our data indicate that HNO might worsen cerebral ischemia-reperfusion injury by increasing oxidative stress and decreasing brain perfusion at concentrations shown to be cardioprotective in vivo.

  13. Apoptosis in rat transient focal cerebral ischemic stroke: clinical implications

    Institute of Scientific and Technical Information of China (English)

    Shoushu Jiao; Jue Wang Gal Hever; Rongzheng Kuang; Jean-Claude Louis; Ella Magal

    2000-01-01

    @@In the early phase of cerebral ischemia, factors threatening neuronal survival in the penumbra include mainly glutamate excitotoxicity, free radical damage and energy failure resulting from recurrent depolarization waves. However, at later times, other mechanisms come into play. The initial ischemic event activates a variety of genetic programs that unfold over the course of hours and days. Both positron emission tomography and magnetic resonance based techniques demonstrate that the development of irretrievable tissue damage is relatively slow, progressing over the course of several days in some cases, and a viable tissue, defined by hemodynamic and metabolic criteria,is still present many hours after stroke in human or in monkey. These findings suggest that the brain can potentially be “rescued” from infarction many hours after onset of ischemia and challenge the widespread notion of an early and short “therapeutic window” (~3-6h). This realization is of critical importance for stroke therapy because most patients reach medical attention at a time when current therapeutic strategies may no longer be effective. Therefore, it would be highly desirable to develop therapeutic interventions that can be instituted many hours after the onset of ischemia. We believe that addressing the mechanisms of delayed cell death is key to a successful therapy. The studies presented here were designed to document the potential contribution of apoptosis to ischemia induced neuronal death. We will discuss the morphological, biochemical and pharmacological evidence for apoptosis in the ischemic stroke.

  14. Ischemic postconditioning fails to protect against neonatal cerebral stroke.

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    Pierre-Louis Leger

    Full Text Available The lack of efficient neuroprotective strategies for neonatal stroke could be ascribed to pathogenic ischemic processes differentiating adults and neonates. We explored this hypothesis using a rat model of neonatal ischemia induced by permanent occlusion of the left distal middle cerebral artery combined with 50 min of occlusion of both common carotid arteries (CCA. Postconditioning was performed by repetitive brief release and occlusion (30 s, 1 and/or 5 min of CCA after 50 min of CCA occlusion. Alternative reperfusion was generated by controlled release of the bilateral CCA occlusion. Blood-flow velocities in the left internal carotid artery were measured using color-coded pulsed Doppler ultrasound imaging. Cortical perfusion was measured using laser Doppler. Cerebrovascular vasoreactivity was evaluated after inhalation with the hypercapnic gas or inhaled nitric oxide (NO. Whatever the type of serial mechanical interruptions of blood flow at reperfusion, postconditioning did not reduce infarct volume after 72 hours. A gradual perfusion was found during early re-flow both in the left internal carotid artery and in the cortical penumbra. The absence of acute hyperemia during early CCA re-flow, and the lack of NO-dependent vasoreactivity in P7 rat brain could in part explain the inefficiency of ischemic postconditioning after ischemia-reperfusion.

  15. Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy.

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    Distefano, Giuseppe; Praticò, Andrea D

    2010-09-16

    Hypoxic-ischemic encephalopathy (HIE) is the most important cause of cerebral damage and long-term neurological sequelae in the perinatal period both in term and preterm infant. Hypoxic-ischemic (H-I) injuries develop in two phases: the ischemic phase, dominated by necrotic processes, and the reperfusion phase, dominated by apoptotic processes extending beyond ischemic areas. Due to selective ischemic vulnerability, cerebral damage affects gray matter in term newborns and white matter in preterm newborns with the typical neuropathological aspects of laminar cortical necrosis in the former and periventricular leukomalacia in the latter. This article summarises the principal physiopathological and biochemical processes leading to necrosis and/or apoptosis of neuronal and glial cells and reports recent insights into some endogenous and exogenous cellular and molecular mechanisms aimed at repairing H-I cerebral damage.

  16. Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy

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    Praticò Andrea D

    2010-09-01

    Full Text Available Abstract Hypoxic-ischemic encephalopathy (HIE is the most important cause of cerebral damage and long-term neurological sequelae in the perinatal period both in term and preterm infant. Hypoxic-ischemic (H-I injuries develop in two phases: the ischemic phase, dominated by necrotic processes, and the reperfusion phase, dominated by apoptotic processes extending beyond ischemic areas. Due to selective ischemic vulnerability, cerebral damage affects gray matter in term newborns and white matter in preterm newborns with the typical neuropathological aspects of laminar cortical necrosis in the former and periventricular leukomalacia in the latter. This article summarises the principal physiopathological and biochemical processes leading to necrosis and/or apoptosis of neuronal and glial cells and reports recent insights into some endogenous and exogenous cellular and molecular mechanisms aimed at repairing H-I cerebral damage.

  17. 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

  18. Investigation of cerebral iron deposition in aged patients with ischemic cerebrovascular disease using susceptibility-weighted imaging

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    Liu, Yin; Liu, Jun; Liu, Huanghui; Liao, Yunjie; Cao, Lu; Ye, Bin; Wang, Wei

    2016-01-01

    Objective The aim of this study was to investigate focal iron deposition level in the brain in patients with ischemic cerebrovascular disease and its correlation with cerebral small vessel disease imaging markers. Patients and methods Seventy-four patients with first-ever transient ischemic attack (median age: 69 years; 30 males and 44 females) and 77 patients with positive ischemic stroke history (median age: 72 years; 43 males and 34 females) were studied retrospectively. On phase image of susceptibility-weighted imaging and regions of interest were manually drawn at the bilateral head of the caudate nucleus, lenticular nucleus (LN), thalamus (TH), frontal white matter, and occipital white matter. The correlation between iron deposition level and the clinical and imaging variables was also investigated. Results Iron deposition level at LN was significantly higher in patients with previous stroke history. It linearly correlated with the presence and number of cerebral microbleeds (CMBs) but not with white matter hyperintensity and lacunar infarct. Multiple linear regression analysis showed that deep structure CMBs were the most relevant in terms of iron deposition at LN. Conclusion Iron deposition at LN may increase in cases of more severe ischemia in aged patients with transient ischemic attack, and it may be an imaging marker for CMB of ischemic origin. PMID:27574434

  19. Cardiological evaluation of patients with a cerebral ischemic event: the relation between heart and brain

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    G.A.M. Pop (Gheorghe)

    1992-01-01

    textabstractIn this study several aspects of the cardiological evaluation of patients with cerebral ischemia are described; its usefulness for diagnosis and treatment is discussed. The aim of this thesis is to approach the clinical and epidemiological aspects of patients with cerebral ischemic event

  20. Temperature modulation of cerebral depolarization during focal cerebral ischemia in rats: correlation with ischemic injury.

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    Chen, Q; Chopp, M; Bodzin, G; Chen, H

    1993-05-01

    The role of cerebral depolarizations in focal cerebral ischemia is unknown. We therefore measured the direct current (DC) electrical activity in the cortex of Wistar rats subjected to transient occlusion of the middle cerebral artery (MCA). Focal ischemia was induced for 90 min by insertion of an intraluminal filament to occlude the MCA. To modulate cell damage, we subjected the rats to hypothermic (30 degrees C, n = 4), normothermic (37 degrees C, n = 4), and hyperthermic (40 degrees C, n = 6) ischemia. Controlled temperatures were also maintained during 1 h of reperfusion. Continuous cortical DC potential changes were measured using two active Ag-AgCl electrodes placed in the cortical lesion. Animals were killed 1 week after ischemia. The brains were sectioned and stained with hematoxylin and eosin, for evaluation of neuronal damage, and calculation of infarct volume. All animals exhibited an initial depolarization within 30 min of ischemia, followed by a single depolarization event in hypothermic animals, and multiple periodic depolarization events in both normothermic and hyperthermic animals. Hyperthermic animals exhibited significantly more (p < 0.05) DC potential deflections (n = 6.17 +/- 0.67) than normothermic animals (n = 2.75 +/- 0.96). The ischemic infarct volume (% of hemisphere) was significantly different for the various groups; hypothermic animals exhibited no measurable infarct volume, while the ischemic infarct volume was 10.2 +/- 12.3% in normothermic animals and 36.5 +/- 3.4% in hyperthermic animals (p < 0.05). A significant correlation was detected between the volume of infarct and number of depolarization events (r = 0.90, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Research progress of cerebral small vessel disease

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    Jun-dong JIA

    2015-03-01

    Full Text Available Cerebral small vessel disease refers to a group of pathological processes with various etiologies that affect small arteries, arterioles, venules, and capillaries of the brain. Recently, the researches of cerebral small vessel disease have got initial progressions, and a definite diagnosis of this disease is comfirmed by biopsy. Given the pathological material is difficult to obtain, clinicians should pay more attention to the imaging features and clinical manifestations. Correct understanding of imaging and clinical manifestations contributes to the early identification of cerebral small vessel disease. Herein, an overview is provided on the present status, common imaging features, pathogenesis, clinical manifestations and treatment of cerebral small vessel disease. DOI: 10.3969/j.issn.1672-6731.2015.02.003

  2. Age-related reduction of cerebral ischemic preconditioning: myth or reality?

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    Della-Morte D

    2013-08-01

    Full Text Available David Della-Morte,1,2 Francesco Cacciatore,3 Elisa Salsano,4 Gilda Pirozzi,4 Maria Teresa Del Genio,4 Iole D'Antonio,4 Gaetano Gargiulo,5 Raffaele Palmirotta,2 Fiorella Guadagni,2 Tatjana Rundek,1 Pasquale Abete41Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA; 2Department of Advanced Biotechnologies and Bioimaging, IRCCS San Raffaele, Rome, Italy; 3Istituto Scientifico di Campoli/Telese, Fondazione Salvatore Maugeri, IRCCS, Benevento, Italy; 4Dipartimento di Scienze Mediche Traslazionali, Università di Napoli "Federico II," Naples, Italy; 5AON, SS Antonio e Biagio e Cesare Arrigo, Struttura Complessa di Geriatria, Alessandria, ItalyAbstract: Stroke is one of the leading causes of death in industrialized countries for people older than 65 years of age. The reasons are still unclear. A reduction of endogenous mechanisms against ischemic insults has been proposed to explain this phenomenon. The “cerebral” ischemic preconditioning mechanism is characterized by a brief episode of ischemia that renders the brain more resistant against subsequent longer ischemic events. This ischemic tolerance has been shown in numerous experimental models of cerebral ischemia. This protective mechanism seems to be reduced with aging both in experimental and clinical studies. Alterations of mediators released and/or intracellular pathways may be responsible for age-related ischemic preconditioning reduction. Agents able to mimic the “cerebral” preconditioning effect may represent a new powerful tool for the treatment of acute ischemic stroke in the elderly. In this article, animal and human cerebral ischemic preconditioning, its age-related difference, and its potential therapeutical applications are discussed.Keywords: ischemic preconditioning, stroke, transient cerebral ischemic attack, mortality, elderly

  3. 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.

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

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    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.

  5. Expression of brain-derived neurotrophic factor in rat hippocampus following focal cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    Yingping Li; Ruifang Guo; Kaifeng Lu

    2008-01-01

    BACKGROUND: The functional role of brain-derived neurotrophic factor (BDNF) is enhanced following cerebral ischemic injury providing neurons with an important self-protection mechanism in early stage ischemia/hypoxia.OBJECTIVE: To investigate the expression pattern of BDNF in different rat hippocampal regions following focal cerebral ischemic injury.DESIGN, TIME AND SETTING: We performed a comparative and neurobiological study of animals in the Department of Histology and Embryology and the Central Laboratory, Hebei Medical University from March to December 2003.MATERIALS: Forty healthy Sprague Dawley rats were randomly divided into a cerebral ischemla group and a sham operation group, with 20 rats per group.METHODS: In the cerebral ischemia group, we occluded the right middle cerebral artery with a suture,threading it to a depth of 17-19 mm. In the sham operation group, the threading depth was approximately 10 mm.MAIN OUTCOME MEASURES: We analyzed the expression of BDNF in different hippocampal regions by immunohistochemical staining of brain sections taken on post-operative days 7, 14, 21 and 30.RESULTS: Sham operation group: We observed a number of a few BDNF-positive cells with light staining in the hippocampal CAI CA4 regions and dentate gyrus. Cerebral ischemia group: compared with the sham operation group, BDNF increased on day 7, significantly increased on day 14, and reached a peak on day 21 (P < 0.05). Furthermore, immunologically reactive products were darkly stained, and neurons had long axons.BDNF was particularly highly expressed in the hippocampal CA3 and CA4 regions and dentate gyrus.CONCLUSION: Cerebral ischemic injury can damage hippocampal neurons. Neurons can increase their anti-ischemic capacity by increasing BDNF expression in the hippocampal CA3 and CA4 regions and dentate gyrus.

  6. miR-455 inhibits neuronal cell death by targeting TRAF3 in cerebral ischemic stroke

    Directory of Open Access Journals (Sweden)

    Yao ST

    2016-12-01

    Full Text Available Shengtao Yao,* Bo Tang,* Gang Li, Ruiming Fan, Fang Cao Department of Cerebrovascular Disease, The First Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China *These authors contributed equally to this work Abstract: Ischemic stroke is one of the leading causes of brain disease, with high morbidity, disability, and mortality. MicroRNAs (miRNAs have been identified as vital gene regulators in various types of human diseases. Accumulating evidence has suggested that aberrant expression of miRNAs play critical roles in the pathologies of ischemic stroke. Yet, the precise mechanism by which miRNAs control cerebral ischemic stroke remains unclear. In the present study, we explored whether miR-455 suppresses neuronal death by targeting TRAF3 in cerebral ischemic stroke. The expression levels of miR-455 and TRAF3 were detected by quantitative real-time polymerase chain reaction and Western blot. The role of miR-455 in cell death caused by oxygen–glucose deprivation (OGD was assessed using Cell Counting Kit-8 (CCK-8 assay. The influence of miR-455 on infarct volume was evaluated in mouse brain after middle cerebral artery occlusion (MCAO. Bioinformatics softwares and luciferase analysis were used to find and confirm the targets of miR-455. The results showed that the expression levels of miR-455 significantly decreased in primary neuronal cells subjected to OGD and mouse brain subjected to MCAO. In addition, forced expression of miR-455 inhibited neuronal death and weakened ischemic brain infarction in focal ischemia-stroked mice. Furthermore, TRAF3 was proved to be a direct target of miR-455, and miR-455 could negatively suppress TRAF3 expression. Biological function analysis showed that TRAF3 silencing displayed the neuroprotective effect in ischemic stroke and could enhance miR-455-induced positive impact on ischemic injury both in vitro and in vivo. Taken together, miR-455 played a vital role in protecting neuronal

  7. [Diagnosis and prognosis of cerebral ischemic disturbances course using a method of artificial neuronal networks].

    Science.gov (United States)

    Ivanov, Iu S; Semin, G F

    2004-01-01

    Based on the data of examination of 224 patients with different stages of cerebral ischemic disturbances (CID) and 84 age-matched controls, an artificial neuronal network was constructed and tried in differential diagnosis of CID stages according to the data of transcranial ultrasonic dopplerography. Diagnostic efficacy of the network was 80% for sensitivity, 100% for specificity and 82.7% for reliability. A modeling of the influence of the main risk factors for cerebral ischemia and of the reserve state of cerebral hemodynamics for establishing the stage of CID was performed.

  8. Early retinal inflammatory biomarkers in the middle cerebral artery occlusion model of ischemic stroke

    Science.gov (United States)

    Ritzel, Rodney M.; Pan, Sarah J.; Verma, Rajkumar; Wizeman, John; Crapser, Joshua; Patel, Anita R.; Lieberman, Richard; Mohan, Royce

    2016-01-01

    Purpose The transient middle cerebral artery occlusion (MCAO) model of stroke is one of the most commonly used models to study focal cerebral ischemia. This procedure also results in the simultaneous occlusion of the ophthalmic artery that supplies the retina. Retinal cell death is seen days after reperfusion and leads to functional deficits; however, the mechanism responsible for this injury has not been investigated. Given that the eye may have a unique ocular immune response to an ischemic challenge, this study examined the inflammatory response to retinal ischemia in the MCAO model. Methods Young male C57B/6 mice were subjected to 90-min transient MCAO and were euthanized at several time points up to 7 days. Transcription of inflammatory cytokines was measured with quantitative real-time PCR, and immune cell activation (e.g., phagocytosis) and migration were assessed with ophthalmoscopy and flow cytometry. Results Observation of the affected eye revealed symptoms consistent with Horner’s syndrome. Light ophthalmoscopy confirmed the reduced blood flow of the retinal arteries during occlusion. CX3CR1-GFP reporter mice were then employed to evaluate the extent of the ocular microglia and monocyte activation. A significant increase in green fluorescent protein (GFP)-positive macrophages was seen throughout the ischemic area compared to the sham and contralateral control eyes. RT–PCR revealed enhanced expression of the monocyte chemotactic molecule CCL2 early after reperfusion followed by a delayed increase in the proinflammatory cytokine TNF-α. Further analysis of peripheral leukocyte recruitment by flow cytometry determined that monocytes and neutrophils were the predominant immune cells to infiltrate at 72 h. A transient reduction in retinal microglia numbers was also observed, demonstrating the ischemic sensitivity of these cells. Blood–eye barrier permeability to small and large tracer molecules was increased by 72 h. Retinal microglia exhibited enhanced

  9. Analysis of the XRCC1 gene as a modifier of the cerebral response in ischemic stroke

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    Juo Suh-Hang H

    2006-11-01

    Full Text Available Abstract Background Although there have been studies of the genetic risk factors in the development of stroke, there have been few investigations of role of genes in the cerebral response to ischemia. The brain responds to ischemia in a series of reactions that ultimately influence the volume of a stroke that, in general, correlates with disability. We hypothesize that polymorphisms in genes encoding proteins involved in these reactions could act as modifiers of this response and impact stroke volume. One of the pathways participating in the cerebral ischemic response involves reactive oxygen species which can cause oxidative damage to nucleic acids. DNA repair mechanisms are in place to protect against such damage and imply a role for DNA repair genes in the response of the brain to ischemia and are potential candidate genes for further investigation. Methods We studied two common polymorphisms in the DNA repair gene, XRCC1, C26304T and G28152A, in 134 well characterized patients with non lacunar ischemic strokes. We also performed a case control association study with 113 control patients to assess whether these variants represent risk factors in the development of ischemic stroke. Results Independent of etiology, the "T" allele of the C26304T polymorphism is significantly associated with larger stroke volumes (T-test analysis, p Conclusion Our study suggests a major gene effect of the "T" allele of the C26304T polymorphism modulating the cerebral response to ischemia in non lacunar ischemic stroke.

  10. 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.

  11. Imaging experimental cerebral malaria in vivo: significant role of ischemic brain edema.

    Science.gov (United States)

    Penet, Marie-France; Viola, Angèle; Confort-Gouny, Sylviane; Le Fur, Yann; Duhamel, Guillaume; Kober, Frank; Ibarrola, Danielle; Izquierdo, Marguerite; Coltel, Nicolas; Gharib, Bouchra; Grau, Georges E; Cozzone, Patrick J

    2005-08-10

    The first in vivo magnetic resonance study of experimental cerebral malaria is presented. Cerebral involvement is a lethal complication of malaria. To explore the brain of susceptible mice infected with Plasmodium berghei ANKA, multimodal magnetic resonance techniques were applied (imaging, diffusion, perfusion, angiography, spectroscopy). They reveal vascular damage including blood-brain barrier disruption and hemorrhages attributable to inflammatory processes. We provide the first in vivo demonstration for blood-brain barrier breakdown in cerebral malaria. Major edema formation as well as reduced brain perfusion was detected and is accompanied by an ischemic metabolic profile with reduction of high-energy phosphates and elevated brain lactate. In addition, angiography supplies compelling evidence for major hemodynamics dysfunction. Actually, edema further worsens ischemia by compressing cerebral arteries, which subsequently leads to a collapse of the blood flow that ultimately represents the cause of death. These findings demonstrate the coexistence of inflammatory and ischemic lesions and prove the preponderant role of edema in the fatal outcome of experimental cerebral malaria. They improve our understanding of the pathogenesis of cerebral malaria and may provide the necessary noninvasive surrogate markers for quantitative monitoring of treatment.

  12. 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.

  13. Regional cerebral blood flow in acute stage with ischemic cerebrovascular disease by xenon-133 inhalation and single photon emission computerized tomography

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    Kurokawa, Hiroyuki; Iino, Katsuro; Kojima, Hisashi; Saito, Hitoshi; Suzuki, Mikio; Watanabe, Kazuo; Kato, Toshiro

    1987-05-01

    Single photon emission computed tomography (SPECT) with xenon-133 inhalation method was undertaken within 48 hr after the onset in 68 patients with ischemic cerebrovascular disease. The results for regional cerebral blood flow (rCBF) were compared with concurrently available computed tomography (CT) scans. In patients with cerebral infarction, SPECT detected ischemic lesions earlier than CT, with the detectability being 92 %. The area with a decreased blood flow, as seen on SPECT, was more extensive than the low density area on CT, with a concomitant decrease in blood flow in the contralateral cerebral hemisphere. Crossed cerebellar diaschisis was associated with stenosis of the internal carotid artery in 50 % (7/14), and with stenosis of the middle cerebral artery in 35 % (9/26). Abnormal SPECT findings were seen in 47 % (8/17) of the patients with transient ischemic attack (TIA). Five TIA patients had a decreased rCBF on SPECT, which was not provided by CT scans. On the contrary, small infarct lesions in the cerebral basal ganglia, as observed in 4 patients, was not detected by SPECT, but detected by CT. This may imply the limitations of SPECT in the detection of deep-seated lesions of the cerebrum. The results led to the conclusion that SPECT can be performed safely even in acute, seriously ill patients to know changes in rCBF because it is noninvasive and is capable of being repeated in a short time. (Namekawa, K.).

  14. Expression of hypoxia inducible factor-1 alpha and ischemic erythropoietin tolerance in the brain of cerebral ischemic tolerance model rats

    Institute of Scientific and Technical Information of China (English)

    Renliang Zhao; Ruijian Dong; Zhongling Sun

    2006-01-01

    BACKGROUND: Hypoxia inducible factor-1 alpha (HIF-1 α) and erythropoietin(EPO), possessing neuroprotective effect in the cerebral ischemia, might play an important role in the formation of cerebral ischemic tolerance (IT).OBJECTIVE:To observe the neuroprotective effect of cerebral ischemic preconditioning(IPC) of rats, and the expression and mechanism of HIF-1α and target gene erythropoietin in the brain tissue following the formation of cerebral IT.DESIGN :A randomized and controlled observation.SETTING: Department of Neurology, the Affiliated Hospital of Medical College, Qingdao University.MATERIALS: Totally 84 enrolled adult healthy male Wistar rats of clean grade, weighing 250 to 300 g, were provided by the Animal Experimental Department, Tongji Medical College of Huazhong University of Science and Technology. Ready-to-use SABC reagent kit and rabbit anti-rat HIF-1α monoclonal antibody were purchased from Boshide Bioengineering Co. Ltd (Wuhan); Rabbit anti-rat EPO monoclonal antibody was purchased from Santa Cruz Company (USA).METHODS: This experiment was carried out in the Department of Anatomy, Medical College, Qingdao University during March 2005 to March 2006. ① The 84 rats were divided into 3 groups by a lot: IPC group (n=40),sham-operation group (n=40) and control group (n=4). In the IPC group, middle cerebral artery was occluded for 2 hours respectively on the 1st, 3rd, 7th, 14th and 21st days of the reperfusion following 10-minute preischemia was made using a modified middle cerebral artery second suture method from Zea-Longa. The rats were sacrificed 22 hours after reperfusion in the end of middle cerebral artery occlusion (MCAO). That was to say,after 10-minute preischemia, suture was exited to the external carotid artery and embedded subcutaneously.Middle cerebral artery was occluded again to form the second reperfusion at the set time point after reperfusion. Twenty-two hours later, rats were sacrificed; In the sham-operation group

  15. Study on the Mechanism of mTOR-Mediated Autophagy during Electroacupuncture Pretreatment against Cerebral Ischemic Injury

    Science.gov (United States)

    Wu, Zhou-Quan; Cui, Su-yang; Zhu, Liang

    2016-01-01

    This study is aimed at investigating the association between the electroacupuncture (EA) pretreatment-induced protective effect against early cerebral ischemic injury and autophagy. EA pretreatment can protect cerebral ischemic and reperfusion injuries, but whether the attenuation of early cerebral ischemic injury by EA pretreatment was associated with autophagy is not yet clear. This study used the middle cerebral artery occlusion model to monitor the process of ischemic injury. For rats in the EA pretreatment group, EA pretreatment was conducted at Baihui acupoint before ischemia for 30 min for 5 consecutive days. The results suggested that EA pretreatment significantly increased the expression of autophagy in the cerebral cortical area on the ischemic side of rats. But the EA pretreatment-induced protective effects on the brain could be reversed by the specific inhibitor 3-methyladenine of autophagy. Additionally, the Pearson correlation analysis indicated that the impact of EA pretreatment on p-mTOR (2481) was negatively correlated with its impact on autophagy. In conclusion, the mechanism of EA pretreatment at Baihui acupoint against cerebral ischemic injury is mainly associated with the upregulation of autophagy expression, and its regulation of autophagy may depend on mTOR-mediated signaling pathways. PMID:27547233

  16. Compensatory cerebral motor control following presumed perinatal ischemic stroke

    NARCIS (Netherlands)

    van der Hoorn, Anouk; Potgieser, Adriaan R E; Brouwer, Oebele F; de Jong, Bauke M

    2014-01-01

    Case: A fifteen year-old left-handed girl presented with right-sided focal motor seizures. Neuroimaging showed a large left hemisphere lesion compatible with a middle cerebral artery stroke of presumed perinatal origin. She was not previously diagnosed with a motor deficit, although neurological exa

  17. Growth factor-and cytokine-stimulated endothelial progenitor cells in post-ischemic cerebral neovascularization

    Institute of Scientific and Technical Information of China (English)

    Philip V.Peplow

    2014-01-01

    Endothelial progenitor cells are resident in the bone marrow blood sinusoids and circulate in the peripheral circulation. They mobilize from the bone marrow after vascular injury and home to the site of injury where they differentiate into endothelial cells. Activation and mobilization of endothelial progenitor cells from the bone marrow is induced via the production and release of endothelial progenitor cell-activating factors and includes speciifc growth factors and cytokines in response to peripheral tissue hypoxia such as after acute ischemic stroke or trauma. Endotheli-al progenitor cells migrate and home to speciifc sites following ischemic stroke via growth factor/cytokine gradients. Some growth factors are less stable under acidic conditions of tissue isch-emia, and synthetic analogues that are stable at low pH may provide a more effective therapeutic approach for inducing endothelial progenitor cell mobilization and promoting cerebral neovas-cularization following ischemic stroke.

  18. 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.

  19. Inhibition of autophagy contributes to ischemic postconditioning-induced neuroprotection against focal cerebral ischemia in rats.

    Directory of Open Access Journals (Sweden)

    Li Gao

    Full Text Available BACKGROUND: Ischemic postconditioning (IPOC, or relief of ischemia in a stuttered manner, has emerged as an innovative treatment strategy to reduce programmed cell death, attenuate ischemic injuries, and improve neurological outcomes. However, the mechanisms involved have not been completely elucidated. Recent studies indicate that autophagy is a type of programmed cell death that plays elusive roles in controlling neuronal damage and metabolic homeostasis. This study aims to determine the role of autophagy in IPOC-induced neuroprotection against focal cerebral ischemia in rats. METHODOLOGY/PRINCIPAL FINDINGS: A focal cerebral ischemic model with permanent middle cerebral artery (MCA occlusion plus transient common carotid artery (CCA occlusion was established. The autophagosomes and the expressions of LC3/Beclin 1/p62 were evaluated for their contribution to the activation of autophagy. We found that autophagy was markedly induced with the upregulation of LC3/Beclin 1 and downregulation of p62 in the penumbra at various time intervals following ischemia. IPOC, performed at the onset of reperfusion, reduced infarct size, mitigated brain edema, inhibited the induction of LC3/Beclin 1 and reversed the reduction of p62 simultaneously. Rapamycin, an inducer of autophagy, partially reversed all the aforementioned effects induced by IPOC. Conversely, autophagy inhibitor 3-methyladenine (3-MA attenuated the ischemic insults, inhibited the activation of autophagy, and elevated the expression of anti-apoptotic protein Bcl-2, to an extent comparable to IPOC. CONCLUSIONS/SIGNIFICANCE: The present study suggests that inhibition of the autophagic pathway plays a key role in IPOC-induced neuroprotection against focal cerebral ischemia. Thus, pharmacological inhibition of autophagy may provide a novel therapeutic strategy for the treatment of stroke.

  20. Learning and memory changes in rats following exogenous human hepatocyte growth factor gene injection into cerebral ischemic penumbra

    Institute of Scientific and Technical Information of China (English)

    Zhijun You; Yong Liu; Jianye Yang; Qingping Jiang

    2011-01-01

    Human hepatocyte growth factor can be used to treat cerebral infarction, administered by lateral ventricular, cerebellomedullary cistern or subarachnoid injections. However, the target gene expression product is scarcely found in the ischemic penumbra, but extensively distributes in other regions, increasing the risks of gene therapy. The present study directly transfected hepatocyte growth factor gene into the ischemic penumbra of rats with transient middle cerebral artery occlusion. Immunohistochemical analysis revealed that infarct volume was significantly decreased, hepatocyte growth factor protein expression level and vessel quantity in the ischemic penumbra were significantly increased, and learning and memory were significantly improved.

  1. Ischemic Postconditioning Alleviates Brain Edema After Focal Cerebral Ischemia Reperfusion in Rats Through Down-Regulation of Aquaporin-4.

    Science.gov (United States)

    Han, Dong; Sun, Miao; He, Ping-Ping; Wen, Lu-Lu; Zhang, Hong; Feng, Juan

    2015-07-01

    Cerebral edema is a serious complication associated with cerebral ischemia/reperfusion (I/R). Aquaporin-4 (AQP4) plays a role in generating postischemic edema after reperfusion. Recently, ischemic postconditioning (Postcond) has been shown to produce neuroprotective effects and reduce brain edema in rats after cerebral I/R. It is unclear if ischemic Postcond alleviates brain edema injury through regulation of AQP4. In this study, middle cerebral artery occlusion (MCAO) was induced in rats by filament insertion for 2 h following 24-h reperfusion: ischemic Postcond treatment was performed before reperfusion in the experimental group. We used the wet-dry weight ratio and transmission electron microscopy to evaluate brain edema after 24 h of reperfusion. We used immunohistochemistry and Western blot analyses to evaluate the distribution and expression of AQP4. Ischemic Postcond significantly reduced the water content of the brain tissue and swelling of the astrocytic foot processes. AQP4 expression increased in the I/R and Postcond groups compared to the sham group, but it decreased in the Postcond group compared to the I/R group. The results of our study suggest that ischemic Postcond effectively reduces brain edema after reperfusion by inhibiting AQP4 expression. The data in this study support the use of ischemic Postcond for alleviating brain edema after cerebral I/R.

  2. Attenuation of Cerebral Ischemic Injury in Smad1 Deficient Mice.

    Directory of Open Access Journals (Sweden)

    Jamie K Wong

    Full Text Available Stroke results in brain tissue damage from ischemia and oxidative stress. Molecular regulators of the protective versus deleterious cellular responses after cerebral ischemia remain to be identified. Here, we show that deletion of Smad1, a conserved transcription factor that mediates canonical bone morphogenetic protein (BMP signaling, results in neuroprotection in an ischemia-reperfusion (I/R stroke model. Uninjured mice with conditional deletion of Smad1 in the CNS (Smad1 cKO displayed upregulation of the reactive astrocyte marker GFAP and hypertrophic morphological changes in astrocytes compared to littermate controls. Additionally, cultured Smad1(-/- astrocytes exhibited an enhanced antioxidant capacity. When subjected to I/R injury by transient middle cerebral artery occlusion (tMCAO, Smad1 cKO mice showed enhanced neuronal survival and improved neurological recovery at 7 days post-stroke. This neuroprotective phenotype is associated with attenuated reactive astrocytosis and neuroinflammation, along with reductions in oxidative stress, p53 induction, and apoptosis. Our data suggest that Smad1-mediated signaling pathway is involved in stroke pathophysiology and may present a new potential target for stroke therapy.

  3. 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

  4. Wavelet coherence analysis of dynamic cerebral autoregulation in neonatal hypoxic–ischemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Fenghua Tian

    2016-01-01

    Full Text Available Cerebral autoregulation represents the physiological mechanisms that keep brain perfusion relatively constant in the face of changes in blood pressure and thus plays an essential role in normal brain function. This study assessed cerebral autoregulation in nine newborns with moderate-to-severe hypoxic–ischemic encephalopathy (HIE. These neonates received hypothermic therapy during the first 72 h of life while mean arterial pressure (MAP and cerebral tissue oxygenation saturation (SctO2 were continuously recorded. Wavelet coherence analysis, which is a time-frequency domain approach, was used to characterize the dynamic relationship between spontaneous oscillations in MAP and SctO2. Wavelet-based metrics of phase, coherence and gain were derived for quantitative evaluation of cerebral autoregulation. We found cerebral autoregulation in neonates with HIE was time-scale-dependent in nature. Specifically, the spontaneous changes in MAP and SctO2 had in-phase coherence at time scales of less than 80 min (<0.0002 Hz in frequency, whereas they showed anti-phase coherence at time scales of around 2.5 h (~0.0001 Hz in frequency. Both the in-phase and anti-phase coherence appeared to be related to worse clinical outcomes. These findings suggest the potential clinical use of wavelet coherence analysis to assess dynamic cerebral autoregulation in neonatal HIE during hypothermia.

  5. 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

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    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)

  6. Edema and vascular permeability in cerebral ischemia: comparison between ischemic neuronal damage and infarction.

    Science.gov (United States)

    Petito, C K; Pulsinelli, W A; Jacobson, G; Plum, F

    1982-07-01

    The respective influences of ischemic neuronal damage and infarction on the development of abnormal blood-brain barrier (BBB) permeability and cerebral edema were evaluated in a rat model of temporary four-vessel occlusion in which ischemic neuronal damage with only infrequent infarction is produced. Survival times ranged from 40 minutes to 5 days after ischemia. Evans blue and horseradish peroxidase (HRP) were given before sacrifice. The majority of brain showed moderate ischemic neuronal damage inthe striatum. In these areas there was neither leakage of Evans blue nor extravasation of HRP. Astrocytic processes were moderately swollen. Large, grossly-visible unilateral infarcts were present in only 5 animals, and all showed abnormal BBB permeability of HRP which occurred via enchanced pinocytosis, and occasionally via diffuse leakage through necrotic vessels. Astrocytic processes were markedly swollen and their plasma membranes were disrupted. Whole brain and regional water content in a parallel series of animals were measured from 15 minutes (min) to 48 hours (h) postischemia. They showed a transient, 1% increase in whole brain water content from 15 to 60 min postischemia, but no increase in regional water content at any postischemic interval. These studies suggest that ischemia produces BBB permeability to large molecules, and sustained cerebral edema only when the process damages blood vessels and astrocytes; neuronal necrosis alone is insufficient.

  7. 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.

  8. Antileukocyte therapy of cerebral ischemic stroke in MCAO model in rats

    Institute of Scientific and Technical Information of China (English)

    Zuming Luo; Xiaohui Zeng; Huiling Chen

    2000-01-01

    OBJECTIVE To Study protecting effect of antileukocytic drugs on cerebrol ischemic injury. BACKGROUND The purposes of prcsent study aimed at comparing the protecting effect of some antileukocytic drugs: chloroquine, Colchieine, Cyclophosphamid (CTX) ,Cyclosporin A, Multiglycoside tripteygil against cerebral ischemic injury in MCAO models in the rats. METHODS 130 SD rats with MCAO model randomly divided into one control group and 10 treatment groups. The observation items were as follows: (1) The infarction volume. (2) Brain edema. (3) Histopathoiogical evaluation. (4) The count of neurons and microglia cells in the infarction area. (5) Neurological dysfunction score. (6) The determination of serum lL-1 β and TNF- α levels. RESULTS Antileukocytic drugs can decrease the volume of infarction, brain edema, inflammatory reaction and neuron death of ischemic injury, the low dose of chloroquine plus colchicine plus CTX had better effects, and prolonged therapeutic time windows. DISCUSSION The accumulation of infiammatory cell and cytoking release from them can promote and increase neuron death in infarction area. CONCLUSION Antileukocytic drugs are of protecting effect on ischemic neuron in MCAO model in rats.

  9. Imaging Evidence for Cerebral Hyperperfusion Syndrome after Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Yi Zhang

    2016-01-01

    Full Text Available Background. Cerebral hyperperfusion syndrome (CHS, a rare complication after cerebral revascularization, is a well-described phenomenon after carotid endarterectomy or carotid artery stenting. However, the imaging evidence of CHS after intravenous tissue plasminogen activator (iv tPA for acute ischemic stroke (AIS has not been reported. Case Report. Four patients were determined to have manifestations of CHS with clinical deterioration after treatment with iv tPA, including one patient who developed seizure, one patient who had a deviation of the eyes toward lesion with worsened mental status, and two patients who developed worsened hemiparesis. In all four patients, postthrombolysis head CT examinations were negative for hemorrhage; CT angiogram showed patent cervical and intracranial arterial vasculature; CT perfusion imaging revealed hyperperfusion with increased relative cerebral blood flow and relative cerebral blood volume and decreased mean transit time along with decreased time to peak in the clinically related artery territory. Vascular dilation was also noted in three of these four cases. Conclusions. CHS should be considered in patients with clinical deterioration after iv tPA and imaging negative for hemorrhage. Cerebral angiogram and perfusion studies can be useful in diagnosing CHS thereby helping with further management.

  10. In vivo imaging of hemodynamics and oxygen metabolism in acute focal cerebral ischemic rats with laser speckle imaging and functional photoacoustic microscopy

    Science.gov (United States)

    Deng, Zilin; Wang, Zhen; Yang, Xiaoquan; Luo, Qingming; Gong, Hui

    2012-08-01

    Stroke is a devastating disease. The changes in cerebral hemodynamics and oxygen metabolism associated with stroke play an important role in pathophysiology study. But the changes were difficult to describe with a single imaging modality. Here the changes in cerebral blood flow (CBF), cerebral blood volume (CBV), and oxygen saturation (SO2) were yielded with laser speckle imaging (LSI) and photoacoustic microscopy (PAM) during and after 3-h acute focal ischemic rats. These hemodynamic measures were further synthesized to deduce the changes in oxygen extraction fraction (OEF). The results indicate that all the hemodynamics except CBV had rapid declines within 40-min occlusion of middle cerebral artery (MCAO). CBV in arteries and veins first increased to the maximum value of 112.42±36.69% and 130.58±31.01% by 15 min MCAO; then all the hemodynamics had a persistent reduction with small fluctuations during the ischemic. When ischemia lasted for 3 h, CBF in arteries, veins decreased to 17±14.65%, 24.52±20.66%, respectively, CBV dropped to 62±18.56% and 59±18.48%. And the absolute SO2 decreased by 40.52±22.42% and 54.24±11.77%. After 180-min MCAO, the changes in hemodynamics and oxygen metabolism were also quantified. The study suggested that combining LSI and PAM provides an attractive approach for stroke detection in small animal studies.

  11. 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.

  12. 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.

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

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    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.

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

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    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

  15. A Voxel-based Morphometric Analysis of Cerebral Gray Matter in Subcortical Ischemic Vascular Dementia Patients and Normal Aged Controls

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    Chuanming Li, Hanjian Du, Jian Zheng, Jian Wang

    2011-01-01

    Full Text Available BACKGROUND AND PURPOSE: The present study was designed to detect the abnormalities of the cerebral grey-matter density in subcortical ischemic vascular dementia patients by FSL-VBM method to promote the early diagnosis of it.METHODS: Nine subcortical ischemic vascular dementia patients and nine age-matched normal controls underwent MRI brain structure scanning that was performed on a SIEMENS AVANTO 1.5 Tesla scanner and standard T1-weighted high-resolution anatomic scans of MPRAGE sequence were obtained. The 3-demensional MPRAGE images were processed with FSL-VBM package and the cerebral gray matter density was compared between the subcortical ischemic vascular dementia patients and normal controls.RESULTS: Compared with the normal control group, the cerebral gray matter density of subcortical ischemic vascular dementia patients was found significantly decreasing, including brain regions of thalamus, parietal lobe, frontal lobe and temporal lobe (P<0.05.CONCLUSIONS: The cerebral gray matter density alterations have closed correlation with cognitive dysfunction in subcortical ischemic vascular dementia patient and can be detected by MRI. MRI has some potential value in the diagnosis of them.

  16. [The follow up of patients with extracranial pathology of the carotid arteries and ischemic disorders of cerebral circulation].

    Science.gov (United States)

    Dzhibladze, D N; Amintaeva, A G; Lagoda, O V; Ionova, V G

    2003-01-01

    According to the populational studies, about 50% of ischemic disorders of cerebral circulation, both persistent and transient, are induced by thrombotic or embolic complications of atherosclerotic plaques which produce an adverse effect on the large and small caliber arteries; about 20-25% is associated with lesion of the small diameter intracranial vessels, about 20% with embolism from the heart, and the remaining disorders fall within other rare causes. The prevalence of atherosclerotic lesions of the vessels feeding the brain, the severity of their clinical manifestations, insufficient efficacy of conservative therapy and the high risk of surgical treatment remain as before a matter of great medical and social concern. In connection with an appreciable progress of vascular surgery carotid endarterectoray (GEAE) as one of the radical approaches to correction of the pathology of the carotid artery segment is widespread at the large centers of vascular surgery of different countries. However, in spite of the fact that CEAE is an advanced and radical technique of preventive operation, it produces only a local effect on vascular diseases whereas the other, no less important pathogenetic mechanisms leading to disorders of cerebral circulation remain unchanged and demand drug correction to avoid repeated disorders of cerebral circulation. Analysis of the long-tern results evidences a stable and lasting effect of CEAE. The postoperative clinical manifestations can be used as the main criterion for the efficacy of CEAE, especially as compared to the purely conservative therepy. The results of the long-term follow up (over the period as long as 15 years) of a large group of operated patients demonstrate that the majority of them did not show the emergence of the new focal neurologic symptomatology in the ipsilateral hemisphere and only a small percentage of cases developed stroke. The major western statistics provide the analogous results.

  17. 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.

  18. 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

  19. Blood microRNAs as potential diagnostic and prognostic markers in cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    Bridget Martinez; Philip V Peplow

    2016-01-01

    MicroRNAs are a family of small, genome-encoded endogenous RNAs that are transcribed but are not translated into proteins. They serve essential roles in virtually every aspect of brain function, including neurogenesis, neural development, and cellular responses leading to changes in synaptic plasticity. They are also implicated in neurodegeneration and neurological disorders, in responses to hypoxia and ischemia, and in ischemic tolerance induced by ischemic preconditioning. In recent developments, miRNA expres-sion proifling has been examined in stroke, and these studies indicate that miRNAs have emerged as key mediators in ischemic stroke biology. Both increased and decreased miRNA levels may be needed either as prevention or treatment of stroke. Novel approaches are being developed to get miRNA related therapeu-tics into the brain across an intact blood-brain barrier, including chemical modiifcation, use of targeting molecules and methods to disrupt the blood-brain barrier.

  20. Progressive Ischemic Stroke due to Thyroid Storm-Associated Cerebral Venous Thrombosis

    Science.gov (United States)

    Tanabe, Natsumi; Hiraoka, Eiji; Hoshino, Masataka; Deshpande, Gautam A.; Sawada, Kana; Norisue, Yasuhiro; Tsukuda, Jumpei; Suzuki, Toshihiko

    2017-01-01

    Patient: Female, 49 Final Diagnosis: Cerebral venous thrombosis Symptoms: Altered mental state • weakness in limbs Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Rare co-existance of disease or pathology Background: Cerebral venous thrombosis (CVT) is a rare but fatal complication of hyperthyroidism that is induced by the hypercoagulable state of thyrotoxicosis. Although it is frequently difficult to diagnose CVT promptly, it is important to consider it in the differential diagnosis when a hyperthyroid patient presents with atypical neurologic symptoms. Care Report: A 49-year-old Japanese female with unremarkable medical history came in with thyroid storm and multiple progressive ischemic stroke identified at another hospital. Treatment for thyroid storm with beta-blocker, glucocorticoid, and potassium iodide-iodine was started and MR venography was performed on hospital day 3 for further evaluation of her progressive ischemic stroke. The MRI showed CVT, and anticoagulation therapy, in addition to the anti-thyroid agents, was initiated. The patient’s thyroid function was successfully stabilized by hospital day 10 and further progression of CVT was prevented. Conclusions: Physicians should consider CVT when a patient presents with atypical course of stroke or with atypical MRI findings such as high intensity area in apparent diffusion coefficient (ADC) mapping. Not only is an early diagnosis and initiation of anticoagulation important, but identifying and treating the underlying disease is essential to avoid the progression of CVT. PMID:28228636

  1. Modulation of The Balance Between Cannabinoid CB1 and CB2 Receptor Activation During Cerebral Ischemic/Reperfusion Injury

    OpenAIRE

    ZHANG, Ming; Martin, Billy R.; Adler, Martin W.; Razdan, Raj K.; Ganea, Doina; Tuma, Ronald F.

    2008-01-01

    Cannabinoid receptor activation has been shown to modulate both neurotransmission (CB1) and neuroinflammatory (CB2) responses. There are conflicting reports in the literature describing the influence of cannabinoid receptor activation on ischemic/reperfusion injury. The goal of this study was to evaluate how changing the balance between CB1 and CB2 activation following cerebral ischemia influences outcome. CB1 and CB2 expression were tested at different times after transient middle cerebral a...

  2. Relationship between serum S-100 protein level and ischemic damage degree in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    HE Ming-li; XU Bing-chao; HUANG Guo-sheng

    2005-01-01

    Objective: To investigate the time course of serum S-100 concentrations of patients with acute cerebral infarction,and their relation with the clinical data and the prognosis. Methods: Serum S-100 levels were serially determined in 35 patients with acute cerebral infarction within 12 h, at 24 h and day 2, 3, 4, 5,7 and 10 after acute cerebral infarction and in 20 age- and sex-matched control subjects. An S-100 content assay was performed using a two-site radioimmunoassay technique. The clinical status was assessed using NIH Stroke Scale. The functional deficit at 4 weeks after acute cerebral infarction was scored using the modified Rankin scale. A cranial computed tomography was performed initially. Results: Elevated concentrations of S100 (>0.2 μg/L) were observed in 29 of 36 patients with acute cerebral infarction,but none of the control subjects. The S-100 peak levels were at day 2 and 3 after acute cerebral infarction and were significantly high in those patients with severe neurological deficit at admission, with extensive infarction or with space-occupying effect of ischemic edema as compared with the rest of the populations. Conclusion: Serum S-100 level assay can be used as a peripheral marker of ischemic brain damage, and may be helpful for evaluation of therapeutic effects in acute ischemic stroke.

  3. Aortic arch and intra-/extracranial cerebral arterial atherosclerosis in patients suffering acute ischemic strokes

    Institute of Scientific and Technical Information of China (English)

    郭毅; 姜昕; 陈实; 张少文; 赵宏文; 吴瑛

    2003-01-01

    Objective To determine the distribution of aortic arch and intra/extracranial cerebral arterial atherosclerosis in Chinese patients who had suffered acute ischemic strokes. Methods Eighty-nine patients with acute ischemic strokes were included in this study. Transesophageal echocardiography (TEE) was used to evaluate potential sources of embolisms in the aortic arch and in the heart; duplex ultrasound was used for the carotid artery; and intracranial Doppler (TCD) imaging was used for the middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA). An atherosclerotic lesion in the aortic arch was defined as normal (0); mild plaque (1); moderate plaque (2); and protruding plaque or mobile plaque (3). A lesion in the carotid artery was considered a plaque if the maximal carotid plaque thickness was 1.2 mm. TCD results were deemed abnormal if flow velocity was either greater or lower than normal, and, in the case of the MCA, if an asymmetry index above 21% was measured. Results Of the 89 patients, 52 (58.43%) patients showed evidence of aortic arch atherosclerosis (AAA), including 11 (12.36%) patients graded mild, 18 (20.22%) patients graded moderate, and 23 (25.84%) patients graded severe. Of the 23 patients with severe AAA, AAA was determined to be an important potential embolic source in 14 patients. Forty-nine (50.56%) patients had carotid arterial plaques (CAPs). The incidence of carotid plaques was higher among patients with AAA than among patients without AAA (71.15% vs 21.62%, OR=3.291, 95% CI=1.740-6.225, P<0.001). TCD abnormalities affecting the MCA were found in 54 (60.67%) patients. Differences in incidence of TCD abnormalities between patients with AAA and without AAA (69.23% vs 48.65%) were not significant (OR=1.423, 95% CI=0.976-2.076, P=0.05). There was a higher incidence of AAA in older, male patients with a history of diabetes and smoking. Conclusions AAA is an important potential source of

  4. 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

  5. Pre, intra and post-ischemic hypothermic neuroprotection in temporary focal cerebral ischemia in rats: morphometric analysis

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    Roberto Alexandre Dezena

    2012-08-01

    Full Text Available OBJECTIVE: To evaluate the neuroprotection of mild hypothermia, applied in different moments, in temporary focal cerebral ischemia in rats. METHODS: Rats was divided into Control (C, Sham (S, Ischemic-control(IC, Pre-ischemic Hypothermia (IH1, Intra-ischemic Hypothermia (IH2, and Post-ischemic Hypothermia (IH3 groups. Morphometry was performed using the KS400 software (Carl Zeiss® in coronal sections stained by Luxol Fast Blue. Ischemic areas and volumes were obtained. RESULTS: Statistically, blue areas showed difference for C vs. IC, IC vs. IH1 and IC vs. IH2 (p=0.0001; p=0.01; p=0.03, and no difference between C vs. S, IC vs. IH3 and IH vs. IH2 (p=0.39; p=0.85; p=0.63. Red areas showed difference between C vs. IC, IC vs. IH1 and IC vs. IH2 (p=0.0001; p=0.009; p=0.03, and no difference between C vs. S, IC vs. IH3 and IH1 vs. IH2 (p=0.48; p=0.27; p=0.68. Average ischemic areas and ischemic volumes showed difference between IC vs. IH1 and IC vs. IH2 (p=0.0001 and p=0.0011, and no difference between IC vs. IH3 and IH1 vs. IH2 (p=0.57; p=0.79. CONCLUSION: Pre-ischemic and intra-ischemic hypothermia were shown to be similarly neuroprotective, but this was not true for post-ischemic hypothermia.

  6. Impact of coexisting coronary artery disease on the occurrence of cerebral ischemic lesions after carotid stenting.

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    Kuo-Lun Huang

    Full Text Available BACKGROUND: Coronary artery disease (CAD may coexist with extracranial carotid artery stenosis (ECAS, but the influence of CAD on procedure-related complications after carotid artery stenting (CAS has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI scanning. METHODS: Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days. RESULTS: Among 126 patients (69.5±9.0 years recruited for unilateral protected CAS, 33 (26% patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33 and 48% (45 in 93 of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6-10.0; P = .0018, and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032. In patients with no CAD (n = 55, asymptomatic CAD (n = 41 and symptomatic CAD (n = 30, the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048, and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120. CONCLUSIONS: The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.

  7. Relationship between AQP4 expression and DWI of the cerebral ischemic edema in rats

    Institute of Scientific and Technical Information of China (English)

    鲁宏; 孙善全

    2003-01-01

    Objective: To study the correlation between aquaporin-4(AQP4) expression and diffusion-weighted imaging (DWI) in the process of ischemic brain edema for the molecular biologic mechanism of DWI. Methods: A total of 34 Wistar rats were divided into 8 groups randomly: Non-operated group (n=4), sham-operated group (n=6), and operated group, receiving right middle cerebral artery occlusion (MCAO) for 15 and 30 min, and 1, 3, 6 and 24 h respectively (6 subgroups, n=4). All groups were imaged with DWI and T2WI. The apparent diffusion coefficient (ADC), relevant density (rd) and relevant area (rs) of hyperintensity of the lesions on DWI and T2WI were measured. Relevant ADC (rADC), relevant area of immunohistochemical staining for AQP4 (rS), optical density of AQP4 hybridization (α) were calculated. After that the animals were sacrificed and perfused at different time intervals, correlations between DWI, ADC, and AQP4 expression (rS, α) in ischemic tissue was made. Results: There was a significant correlation between rS and α (r=0.949). The abnormal high intensity was found in DWI of the ipsilateral MAC territory at 15 min after MCAO. The ADC value decreased quickly within 1 h after MCAO, the rd and rs of DWI increased rapidly and the expression of AQP4 increased quickly, too. However, there was no change on the T2WI. In the period of time (15 min-1 h), the AQP4 expression(α) had a strong relation to the rd and rs( r=0.914, 0.895). With the progress of the time, the ADC value of MCAO decreased further to (2.1±0.6)×10-4 mm2/s at 3 h, and then followed an increased slowly till 24 h, but the rd and the rs as well as the expression of AQP4 continuously increased during the stage. The T2WI detected the lesion at the average time (1.4 h) after MCAO, and the rs of T2WI was less than that of DWI at the same time in the same layer (P<0.05). Conclusion: The results imply that high expression of AQP4 may play a key role in ischemic brain edema. It is, certainly, one of the

  8. Characteristics and dynamics of cognitive impairment in patients with primary and recurrent cerebral ischemic hemispheric stroke

    Directory of Open Access Journals (Sweden)

    A. A. Kozyolkin

    2014-08-01

    Full Text Available Acute cerebrovascular disease is a global medical and social problem of the modern angioneurology, occupying leading positions in the structure of morbidity and mortality among adult population of the world. Ischemic stroke – is one of the most common pathology. Today this disease took out the world pandemic. More than 16 million new cases of cerebral infarction recorded in the world each year and it “kills” about 7 million of people. About 111,953 cases of cerebral stroke were registered in 2013 in Ukraine. Cognitive impairment, t hat significantly disrupt daily activities and life of the patient, is one of the most significant post-stroke complications that have social, medical and biological significance. Aim. The purpose of this investigation was to study features and dynamics of cognitive impairments in patients with primary and recurrent cerebral hemispheric ischemic stroke (CHIS in the acute stage of the disease. Materials and methods. To achieve the aim, and the decision of tasks in the clinic of nervous diseases Zaporozhye State Medical University (supervisor - Doctor of Medicine, Professor Kozelkin A. based on the department of acute cerebrovascular disease were performed comparative, prospective cohort study, which included comprehensive clinical and paraclinical examinations of 41 patients (26 men and 15 women aged 45 to 85 years (mean age 66,4 ± 1,4 years with acute left-hemispheric (2 patients and right - hemispheric (39 patients CHIS . First up was a group of 28 patients (19 men and 9 women, mean age 65,6 ± 1,6 years, who suffered from primary CHIS. The second group consisted of 13 patients (7 men and 6 women, mean age 68,1 ± 2,5 years with recurrent CHIS. The groups were matched by age, sex, localization of the lesion and the initial level of neurological deficit. All patients underwent physical examination, neurological examination. Dynamic clinical neurological examination assessing the severity of stroke was conducted

  9. Matrine attenuates focal cerebral ischemic injury by improving antioxidant activity and inhibiting apoptosis in mice.

    Science.gov (United States)

    Zhao, Peng; Zhou, Ru; Zhu, Xiao-Yun; Hao, Yin-Ju; Li, Nan; Wang, Jie; Niu, Yang; Sun, Tao; Li, Yu-Xiang; Yu, Jian-Qiang

    2015-09-01

    cerebral ischemic injury and that these effects are associated with its antioxidant and anti-apoptotic properties.

  10. The follow-up research on the value of the plasma homocystine after methionine loading test on the recurrent ischemic vascular event in cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    刘怀翔

    2014-01-01

    Objective To evaluate the effect of the plasma homocystine(Hcy)after methionine loading test(MLT)on the recurrence of ischemic vascular event,including cerebral infarction,transient ischemic attack(TIA),acute coronary syndrome,other vascular embolism in cerebral infarction patients.Methods The fasting plasma homocystine(FHcy)and homocystine after MLT(PHcy)levels were measured by high-performance liquid chromatog-

  11. Protective Effects of Focal Ischemic Preconditioning and HSP70 Expression on Middle Cerebral Artery Occlusion in Rats

    Institute of Scientific and Technical Information of China (English)

    ZHAO Jianhua; SUN Senggang; CHEN Xiaowu

    2006-01-01

    To systematically evaluate the importance of protein synthesis in ischemic preconditioning (PC)-induced ischemic tolerance (IT), temporary middle cerebral artery occlusion (MCAO)by Longa (20 min) was used for PC (ischemic precondioning). Twenty-four hours of reperfusion was allowed after PC and before permanent MCAO to establish ischemic tolerance (IT) to compare with non-PC (sham-operated) rats (n=5 for each group). Infarct size and neurological deficits were measured 24 h after PMCAO. Samples of brain were taken for the determination of HSP70 expression by Western blot analysis. The effects of the protein synthesis inhibitor cycloheximide administered just before PC or administered long after PC but just before PMCAO on IT were also determined (n=5 for each group). Our results showed that hemispheric infarct was significantly reduced (P<0.01) only if PC was performed after 24 h, and PC significantly (P<0.05) reduced neurological deficits (similar to reductions in infarct size). Cycloheximide eliminated ischemic PC-induced IT effects on both brain injury and neurological deficits if administered before PC but not if administered long after PC but before PMCAO. PC produced no brain injury but did increase HSP70 protein 24 h after PC. Cycloheximide eliminated that effect. The results suggest that PC is a powerful inducer of ischemic brain tolerance as reflected by the preservation of brain tissue and motor function. PC induces IT that is dependent on de novo protein synthesis.

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

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    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.

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

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    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.

  14. Inhibiting p38 mitogen-activated protein kinase attenuates cerebral ischemic injury in Swedish mutant amyloid precursor protein transgenic mice

    Institute of Scientific and Technical Information of China (English)

    Liangyu Zou; Haiyan Qin; Yitao He; Heming Huang; Yi Lu; Xiaofan Chu

    2012-01-01

    Cerebral ischemia was induced using photothrombosis 1 hour after intraperitoneal injection of the p38 mitogen-activated protein kinase (MAPK) inhibitor SB239063 into Swedish mutant amyloid precursor protein (APP/SWE) transgenic and non-transgenic mice. The number of surviving neurons in the penumbra was quantified using Nissl staining, and the activity of p38 MAPKs was measured by western blotting. The number of surviving neurons in the penumbra was significantly reduced in APP/SWE transgenic mice compared with non-transgenic controls 7 days after cerebral ischemia, but the activity of p38 MAPKs was significantly elevated compared with the non-ischemic hemisphere in the APP/SWE transgenic mice. SB239063 prevented these changes. The APP/SWE mutation exacerbated ischemic brain injury, and this could be alleviated by inhibiting p38 MAPK activity.

  15. [Heart disorders secondary to cerebral ischemic infarct. A clinical study of 20 patients and diagnostico-therapeutic considerations].

    Science.gov (United States)

    Cosentino, F; Salvati, M; Artizzu, S; Caruso, R; Fiorenza, F; Ramundo, E O; Cosentino, F

    1990-01-01

    The role of heart disorders in the onset of stroke has been examined in depth, but scarce attention has been paid to the relationship between cerebral ischemic stroke and subsequent heart disorders. The paper reports the results of a study of this relationship. The present state of knowledge is outlined together with the possible risk factors which might be useful in constructing a suitable therapeutic-prophylactic protocol to reduce the cardiological risks of "acute" neurosurgical treatment.

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

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    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

  17. Toward fully automated processing of dynamic susceptibility contrast perfusion MRI for acute ischemic cerebral stroke.

    Science.gov (United States)

    Kim, Jinsuh; Leira, Enrique C; Callison, Richard C; Ludwig, Bryan; Moritani, Toshio; Magnotta, Vincent A; Madsen, Mark T

    2010-05-01

    We developed fully automated software for dynamic susceptibility contrast (DSC) MR perfusion-weighted imaging (PWI) to efficiently and reliably derive critical hemodynamic information for acute stroke treatment decisions. Brain MR PWI was performed in 80 consecutive patients with acute nonlacunar ischemic stroke within 24h after onset of symptom from January 2008 to August 2009. These studies were automatically processed to generate hemodynamic parameters that included cerebral blood flow and cerebral blood volume, and the mean transit time (MTT). To develop reliable software for PWI analysis, we used computationally robust algorithms including the piecewise continuous regression method to determine bolus arrival time (BAT), log-linear curve fitting, arrival time independent deconvolution method and sophisticated motion correction methods. An optimal arterial input function (AIF) search algorithm using a new artery-likelihood metric was also developed. Anatomical locations of the automatically determined AIF were reviewed and validated. The automatically computed BAT values were statistically compared with estimated BAT by a single observer. In addition, gamma-variate curve-fitting errors of AIF and inter-subject variability of AIFs were analyzed. Lastly, two observes independently assessed the quality and area of hypoperfusion mismatched with restricted diffusion area from motion corrected MTT maps and compared that with time-to-peak (TTP) maps using the standard approach. The AIF was identified within an arterial branch and enhanced areas of perfusion deficit were visualized in all evaluated cases. Total processing time was 10.9+/-2.5s (mean+/-s.d.) without motion correction and 267+/-80s (mean+/-s.d.) with motion correction on a standard personal computer. The MTT map produced with our software adequately estimated brain areas with perfusion deficit and was significantly less affected by random noise of the PWI when compared with the TTP map. Results of image

  18. Imaging cerebral small vessel disease at 7 Tesla MRI

    NARCIS (Netherlands)

    Conijn, M.M.A.

    2011-01-01

    Cerebral small vessel disease is a term often used to refer to lacunar infarcts, white matter lesions (WML) and microbleeds; lesions that are thought to be caused by changes in the small vessels of the brain. These lesions are commonly found in the general elderly population. However, it is hard to

  19. Periodic 17β-estradiol pretreatment protects rat brain from cerebral ischemic damage via estrogen receptor-β.

    Directory of Open Access Journals (Sweden)

    Ami P Raval

    Full Text Available Although chronic 17β-estradiol (E2 has been shown to be a cognition-preserving and neuroprotective agent in animal brain injury models, concern regarding its safety was raised by the failed translation of this phenomenon to the clinic. Previously, we demonstrated that a single bolus of E2 48 hr prior to ischemia protected the hippocampus from damage in ovariectomized rats via phosphorylation of cyclic-AMP response element binding protein, which requires activation of estrogen receptor subtype beta (ER-β. The current study tests the hypothesis that long-term periodic E2-treatment improves cognition and reduces post-ischemic hippocampal injury by means of ER-β activation. Ovariectomized rats were given ten injections of E2 at 48 hr intervals for 21 days. Hippocampal-dependent learning, memory and ischemic neuronal loss were monitored. Results demonstrated that periodic E2 treatments improved spatial learning, memory and ischemic neuronal survival in ovariectomized rats. Additionally, periodic ER-β agonist treatments every 48 hr improved post-ischemic cognition. Silencing of hippocampal ER-β attenuated E2-mediated ischemic protection suggesting that ER-β plays a key role in mediating the beneficial effects of periodic E2 treatments. This study emphasizes the need to investigate a periodic estrogen replacement regimen to reduce cognitive decline and cerebral ischemia incidents/impact in post-menopausal women.

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

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    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.

  1. Protein Kinase C Epsilon Promotes Cerebral Ischemic Tolerance Via Modulation of Mitochondrial Sirt5

    Science.gov (United States)

    Morris-Blanco, Kahlilia C.; Dave, Kunjan R.; Saul, Isabel; Koronowski, Kevin B.; Stradecki, Holly M.; Perez-Pinzon, Miguel A.

    2016-01-01

    Sirtuin 5 (SIRT5) is a mitochondrial-localized NAD+-dependent lysine desuccinylase and a major regulator of the mitochondrial succinylome. We wanted to determine whether SIRT5 is activated by protein kinase C epsilon (PKCε)-mediated increases in mitochondrial Nampt and whether SIRT5 regulates mitochondrial bioenergetics and neuroprotection against cerebral ischemia. In isolated mitochondria from rat cortical cultures, PKCε activation increased SIRT5 levels and desuccinylation activity in a Nampt-dependent manner. PKCε activation did not lead to significant modifications in SIRT3 activity, the major mitochondrial lysine deacetylase. Assessments of mitochondrial bioenergetics in the cortex of wild type (WT) and SIRT5−/− mice revealed that SIRT5 regulates oxygen consumption in the presence of complex I, complex II, and complex IV substrates. To explore the potential role of SIRT5 in PKCε-mediated protection, we compared WT and SIRT5−/− mice by employing both in vitro and in vivo ischemia paradigms. PKCε-mediated decreases in cell death following oxygen-glucose deprivation were abolished in cortical cultures harvested from SIRT5−/− mice. Furthermore, PKCε failed to prevent cortical degeneration following MCAO in SIRT5−/− mice. Collectively this demonstrates that SIRT5 is an important mitochondrial enzyme for protection against metabolic and ischemic stress following PKCε activation in the brain. PMID:27435822

  2. Cerebroprotective effect of Moringa oleifera against focal ischemic stroke induced by middle cerebral artery occlusion.

    Science.gov (United States)

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

    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 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.

  3. Characters of MR diffusion tensor imaging in cerebral ischemic corticospinal tract injury

    Institute of Scientific and Technical Information of China (English)

    Ziqian Chen; Ping Ni; Hui Xiao; Youqiang Ye; Gennian Qian; Shangwen Xu; Xizhang Yang; Jinhua Chen; Biyun Zhang

    2006-01-01

    BACKGROUND: Diffusion tensor imaging (DTI) is one of the noninvasive methods to study the morphological structure of brain white matter fibrous bands in vivo, and it has been applied primarily in clinic. DTI is acknowledged as the more effective imaging method to diagnose ultra-acute and/or acute cerebral infarction.OBJECTIVE: To observe the anisotropic characters of cerebral white matter fibrous bands in patients with ischemic stroke by using DTI, and investigate the correlation between the damage of corticospinal tract and muscle strength in patients with ischemic stroke at acute period.DESIGN: A case-control observation.SETTING: Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIpANTS: Nine inpatients with injury of motor function induced by acute ischemic stroke (patient group) at 6 hours to 2 weeks after the attack were selected from the Department of Neurology, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from September 2005 to March 2006,and they all accorded with the present diagnostic standard for cerebrovascular disease in China. There were 5 males and 4 females, aged 16-87 years. At the same time, nine healthy right-handed physical examinees matched by age and sex with the patients were taken as the control group, and they all had no nervous disease, mental diseases, cerebrovascular abnormalities and injury history, etc. All the subjects were informed with the detected items and agreed to participate in the study.METHODS: All the 9 patients with ischemic stroke at acute period and 9 healthy subjects were examined with MRI, T1 weighted imaging, T2 weighted imaging and DTI. And the data were processed offline with dTV.Ⅱ software, the images of fractional anisotropy and directional encoded color (DEC) were obtained, and the three-dimensional fibrous band images of bilateral corticospinal tracts were reconstructed. In the control group, the values of fractional anisotropy

  4. Elevated global SUMOylation in Ubc9 transgenic mice protects their brains against focal cerebral ischemic damage.

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    Yang-Ja Lee

    Full Text Available We have previously shown that a massive increase in global SUMOylation occurs during torpor in ground squirrels, and that overexpression of Ubc9 and/or SUMO-1 in cell lines and cortical neurons protects against oxygen and glucose deprivation. To examine whether increased global SUMOylation protects against ischemic brain damage, we have generated transgenic mice in which Ubc9 is expressed strongly in all tissues under the chicken β-actin promoter. Ubc9 expression levels in 10 founder lines ranged from 2 to 30 times the endogenous level, and lines that expressed Ubc9 at modestly increased levels showed robust resistance to brain ischemia compared to wild type mice. The infarction size was inversely correlated with the Ubc9 expression levels for up to five times the endogenous level. Although further increases showed no additional benefit, the Ubc9 expression level was highly correlated with global SUMO-1 conjugation levels (and SUMO-2,3 levels to a lesser extent up to a five-fold Ubc9 increase. Most importantly, there were striking reciprocal relationships between SUMO-1 (and SUMO-2,3 conjugation levels and cerebral infarction volumes among all tested animals, suggesting that the limit in cytoprotection by global SUMOylation remains undefined. These results support efforts to further augment global protein SUMOylation in brain ischemia.

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

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    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.

  6. electrical stimulation of the vagus nerve protects against cerebral ischemic injury through an anti-inlfammatory mechanism

    Institute of Scientific and Technical Information of China (English)

    Yao-xian Xiang; Wen-xin Wang; Zhe Xue; Lei Zhu; Sheng-bao Wang; Zheng-hui Sun

    2015-01-01

    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 stimula-tion (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-α and in-terleukin-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-α and interleukin-6 expression.

  7. Effects of angiopoietin-1 on hemorrhagic transformation and cerebral edema after tissue plasminogen activator treatment for ischemic stroke in rats.

    Science.gov (United States)

    Kawamura, Kunio; Takahashi, Tetsuya; Kanazawa, Masato; Igarashi, Hironaka; Nakada, Tsutomu; Nishizawa, Masatoyo; Shimohata, Takayoshi

    2014-01-01

    An angiogenesis factor, angiopoietin-1 (Ang1), is associated with the blood-brain barrier (BBB) disruption after focal cerebral ischemia. However, whether hemorrhagic transformation and cerebral edema after tissue plasminogen activator (tPA) treatment are related to the decrease in Ang1 expression in the BBB remains unknown. We hypothesized that administering Ang1 might attenuate hemorrhagic transformation and cerebral edema after tPA treatment by stabilizing blood vessels and inhibiting hyperpermeability. Sprague-Dawley rats subjected to thromboembolic focal cerebral ischemia were assigned to a permanent ischemia group (permanent middle cerebral artery occlusion; PMCAO) and groups treated with tPA at 1 h or 4 h after ischemia. Endogenous Ang1 expression was observed in pericytes, astrocytes, and neuronal cells. Western blot analyses revealed that Ang1 expression levels on the ischemic side of the cerebral cortex were decreased in the tPA-1h, tPA-4h, and PMCAO groups as compared to those in the control group (P = 0.014, 0.003, and 0.014, respectively). Ang1-positive vessel densities in the tPA-4h and PMCAO groups were less than that in the control group (p = 0.002 and cerebral homogenate (p = 0.007) and cerebral edema due to BBB damage (p = 0.038), as compared to administering COMP protein alone. In conclusion, Ang1 might be a promising target molecule for developing vasoprotective therapies for controlling hemorrhagic transformation and cerebral edema after tPA treatment.

  8. PET Demonstrates Functional Recovery after Treatment by Danhong Injection in a Rat Model of Cerebral Ischemic-Reperfusion Injury.

    Science.gov (United States)

    Wang, Zefeng; Song, Fahuan; Li, Jinhui; Zhang, Yuyan; He, Yu; Yang, Jiehong; Zhou, Huifen; Zhao, Tao; Fu, Wei; Xing, Panke; Wan, Haitong; Tian, Mei; Zhang, Hong

    2014-01-01

    This study aimed to investigate neuroprotection of Danhong injection (DHI) in a rat model of cerebral ischemia using (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET). Method. Rats were divided into 5 groups: sham group, ischemia-reperfusion untreated (IRU) group, DHI-1 group (DHI 1 mL/kg/d), DHI-2 group (DHI 2 mL/kg/d), and DHI-4 group (DHI 4 mL/kg/d). AII the treated groups were intraperitoneally injected with DHI daily for 14 days. The therapeutic effects in terms of cerebral infarct volume, neurological function, and cerebral glucose metabolism were evaluated. Expression of TNF-α and IL-1β was detected with enzyme-linked immunosorbent assay (ELISA). Levels of mature neuronal marker (NeuN), glial marker (GFAP), vascular density factor (vWF), and glucose transporter 1 (GLUT1) were assessed by immunohistochemistry. Results. Compared with the IRU group, rats treated with DHI showed dose dependent reductions in cerebral infarct volume and levels of proinflammatory cytokines, improvement of neurological function, and recovery of cerebral glucose metabolism. Meanwhile, the significantly increased numbers of neurons, gliocytes, and vessels and the recovery of glucose utilization were found in the peri-infarct region after DHI treatment using immunohistochemical analysis. Conclusion. This study demonstrated the metabolic recovery after DHI treatment by micro-PET imaging with (18)F-FDG and the neuroprotective effects of DHI in a rat model of cerebral ischemic-reperfusion injury.

  9. PET Demonstrates Functional Recovery after Treatment by Danhong Injection in a Rat Model of Cerebral Ischemic-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Zefeng Wang

    2014-01-01

    Full Text Available This study aimed to investigate neuroprotection of Danhong injection (DHI in a rat model of cerebral ischemia using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET. Method. Rats were divided into 5 groups: sham group, ischemia-reperfusion untreated (IRU group, DHI-1 group (DHI 1 mL/kg/d, DHI-2 group (DHI 2 mL/kg/d, and DHI-4 group (DHI 4 mL/kg/d. AII the treated groups were intraperitoneally injected with DHI daily for 14 days. The therapeutic effects in terms of cerebral infarct volume, neurological function, and cerebral glucose metabolism were evaluated. Expression of TNF-α and IL-1β was detected with enzyme-linked immunosorbent assay (ELISA. Levels of mature neuronal marker (NeuN, glial marker (GFAP, vascular density factor (vWF, and glucose transporter 1 (GLUT1 were assessed by immunohistochemistry. Results. Compared with the IRU group, rats treated with DHI showed dose dependent reductions in cerebral infarct volume and levels of proinflammatory cytokines, improvement of neurological function, and recovery of cerebral glucose metabolism. Meanwhile, the significantly increased numbers of neurons, gliocytes, and vessels and the recovery of glucose utilization were found in the peri-infarct region after DHI treatment using immunohistochemical analysis. Conclusion. This study demonstrated the metabolic recovery after DHI treatment by micro-PET imaging with 18F-FDG and the neuroprotective effects of DHI in a rat model of cerebral ischemic-reperfusion injury.

  10. The Neuroprotective Effect of Rosemary (Rosmarinus officinalis L.) Hydro-alcoholic Extract on Cerebral Ischemic Tolerance in Experimental Stroke

    Science.gov (United States)

    Seyedemadi, Parisa; Rahnema, Mehdi; Bigdeli, Mohammad Reza; Oryan, Shahrebano; Rafati, Hassan

    2016-01-01

    The prevention of BBB breakdown and the subsequent vasogenic edema are important parts of the medical management of ischemic stroke. The purpose of this study was to investigate the ischemic tolerance effect of Rosmarinus officinalis leaf hydro-alcoholic extract (RHE). Five groups of animals were designed: sham (underwent surgery without MCAO) and MCAO groups, the MCAO groups were pretreated orally by gavages with RHE (50, 75, and 100 mg/Kg/day), daily for 30 days. Two hours after the last dose, serum lipid levels were determined and then the rats were subjected to 60 min of middle cerebral artery occlusion followed by 24 h of reperfusion. Subsequently, brain infarct size, brain edema and Evans Blue dye extravasations were measured and neurological deficits were scored. Dietary RHE could significantly reduce cortical and sub-cortical infarct volumes (211.55 ± 24.88 mm3 vs. 40.59 ± 10.04 mm3 vs. 29.96 ± 12.19 mm3vs. 6.58 ± 3.2 mm3), neurologic deficit scores, cerebral edema (82.34 ± 0.42% vs. 79.92 ± 0.49% vs. 79.45 ± 0.26% vs. 79.30 ± 0.19%), blood–brain barrier (BBB) permeability (7.73 ± 0.4 μg/g tissue vs. 4.1 ± 0.23 μg/g tissue vs. 3.58 ± 0.3 μg/g tissue vs. 3.38 ± 0.25 μg/g tissue) in doses of 50, 75 and 100 mg/Kg/day as compared with the control group in the transient model of focal cerebral ischemia. Although pretreatment with RHE plays an important role in the generation of tolerance against cerebral I/R injury, further studies are needed to clarify the mechanism of the ischemic tolerance. PMID:28243285

  11. 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.

  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.

    Science.gov (United States)

    Guo, Zongjun; Wang, Lumin

    2012-07-25

    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. Cerebral ischemia/stroke and small ubiquitin-like modifier (SUMO) conjugation--a new target for therapeutic intervention?

    Science.gov (United States)

    Yang, Wei; Sheng, Huaxin; Homi, H Mayumi; Warner, David S; Paschen, Wulf

    2008-08-01

    Transient cerebral ischemia/stroke activates various post-translational protein modifications such as phosphorylation and ubiquitin conjugation that are believed to play a major role in the pathological process triggered by an interruption of blood supply and culminating in cell death. A new system of post-translational protein modification has been identified, termed as small ubiquitin-like modifier (SUMO) conjugation. Like ubiquitin, SUMO is conjugated to the lysine residue of target proteins in a complex process. This review summarizes observations from recent experiments focusing on the effect of cerebral ischemia on SUMO conjugation. Transient global and focal cerebral ischemia both induced a rapid, dramatic and long-lasting rise in levels of SUMO2/3 conjugation. After transient focal cerebral ischemia, SUMO conjugation was particularly prominent in neurons located at the border of the ischemic territory where SUMO-conjugated proteins translocated to the nucleus. Many SUMO conjugation target proteins are transcription factors and sumoylation has been shown to have a major impact on the activity, stability, and cellular localization of target proteins. The rise in levels of SUMO-conjugated proteins is therefore likely to have a major effect on the fate of post-ischemic neurons. The sumoylation process could provide an exciting new target for therapeutic intervention.

  14. Structural network connectivity and cognition in cerebral small vessel disease

    NARCIS (Netherlands)

    Tuladhar, A.M.; Dijk, E.J. van; Zwiers, M.P.; Norden, A.G.W. van; Laat, K.F. de; Shumskaya, A.N.; Norris, D.G; Leeuw, F.E. de

    2016-01-01

    Cerebral small vessel disease (SVD), including white matter hyperintensities (WMH), lacunes and microbleeds, and brain atrophy, are related to cognitive impairment. However, these magnetic resonance imaging (MRI) markers for SVD do not account for all the clinical variances observed in subjects with

  15. Sublingual Microvascular Changes in Patients With Cerebral Small Vessel Disease

    NARCIS (Netherlands)

    M. Khalilzada; K. Dogan; C. Ince; J. Stam

    2011-01-01

    Background and Purpose-It is unknown whether changes in cerebral small vessel disease (SVD) are limited to the brain or part of a generalized vascular disorder. Methods-We examined the sublingual microcirculation of 10 healthy controls, 10 patients with large vessel disease, and 8 with SVD, with sid

  16. Fullerenols and glucosamine fullerenes reduce infarct volume and cerebral inflammation after ischemic stroke in normotensive and hypertensive rats.

    Science.gov (United States)

    Fluri, Felix; Grünstein, Dan; Cam, Ertugrul; Ungethuem, Udo; Hatz, Florian; Schäfer, Juliane; Samnick, Samuel; Israel, Ina; Kleinschnitz, Christoph; Orts-Gil, Guillermo; Moch, Holger; Zeis, Thomas; Schaeren-Wiemers, Nicole; Seeberger, Peter

    2015-03-01

    Cerebral inflammation plays a crucial role in the pathophysiology of ischemic stroke and is involved in all stages of the ischemic cascade. Fullerene derivatives, such as fullerenol (OH-F) are radical scavengers acting as neuroprotective agents while glucosamine (GlcN) attenuates cerebral inflammation after stroke. We created novel glucosamine-fullerene conjugates (GlcN-F) to combine their protective effects and compared them to OH-F regarding stroke-induced cerebral inflammation and cellular damage. Fullerene derivatives or vehicle was administered intravenously in normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) immediately after transient middle cerebral artery occlusion (tMCAO). Infarct size was determined at day 5 and neurological outcome at days 1 and 5 after tMCAO. CD68- and NeuN-staining were performed to determine immunoreactivity and neuronal survival respectively. Cytokine and toll like receptor 4 (TLR-4) expression was assessed using quantitative real-time PCR. Magnetic resonance imaging revealed a significant reduction of infarct volume in both, WKY and SHR that were treated with fullerene derivatives. Treated rats showed an amelioration of neurological symptoms as both OH-F and GlcN-F prevented neuronal loss in the perilesional area. Cerebral immunoreactivity was reduced in treated WKY and SHR. Expression of IL-1β and TLR-4 was attenuated in OH-F-treated WKY rats. In conclusion, OH-F and GlcN-F lead to a reduction of cellular damage and inflammation after stroke, rendering these compounds attractive therapeutics for stroke.

  17. Post-hypoxic and ischemic neuroprotection of BMP-7 in the cerebral cortex and caudate-putamen tissue of rat.

    Science.gov (United States)

    Luan, Liju; Yang, Xiaomei; Zhou, Changman; Wang, Ke; Qin, Lihua

    2015-03-01

    Previous reports have indicated that exogenous bone morphogenetic protein-7 (BMP-7) has a neuroprotective effect after cerebral ischemia injury and promotes motor function recovery, but the appropriate BMP-7 concentration and time course are unclear. Here, we assessed endogenous BMP-7 expression in hypoxia and ischemia-damaged brain tissues and investigated the effects of different BMP-7 concentrations in pre- and post-hypoxic primary rat neurons. The results showed that BMP-7 expression was significantly higher in the ischemic hemisphere. The expressions of BMP-7 and caspase-3 were localized in the cytoplasm of the primary cerebral cortical and caudate-putamen neurons 24h after hypoxia/reoxygenation. After BMP-7 treatment, the number of caspase-3 positive neurons began to decrease with increasing BMP-7 concentrations up to 80ng/ml, but not beyond. Although the numbers of caspase-3-positive neurons between pre- and post-hypoxia/reoxygenation were not significantly different, more dendrites were observed in the groups treated prior to hypoxia/reoxygenation. These results suggest that increased BMP-7 expression can be induced in the cerebral cortex and caudate-putamen both in vivo and in vitro in hypoxic-ischemic states. The neuroprotective mechanism of BMP-7 may include apoptosis suppression, and its effect was enhanced from 40 to 80ng/ml. Pre-hypoxic BMP-7 treatment may be useful to stimulate dendrite sprouting in non-injured neurons.

  18. 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.

  19. 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.

  20. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer [Klinikum der Universitaet Muenchen (Germany). Abt. fuer Neuroradiologie

    2011-03-15

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  1. Improving effect of Ginkgolide B on mitochondrial respiration of ischemic neuron after cerebral thrombosis in tree shrews

    Institute of Scientific and Technical Information of China (English)

    LI Shu-qing; ZHANG Ying; YANG Li-jun

    2007-01-01

    Background It has been known that platelet activating factor receptors (PAFR) may mediate many acute pathological responses and that PAFR antagonist Ginkgolide B (GB) possesses multiple effects, but the actions of GB on PAFR affinity and mitochondrial respiration in the ischemic neuron were unclear until now. This study explored the possible effects of GB on PAFR and the mitochondrial respiration of the neuron in the ischemic microenvironment.Methods Thrombotic cerebral ischemia in tree shrews was induced by a photochemical reaction; changes in the regional cerebral blood flow (rCBF, using 99mTc tracer technique ), the brain water content (specific gravimetric method), PAFR (3H-labelled PAF assay), the respiratory control rate (RCR), the phosphorus-oxygen (P/O) ratio of mitochondrial respiration (Clark oxygen electrode), mitochondrial permeability transition (MPT) pore, and the mitochondrial ultrastructure in the ischemic neurons were also observed. Data were compared between the two groups (the ischemia group vs the sham group, and the ischemia group vs the GB group).Results There were high affinity and low affinity sites for PAFR on the tree threws' brain cell membranes. The varying-affinity PAFR binding sites, the respiration state Ⅲ, the state Ⅳ, RCR, the P/O ratio of the mitochondria, and the rCBF all decreased markedly (respectively, P<0.01 and P<0.05), but the water content increased (P<0.01) in the ischemia group after the application of cerebral thrombosis. In tree shrews treated with GB (5 mg/kg I.v.) 6 hours after photochemical reaction, their PAFR binding sites and respiratory state increased markedly. The rCBF gradually increased and the brain edema ameliorated (P<0.01) at 24h after cerebral ischemia. There were significant differences between the ischemia group and sham group (P<0.01). In GB treated isolated neurons' mitochondria, with or without cerebral ischemia, the energy metabolism of the mitochondria had not been changed

  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. Multiple small bowel ruptures due to ischemic enteritis: A case report

    Institute of Scientific and Technical Information of China (English)

    Stylianos Delikoukos; Gregorios Christodoulidis; Dimitrios Zacharoulis; Antigoni Poultsidi; Constantine Hatzitheofilou

    2006-01-01

    A rare case of multiple small bowel ruptures due to ischemic enteritis (ISE) is reported. The patient was admitted to the hospital with acute abdominal pain followed by bloody diarrhoeas. Preoperative colonoscopic findings were similar to those presented in Crohn's disease. Tntraoperatively, ischemic lesions and multiple ruptures were localized at the jejunum and the proximal ileum. Histopathological examination of the resected bowel segment established the diagnosis of ISE. Although ISE is not common, concurred multiple ruptures of the small bowel is a rare but actual complication.

  4. Neuroprotection of Ischemic Preconditioning is Mediated by Thioredoxin 2 in the Hippocampal CA1 Region Following a Subsequent Transient Cerebral Ischemia.

    Science.gov (United States)

    Lee, Jae-Chul; Park, Joon Ha; Kim, In Hye; Cho, Geum-Sil; Ahn, Ji Hyeon; Tae, Hyun-Jin; Choi, Soo Young; Cho, Jun Hwi; Kim, Dae Won; Kwon, Young-Guen; Kang, Il Jun; Won, Moo-Ho; Kim, Young-Myeong

    2016-04-26

    Preconditioning by brief ischemic episode induces tolerance to a subsequent lethal ischemic insult, and it has been suggested that reactive oxygen species are involved in this phenomenon. Thioredoxin 2 (Trx2), a small protein with redox-regulating function, shows cytoprotective roles against oxidative stress. Here, we had focused on the role of Trx2 in ischemic preconditioning (IPC)-mediated neuroprotection against oxidative stress followed by a subsequent lethal transient cerebral ischemia. Animals used in this study were randomly assigned to six groups; sham-operated group, ischemia-operated group, IPC plus (+) sham-operated group, IPC + ischemia-operated group, IPC + auranofin (a TrxR2 inhibitor) + sham-operated group and IPC + auranofin + ischemia-operated group. IPC was subjected to a 2 minutes of sublethal transient ischemia 1 day prior to a 5 minutes of lethal transient ischemia. A significant loss of neurons was found in the stratum pyramidale (SP) of the hippocampal CA1 region (CA1) in the ischemia-operated-group 5 days after ischemia-reperfusion; in the IPC + ischemia-operated-group, pyramidal neurons in the SP were well protected. In the IPC + ischemia-operated-group, Trx2 and TrxR2 immunoreactivities in the SP and its protein level in the CA1 were not significantly changed compared with those in the sham-operated-group after ischemia-reperfusion. In addition, superoxide dismutase 2 (SOD2) expression, superoxide anion radical ( O2-) production, denatured cytochrome c expression and TUNEL-positive cells in the IPC + ischemia-operated-group were similar to those in the sham-operated-group. Conversely, the treatment of auranofin to the IPC + ischemia-operated-group significantly increased cell damage/death and abolished the IPC-induced effect on Trx2 and TrxR2 expressions. Furthermore, the inhibition of Trx2R nearly cancelled the beneficial effects of IPC on SOD2 expression, O2- production, denatured cytochrome c

  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. 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

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

    DEFF Research Database (Denmark)

    Pynnönen, Lauri; Minkkinen, Minna; Perner, Anders;

    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...

  8. Anti-CD11b monoclonal antibody reduces ischemic cell damage after transient focal cerebral ischemia in rat.

    Science.gov (United States)

    Chen, H; Chopp, M; Zhang, R L; Bodzin, G; Chen, Q; Rusche, J R; Todd, R F

    1994-04-01

    We investigated the effect of an anti-CD11b monoclonal antibody (1B6c) on ischemic cell damage after transient middle cerebral artery occlusion. We divided animals into three groups: MAb 1 group (n = 5)--rats were subjected to 2 hours of transient occlusion and 1B6c (1 mg/kg) was administered intravenously at 0 and 22 hours of reperfusion; MAb 2 group (n = 5)--same experimental protocol as MAb 1 group, except that the initial dose of 1B6c was increased to 2 mg/kg; and control group (n = 5)--same experimental protocol as MAb 2 group, except that an isotype-matched control antibody was administered. Animals were weighed and tested for neurological function before and after occlusion of the middle cerebral artery. Forty-six hours after reperfusion, brain sections were stained with hematoxylin and eosin for histology evaluation. We observed a significant reduction of weight loss and improvement in neurological function after ischemia in the MAb 2 animals compared to MAb 1 and vehicle-treated animals (p < 0.05). The lesion volume was significantly smaller in the MAb 2 group (19.5 +/- 1.9%) compared to MAb 1 (29.9 +/- 2.6%) and vehicle-treated (34.2 +/- 5.4%) groups (p < 0.01). Tissue polymorphonuclear cell numbers were reduced in both 1B6c-administered groups. Our data demonstrate that administration of anti-CD11b antibody results in a dose-dependent, significant functional improvement and reduction of ischemic cell damage after transient focal cerebral ischemia in the rat.

  9. 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.

  10. 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.)

  11. Oral Levosimendan Increases Cerebral Blood Flow Velocities in Patients with a History of Stroke or Transient Ischemic Attack: A Pilot Safety Study

    Directory of Open Access Journals (Sweden)

    Matti Kivikko, MD, PhD

    2015-12-01

    Conclusions: Oral levosimendan increases cerebral blood flow velocities and diminishes NT-pro-BNP levels in patients with earlier ischemic cerebrovascular event. Daily doses up to 1.0 mg were well tolerated, whereas the 2.0 mg dose level induced an increase in ventricular extrasystoles. ClinicalTrials.gov identifier: NCT00698763.

  12. 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

  13. Semiquantitative regional cerebral blood flow evaluation using sup 123 I-IMP SPECT in a case showing transient ischemic attack caused by putaminal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Y.; Ayada, Y.; Takahashi, T.; Toyama, Y.; Matsuo, H. (Second Department of Internal Medicine, Kagawa Medical School (Japan)); Katsuragawa, M.; Tanabe, M. (Department of Radiology, Kagawa Medical School (Japan))

    1991-01-01

    A 69-year-old woman presented a transient cerebral ischemic attack, showing left arm weakness and slurred speech which recovered within 4 h of onset, while computed tomography indicated a putaminal hemorrhage. The regional cerebral blood flow distribution, measured semiquantitatively by use of {sup 123}I amphetamine emission tomography, was disturbed, which persisted more than one month up to a maximum of 4.5 months from the onset of symptoms. the case illustrates a variety of putaminal hemorrhage of good functional and vital prognosis, and provides and example in which the regional cerebral blood flow disturbances might persist for more than one month up to 4.5 months after the occurrence of a transient ischemic attack caused by a putaminal hemorrhage. (author).

  14. Risk factors and clinical features of mild cognitive impairment in patients with ischemic cerebral small vessel disease:a retrospective case series study%缺血性脑小血管病患者轻度认知障碍的危险因素和临床特征:回顾性病例系列研究

    Institute of Scientific and Technical Information of China (English)

    樊亚超; 王海峰; 王新; 孔伟; 邢成名

    2012-01-01

    1.01)分对(4.04±0.99)分;t=13.824,P=0.000]等亚项得分均显著低于非MCI组,而命名和定向力得分无显著差异.在MCI组中,LA-LI组MoCA总分[(17.04±6.15)分对(21.04±3.98)分;P<0.05]以及视空间/执行功能[(1.68± 1.16)分对(3.24±1.13)分;P<0.05]、注意力[(3.92±2.03)分对(5.19±0.87)分;P<0.05]、延迟回忆[(1.35±1.01)分对(1.86±1.58)分;P<0.05]等亚项得分显著低于U组;LA组MoCA总分[(18.18±5.31)分对(21.04±3.98)分;P<0.05]以及视空间/执行功能[(2.56±1.78)分对(3.24±1.13)分;P<0.05]、语言[(0.64±0.23)分对(1.24±0.83)分;P< 0.05]、延迟回忆[(0.69±0.58)分对(1.86±1.58)分;P<0.01]等亚项得分显著低于LI组;LA-LI组视空间/执行功能评分显著低于LA组[(1.68±1.16)分对(2.56±1.78)分;P<0.05]和LI组[(1.68±1.16)分对(3.24±1.13)分;P<0.05].结论 高血压、糖尿病、高脂血症、颈动脉粥样硬化、吸烟和受教育水平较低是SVD患者MCI的独立危险因素.SVD后MCI的认知损害表现为包括视空间/执行功能、延迟回忆在内的多个认知域损害,不同类型脑小血管病之间的认知损害有所不同.%Objective To investigate the risk factors and clinical features of mild cognitive impairment (MCI) in patients with ischemic cerebral small vessel disease (SVD) for early diagnosis and prevention.Methods Montreal Cognitive Assessment Scale (MoCA) was used to screen MCI.The related risk factors and other clinical data were collected,and other neuropsychological tests were conducted.SVD was divided into leukoaraiosis (LA),lacunar infarction (LI),and LA + LI.Results A total of 143 patients with SVD were enrolled (68 in an MCI group,75 in a non-MCI group).Univariate analysis showed that there was no significant difference in the constituent ratio of age and gender between the MCI group and the non-MCI group,but the years of education in the MCI group was shorter than that in the non-MCI group,while the

  15. Ischemic postconditioning enhances glycogen synthase kinase-3β expression and alleviates cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Bo Zhao; Wenwei Gao; Jiabao Hou; Yang Wu; Zhongyuan Xia

    2012-01-01

    The present study established global brain ischemia using the four-vessel occlusion method.Following three rounds of reperfusion for 30 seconds,and occlusion for 10 seconds,followed by reperfusion for 48 hours,infarct area,the number of TUNEL-positive cells and Bcl-2 expression were significantly reduced.However,glycogen synthase kinase-3β activity,cortical Bax and caspase-3 expression significantly increased,similar to results following ischemic postconditioning.Our results indicated that ischemic postconditioning may enhance glycogen synthase kinase-3β activity,a downstream molecule of the phosphatase and tensin homolog deleted on chromosome 10/phosphatidylinositol 3-kinase/protein kinase B signaling pathway,which reduces caspase-3 expression to protect the brain against ischemic injury.

  16. Cerebral ischemia-induced mitochondrial changes in a global ischemic rat model by AFM.

    Science.gov (United States)

    Park, Eunkuk; Choi, Seok Keun; Kang, Sung Wook; Pak, Youngmi Kim; Lee, Gi-Ja; Chung, Joo-Ho; Park, Hun-Kuk

    2015-04-01

    Mitochondria play a central role in cell survival, and apoptotic cell death is associated with morphological changes in mitochondria. Quantification of the morphological and mechanical property changes in brain mitochondria is useful for evaluating the degree of ischemic injury and the neuroprotective effects of various drugs. This study was performed to investigate the changes in brain mitochondria in an 11-vessel occlusion ischemic model treated with magnesium sulfate (MgSO4), utilizing atomic force microscopy (AFM). Rats were randomly divided into three groups consisting of sham (n=6), global ischemia (GI, n=6), and MgSO4-treated global ischemia (MgSO4, n=6). The biophysical properties of brain mitochondria determined from AFM topographic images and adhesion force from force-distance measurements. The mean perimeter of ischemic mitochondria significantly increased to 2,396±541 nm (vs. 1,006±318 nm in control group, PAFM could be effective for evaluating neuronal injury and drug effects.

  17. Monocarboxylate transporter 4 plays a significant role in the neuroprotective mechanism of ischemic preconditioning in transient cerebral ischemia

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    Seongkweon Hong

    2015-01-01

    Full Text Available Monocarboxylate transporters (MCTs, which carry monocarboxylates such as lactate across biological membranes, have been associated with cerebral ischemia/reperfusion process. In this study, we studied the effect of ischemic preconditioning (IPC on MCT4 immunoreactivity after 5 minutes of transient cerebral ischemia in the gerbil. Animals were randomly designated to four groups (sham-operated group, ischemia only group, IPC + sham-operated group and IPC + ischemia group. A serious loss of neuron was found in the stratum pyramidale of the hippocampal CA1 region (CA1, not CA2/3, of the ischemia-only group at 5 days post-ischemia; however, in the IPC + ischemia groups, neurons in the stratum pyramidale of the CA1 were well protected. Weak MCT4 immunoreactivity was found in the stratum pyramidale of the CA1 in the sham-operated group. MCT4 immunoreactivity in the stratum pyramidale began to decrease at 2 days post-ischemia and was hardly detected at 5 days post-ischemia; at this time point, MCT4 immunoreactivity was newly expressed in astrocytes. In the IPC + sham-operated group, MCT4 immunoreactivity in the stratum pyramidale of the CA1 was increased compared with the sham-operated group, and, in the IPC + ischemia group, MCT4 immunoreactivity was also increased in the stratum pyramidale compared with the ischemia only group. Briefly, present findings show that IPC apparently protected CA1 pyramidal neurons and increased or maintained MCT4 expression in the stratum pyramidale of the CA1 after transient cerebral ischemia. Our findings suggest that MCT4 appears to play a significant role in the neuroprotective mechanism of IPC in the gerbil with transient cerebral ischemia.

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

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    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

  19. EEG indices in patients with high risk of ischemic stroke as predictors of initial disturbed cerebral circulation

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    N. A. Isaeva

    2014-01-01

    Full Text Available Abnormal changes were detected in EEG in patients with high risk of ischemic stroke (higher level than in the population. These changes show the disturbances in forming mechanisms of functional condition of cerebrum during the calm wakeful period. Changes were represented by: the registration of EEG IV- type (the E.A. Zhirmunsky type which was characterized by disorganization of alpha activity and of slow waves; the instability of pattern during the record of background activity; the paroxysmal activity in form of flashes of the bilateral synchronized waves; the strengthening of low-frequency and high-amplitude β-activity. Revealed changes in EEG show the presence of initial disturbed cerebral circulation and can be recommended as predictors of these disturbances.

  20. Regulatory T cells are strong promoters of acute ischemic stroke in mice by inducing dysfunction of the cerebral microvasculature.

    Science.gov (United States)

    Kleinschnitz, Christoph; Kraft, Peter; Dreykluft, Angela; Hagedorn, Ina; Göbel, Kerstin; Schuhmann, Michael K; Langhauser, Friederike; Helluy, Xavier; Schwarz, Tobias; Bittner, Stefan; Mayer, Christian T; Brede, Marc; Varallyay, Csanad; Pham, Mirko; Bendszus, Martin; Jakob, Peter; Magnus, Tim; Meuth, Sven G; Iwakura, Yoichiro; Zernecke, Alma; Sparwasser, Tim; Nieswandt, Bernhard; Stoll, Guido; Wiendl, Heinz

    2013-01-24

    We have recently identified T cells as important mediators of ischemic brain damage, but the contribution of the different T-cell subsets is unclear. Forkhead box P3 (FoxP3)-positive regulatory T cells (Tregs) are generally regarded as prototypic anti-inflammatory cells that maintain immune tolerance and counteract tissue damage in a variety of immune-mediated disorders. In the present study, we examined the role of Tregs after experimental brain ischemia/reperfusion injury. Selective depletion of Tregs in the DEREG mouse model dramatically reduced infarct size and improved neurologic function 24 hours after stroke and this protective effect was preserved at later stages of infarct development. The specificity of this detrimental Treg effect was confirmed by adoptive transfer experiments in wild-type mice and in Rag1(-/-) mice lacking lymphocytes. Mechanistically, Tregs induced microvascular dysfunction in vivo by increased interaction with the ischemic brain endothelium via the LFA-1/ICAM-1 pathway and platelets and these findings were confirmed in vitro. Ablation of Tregs reduced microvascular thrombus formation and improved cerebral reperfusion on stroke, as revealed by ultra-high-field magnetic resonance imaging at 17.6 Tesla. In contrast, established immunoregulatory characteristics of Tregs had no functional relevance. We define herein a novel and unexpected role of Tregs in a primary nonimmunologic disease state.

  1. 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;

    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 re...

  2. Current pathophysiological concepts in Cerebral Small Vessel Disease

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    Fred eRincon

    2014-03-01

    Full Text Available The association between cerebral small vessel disease (SVD – in the form of white matter lesions, infarctions, and hemorrhages – with vascular cognitive impairment (VCI, has mostly been deduced from observational studies. Pathological conditions affecting the small vessels of the brain and leading to SVD have suggested plausible molecular mechanisms involved in vascular damage and their impact on brain function. However, much still needs to be clarified in understanding the pathophysiology of VCI, the role of neurodegenerative processes such as Alzheimer disease, and the impact of aging itself. In addition, both genetic predispositions and environmental exposures may potentiate the development of SVD and interact with normal aging to impact cognitive function and require further study. Advances in technology, in the analysis of genetic and epigenetic data, neuroimaging such as MRI, and new biomarkers will help to clarify the complex factors leading to SVD and the expression of VCI.

  3. The Efficacy of Single Barrel Superficial Temporal Artery-middle Cerebral Artery Bypass in Treatment of Adult Patients with Ischemic-type Moyamoya Disease

    Science.gov (United States)

    Ha, Mahnjeong; Choi, Chang Hwa; Lee, Jae Il; Cha, Seung Heon; Lee, Sang Weon

    2016-01-01

    Objective So far, there is no study answering the question of which type of surgical technique is practically the most useful in the treatment of adult patients with ischemic type moyamoya disease (MMD). We evaluated the efficacy of single barrel superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in the treatment of adult patients with ischemic type MMD by retrospectively collecting clinical and radiological data. Materials and Methods A retrospective review identified 31 adult patients who underwent 43 single barrel STA-MCA bypass procedures performed for treatment of ischemic-type MMD between 2006 and 2014. The male to female ratio was 17:14 and the mean age was 41 years (range, 21-65 years). Peri-operative complications, angiographic and clinical outcomes were analyzed retrospectively. Results The permanent neurological morbidity and mortality rates were 2.3% and 0%, respectively. During the observation period of a mean of 35 months (range, 12-73 months), 29 patients (93.5%) had no further cerebrovascular events and transient ischemic attack occurred in two patients (6.5%), resulting in an annual stroke risk of 2.2%. Follow-up computed tomography perfusion (CTP) (mean, 18.4 months after surgery) documented improved cerebral hemodynamics in the revascularized hemispheres (p < 0.001). Post-operative patency was clearly verified in 38 bypasses (88.4%) of 43 bypasses on follow-up imaging (mean, 16.5 months). Conclusion Our results suggest that single barrel STA-MCA bypass with wide dural opening is safe and durable method of cerebral revascularization in adult patients with ischemic type MMD and can be considered as a potential treatment option for adult patients with ischemic type MMD. PMID:27847768

  4. [A Case of Aplastic or Twig-Like Middle Cerebral Artery Presenting with an Intracranial Hemorrhage Two Years after a Transient Ischemic Attack].

    Science.gov (United States)

    Uchiyama, Taku; Okamoto, Hiroaki; Koguchi, Motofumi; Tajima, Yutaka; Suzuyama, Kenji

    2016-02-01

    Aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare anatomical anomaly, which can be associated with intracranial hemorrhage and cerebral ischemia. A 52-year-old woman who presented with sudden headache was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging showed no abnormality; however, magnetic resonance angiogram revealed an occlusion or severe stenosis in the left middle cerebral artery. Three-dimensional CT angiography demonstrated severe stenosis in the left middle cerebral artery. The patient was discharged without any neurological deficit; however, she subsequently complained of temporary weakness in the right hand. It was possibly due to a transient ischemic attack; therefore, cilostazol 200 mg/day was administered for prevention of cerebral ischemia. Single photon emission computed tomography(with or without administration of acetazolamide)showed neither significant decrease in the cerebral blood flow nor cerebrovascular reactivity; hence, surgical revascularization was not performed. However, two years after the initial admission, she was urgently admitted to our hospital with sudden headache and nausea followed by aphasia and weakness of the right extremities. CT images showed diffuse subarachnoid hemorrhage and intracerebral hemorrhage in the left temporo-parietal lobe. Cerebral angiography revealed that the left middle cerebral artery was Ap/T-MCA without cerebral aneurysms. The patient was treated conservatively, and she eventually recovered without any neurological deficit except mild aphasia. Since Ap/T-MCA is associated with both hemorrhagic and ischemic stroke, antiplatelet therapy should be administered carefully. Moreover, it is necessary to consider extracranial-intracranial bypass to reduce hemodynamic stress on the abnormal vessels.

  5. The usefulness of percutaneous transluminal angioplasty of the middle cerebral artery stenosis in patients with transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Chul; Lim, Hyo Soon; Kim, Jae Kyu; Seo, Jeong Jin; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National Univ. Medical School, Kwangju (Korea, Republic of)

    2001-06-01

    To determine the effectiveness of percutaneous transluminal angioplasty(PTA) of atherosclerotic middle cerebral artery(MCA) stenosis in patients with transient ischemic attack (TIA). Ten patients with TIA who had undergone PTA were retrospectively investigated. In all ten, angiography revealed stenosis of the MCA. Mechanical dilatation was performed at the stenotic portion, and the angiographic findings after PTA, as well as peri/post-angioplastic complications, were evaluated. Four to 64 (mean, 23.5) months later, neurologic symptoms and the nature and timing of recurrent attacks were also assessed. The degree of stenosis before PTA was 50-75% in six patients and greater than 75% in four. Complete or partial angiographic recanalization of the stenotic segment occurred in nine patients (90%). During follow-up, seven patients recovered without recurrent TIA or cerebral stroke; one reported a tingling sensation and one experienced vertebrobasilar insufficiency. Motor aphasia developed in one patient after PTA, but after systemic heparinization, improved within 24 hours. One patient who suffered intracranial hemorrhage due to vascular rupture during PTA did three days later. PTA for atherosclerotic MCA stenosis in patients with TIA is an effective therapeutic method.

  6. Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke

    Science.gov (United States)

    Steinkellner, Oliver; Gruber, Clemens; Wabnitz, Heidrun; Jelzow, Alexander; Steinbrink, Jens; Fiebach, Jochen B.; MacDonald, Rainer; Obrig, Hellmuth

    2010-11-01

    We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

  7. Urgent endarterectomy using pretreatment with free radical scavenger, edaravone, and early clamping of the parent arteries for cervical carotid artery stenosis with crescendo transient ischemic attacks caused by mobile thrombus and hemodynamic cerebral ischemia. Case report.

    Science.gov (United States)

    Kobayashi, Masakazu; Ogasawara, Kuniaki; Inoue, Takashi; Saito, Hideo; Komoribayashi, Nobukazu; Suga, Yasunori; Ogawa, Akira

    2007-03-01

    A 68-year-old man with left cervical internal carotid artery stenosis suffered crescendo transient ischemic attacks caused by mobile thrombus detected by carotid echography and secondary impairment of cerebral hemodynamic reserve demonstrated by positron emission tomography. Urgent carotid endarterectomy (CEA) was performed following pretreatment with edaravone and early clamping of the carotid arteries without intraluminal shunting. The postoperative course was uneventful, and postoperative magnetic resonance imaging and single-photon emission computed tomography revealed no new cerebral ischemic lesions and no findings of cerebral hyperperfusion, respectively. The risks associated with CEA are higher for patients with evolving stroke or crescendo transient ischemic attacks than that for patients with stable disease. This case demonstrates that urgent endarterectomy for cervical carotid artery stenosis with crescendo transient ischemic attacks caused by mobile thrombi and hemodynamic cerebral ischemia can be successfully performed following pretreatment with edaravone and early clamping of the carotid arteries.

  8. 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.

  9. SPECT measurement of cerebral hemodynamics in transient ischemic attack patients; Evaluation of pathogenesis and detection of misery perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Toyama, Hiroshi; Takeshita, Gen; Takeuchi, Akira; Ejiri, Kazutaka; Maeda, Hisato; Katada, Kazuhiro; Koga, Sukehiko; Ishiyama, Norio; Kanno, Tetsuo (Fujita-Gakuen Health Univ., Toyoake, Aichi (Japan))

    1989-12-01

    To evaluate the cerebral hemodynamics and the pathogenesis by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV), 42 transient ischemic attack (TIA) patients and 9 normal volunteers were studied using SPECT. We classified these patients into Group A (n=23: no occlusion or stenosis of the internal carotid or middle cerebral artery; non large vessel disease) and Group B (n=19: chronic occlusion or severe stenosis of the internal carotid or middle cerebral artery; large vessel disease). We obtained rCBF with {sup 133}Xe inhalation and rCBV with {sup 99m}Tc-red blood cells. Of 9 normal volunteers aged 43-70 yr (mean age 59.8{plus minus} 8.3 yr), the mean rCBF was 45.8{plus minus} 5.1 (ml/100 g brain/min), the mean rCBV was 4.0{plus minus} 0.4 (ml/100 g brain). The examination was done by comparing the values of the affected hemispheres of Group A and Group B patients with the mean rCBF and the mean rCBV of normal volunteers. Eleven out of Group A patients and 15 out of Group B patients showed decreased rCBF. But of those patients, no patients of Group A showed increased rCBV and 6 out of 19 Group B patients showed increased rCBV. Thromboembolic mechanism which is of Group A patients and Group B patients without increased rCBV, and hemodynamic mechanism which is of Group B patients with increased rCBV were considered as the main cause of TIA. Decreased rCBF and increased rCBV in Group B patients can be assumed as the misery perfusion as reported in PET studies. We conclude that SPECT measurement of not only rCBF but also rCBV on TIA patients is very significant to evaluate the pathogenesis and to detect the misery perfusion. (author).

  10. Subtypes of ischemic cerebral circulation disorders at young age: diagnosis and treatment

    OpenAIRE

    Natalia Vyacheslavovna Pizova

    2012-01-01

    The paper shows that it is urgent to study stroke in young patients aged 15—45 years. In accordance with the TOAST classification, the author presents the major pathogenetic subtypes of ischemic stroke (IS): atherothromboembolic, cardioembolic, lacunar, that of other known and unknown etiology. The clinical picture and diagnostic principles of IS at young age are considered. Particular emphasis is laid on therapy for IS. It is pointed out that the leading therapy option in these patients is t...

  11. 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.

  12. Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses

    Institute of Scientific and Technical Information of China (English)

    Philipp Anton Holzner; Birte Kulemann; Simon Kuesters; Sylvia Timme; Jens Hoeppner; Ulrich Theodor Hopt; Goran Marjanovic

    2011-01-01

    AIM: To investigate the influence of remote ischemic preconditioning (RIPC) on anastomotic integrity. METHODS: Sixty male Wistar rats were randomized to six groups. The control group (n = 10) had an endto- end ileal anastomosis without RIPC. The preconditioned groups (n = 34) varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis (n = 9). On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosal ischemic injury were collected. The data are given as median (range). RESULTS: On postoperative day 4, median bursting pressure was 124 mmHg (60-146 mmHg) in the control group. The experimental groups did not show a statistically significant difference (P > 0.05). Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra- abdominal adhesions in the preconditioned groups than in the control group. CONCLUSION: RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning.

  13. 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.

  14. 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

  15. Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke

    DEFF Research Database (Denmark)

    Hermitte, Laure; Cho, Tae-Hee; Ozenne, Brice;

    2013-01-01

    BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to exp...

  16. Early protective effect of ischemic preconditioning on small intestinal graft in rats

    Institute of Scientific and Technical Information of China (English)

    Shu-Feng Wang; Guo-Wei Li

    2003-01-01

    AIM: To investigate the early protective effect of ischemic preconditioning on small intestinal graft in rats.METHODS: SD rats were randomly divided into the following groups: sham operation group (S group, n=6),small bowel transplantation group (SBT group, n=12),ischemic preconditioning plus small bowel transplantation group (ISBT group, n=12). Heterotopic SBT was performed with a technique modified from that described by Monchik et al.When the graft was revascularized successfully and reperfused for 1 h, samples were obtained from the different groups. Laminin was analyzed with immunohistochemical staining. Quantitative analysis of laminin positive signals was performed using image acquiring analysis system. Apoptotic epithelia of small intestinal graft were detected by the TdT-mediated dUTP nick end labeling method. The morphological change of epithelial basement membrane was observed by transmission electron microscopy.RESULTS: The mean optical density value of laminin positive signals was 39.52±2.60, 13.53±0.44, 25.40±1.79,respectively, in S, SBT and ISBT groups. The average optical density value of laminin positive products in SBT group was sharply lower than that in S group (P<0.05). However,the mean optical density value of laminin positive products in ISBT group was significantly higher than that in SBT group (P<0.05). The apoptotic index (AI) in S, SBT and ISBT group was 2.2±0.83,30.8±3.2, 13.2±2.86, respectively.The AI in SBT group was significantly higher than that in S group (P<0.05), and AI in ISBT group was sharply lower than that in SBT group (P<0.05). On transmission electron microscopy, the epithelial basement membrane in S group stayed normal, but in SBT group it became disrupted and collapsed, even disappeared. The lesion of epithelial basement membrane in ISBT group was slighter compared with that in SBT group.CONCLUSION: Ischemic preconditioning has an early protective effect on epithelial cells and extracellur matrix of small

  17. Subtypes of ischemic cerebral circulation disorders at young age: diagnosis and treatment

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    Natalia Vyacheslavovna Pizova

    2012-01-01

    Full Text Available The paper shows that it is urgent to study stroke in young patients aged 15—45 years. In accordance with the TOAST classification, the author presents the major pathogenetic subtypes of ischemic stroke (IS: atherothromboembolic, cardioembolic, lacunar, that of other known and unknown etiology. The clinical picture and diagnostic principles of IS at young age are considered. Particular emphasis is laid on therapy for IS. It is pointed out that the leading therapy option in these patients is thrombolysis; intravenous recombinant tissue plasminogen activator is more frequently used; oral anticoagulants and antiplatelet agents are certain to prescribe.

  18. Pediatric cerebral stroke: susceptibility-weighted imaging may predict post-ischemic malignant edema.

    Science.gov (United States)

    Bosemani, Thangamadhan; Poretti, Andrea; Orman, Gunes; Meoded, Avner; Huisman, Thierry A G M

    2013-10-01

    Susceptibility-weighted imaging (SWI) is an advanced MRI technique providing information on the blood oxygenation level. Deoxyhemoglobin is increased in hypoperfused tissue characterized by SWI-hypointensity, while high oxyhemoglobin concentration within hyperperfused tissue results in a SWI iso- or hyperintensity compared to healthy brain tissue. We describe a child with a stroke, where SWI in addition to excluding hemorrhage and delineating the thrombus proved invaluable in determining regions of hyperperfusion or luxury perfusion, which contributed further to the prognosis including an increased risk of developing post-ischemic malignant edema.

  19. 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.

  20. White matters - The influence of cerebral small-vessel disease on depression, cognition and functioning

    NARCIS (Netherlands)

    Grool, A.M.

    2012-01-01

    Depression and cognitive impairment are highly prevalent in later life, and frequently co-occur. One of the possible mechanisms that may underlie both conditions is the presence of cerebral small-vessel disease. The presence of cerebral small-vessel disease is strongly associated with common vascula

  1. Limb Ischemic Perconditioning Attenuates Blood-Brain Barrier Disruption by Inhibiting Activity of MMP-9 and Occludin Degradation after Focal Cerebral Ischemia

    Science.gov (United States)

    Ren, Changhong; Li, Ning; Wang, Brian; Yang, Yong; Gao, Jinhuan; Li, Sijie; Ding, Yuchuan; Jin, Kunlin; Ji, Xunming

    2015-01-01

    Remote ischemic perconditioning (PerC) has been proved to have neuroprotective effects on cerebral ischemia, however, the effect of PerC on the BBB disruption and underlying mechanisms remains largely unknown. To address these issues, total 90 adult male Sprague Dawley (SD) rats were used. The rats underwent 90-min middle cerebral artery occlusion (MCAO), and the limb remote ischemic PerC was immediately applied after the onset of MCAO. We found that limb remote PerC protected BBB breakdown and brain edema, in parallel with reduced infarct volume and improved neurological deficits, after MCAO. Immunofluorescence studies revealed that MCAO resulted in disrupted continuity of claudin-5 staining in the cerebral endothelial cells with significant gap formation, which was significantly improved after PerC. Western blot analysis demonstrated that expression of tight junction (TJ) protein occludin was significantly increased, but other elements of TJ proteins, claudin-5 and ZO-1, in the BBB endothelial cells were not altered at 48 h after PerC, compared to MCAO group. The expression of matrix metalloproteinase (MMP-9), which was involved in TJ protein degradation, was decreased after PerC. Interestingly, phosphorylated extracellular signal-regulated kinase 1/2 (pERK1/2), an upstream of MMP-9 signaling, was significantly reduced in the PerC group. Our data suggest that PerC inhibits MMP-9-mediated occludin degradation, which could lead to decreased BBB disruption and brain edema after ischemic stroke. PMID:26618042

  2. Mechanism of functional recovery after repetitive transcranial magnetic stimulation (rTMS) in the subacute cerebral ischemic rat model: neural plasticity or anti-apoptosis?

    Science.gov (United States)

    Yoon, Kyung Jae; Lee, Yong-Taek; Han, Tai Ryoon

    2011-10-01

    Repetitive transcranial magnetic stimulation (rTMS) has been studied increasingly in recent years to determine whether it has a therapeutic benefit on recovery after stroke. However, the underlying mechanisms of rTMS in stroke recovery remain unclear. Here, we evaluated the effect of rTMS on functional recovery and its underlying mechanism by assessing proteins associated with neural plasticity and anti-apoptosis in the peri-lesional area using a subacute cerebral ischemic rat model. Twenty cerebral ischemic rats were randomly assigned to the rTMS or the sham group at post-op day 4. A total of 3,500 impulses with 10 Hz frequency were applied to ipsilesional cortex over a 2-week period. Functional outcome was measured before (post-op day 4) and after rTMS (post-op day 18). The rTMS group showed more functional improvement on the beam balance test and had stronger Bcl-2 and weaker Bax expression on immunohistochemistry compared with the sham group. The expression of NMDA and MAP-2 showed no significant difference between the two groups. These results suggest that rTMS in subacute cerebral ischemia has a therapeutic effect on functional recovery and is associated with an anti-apoptotic mechanism in the peri-ischemic area rather than with neural plasticity.

  3. Utilidad de las secuencias potenciadas en susceptibilidad paramagnética (SWI para diferenciar crisis somestésicas de accidentes isquémicos transitorios en un paciente con angiopatía amiloide cerebral The use of SWI-MRI to differentiate between seizures and transient ischemic attacks in a patient with cerebral amyloid angiopathy

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    C. Gasca-Salas

    2011-08-01

    Full Text Available Introducción. La angiopatía amiloide cerebral (AAC se caracteriza por el depósito de β-amiloide en la pared de las arterias de pequeño y mediano calibre de la corteza cerebral y leptomeninges. La sintomatología puede incluir eventos transitorios de diverso origen, pudiendo ser difícil el diagnóstico diferencial en el momento agudo. Caso clínico. Varón con antecedente de ictus isquémico, que presentó crisis somestésicas secundarias a microsangrado cerebral por AAC que simulaban ataques isquémicos transitorios. Se redujo la medicación antiagregante y posteriormente se inició tratamiento antiepiléptico desapareciendo los episodios. Las secuencias de susceptibilidad paramagnética en Resonancia Magnética cerebral fueron de gran utilidad para el diagnóstico (SWI-RM. Conclusiones. Los microsangrados de la AAC pueden manifestarse en forma de crisis, simulando déficits focales sensitivos transitorios que pueden ser atribuidos erróneamente a isquemia cerebral. Este caso sugiere que, incluso si existe historia de accidentes cerebrovasculares isquémicos, deberían considerarse microsangrados por AAC como causa posible de pseudoaccidentes isquémicos transitorios. Las secuencias SWI-RM pueden ser útiles para identificarlos. De este modo puede prevenirse el inicio o escalada del tratamiento antiagregante o anticoagulante, evitando complicaciones potencialmente devastadoras.Background. Cerebral amyloid angiopathy (CAA is characterized by the deposit of β-amyloid on the walls of small and medium-sized arteries of the cerebral cortex and leptomeninges causing cerebral bleeding. Clinical presentations may include transient neurological events for which differential diagnosis can be difficult. Case report. We report a subject with a medical history of recent stroke who presented somesthetic seizures mimicking transient ischemic attacks owing to CAA microbleeding. Antiplatelet treatment was reduced and after lamotrigine was commenced the

  4. 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...

  5. Light scattering change precedes loss of cerebral adenosine triphosphate in a rat global ischemic brain model.

    Science.gov (United States)

    Kawauchi, Satoko; Sato, Shunichi; Ooigawa, Hidetoshi; Nawashiro, Hiroshi; Ishihara, Miya; Kikuchi, Makoto

    2009-08-14

    Measurement of intrinsic optical signals (IOSs) is an attractive technique for monitoring tissue viability in brains since it enables noninvasive, real-time monitoring of morphological characteristics as well as physiological and biochemical characteristics of tissue. We previously showed that light scattering signals reflecting cellular morphological characteristics were closely related to the IOSs associated with the redox states of cytochrome c oxidase in the mitochondrial respiratory chain. In the present study, we examined the relationship between light scattering and energy metabolism. Light scattering signals were transcranially measured in rat brains after oxygen and glucose deprivation, and the results were compared with concentrations of cerebral adenosine triphosphate (ATP) measured by luciferin-luciferase bioluminescence assay. Electrophysiological signal was also recorded simultaneously. After starting saline infusion, EEG activity ceased at 108+/-17s, even after which both the light scattering signal and ATP concentration remained at initial levels. However, light scattering started to change in three phases at 236+/-15s and then cerebral ATP concentration started to decrease at about 260s. ATP concentration significantly decreased during the triphasic scattering change, indicating that the start of scattering change preceded the loss of cerebral ATP. The mean time difference between the start of triphasic scattering change and the onset of ATP loss was about 24s in the present model. DC potential measurement showed that the triphasic scattering change was associated with anoxic depolarization. These findings suggest that light scattering signal can be used as an indicator of loss of tissue viability in brains.

  6. Electroacupuncture pretreatment attenuates cerebral ischemic injury through α7 nicotinic acetylcholine receptor-mediated inhibition of high-mobility group box 1 release in rats

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    Wang Qiang

    2012-01-01

    Full Text Available Abstract Background We have previously reported that electroacupuncture (EA pretreatment induced tolerance against cerebral ischemic injury, but the mechanisms underlying this effect of EA are unknown. In this study, we assessed the effect of EA pretreatment on the expression of α7 nicotinic acetylcholine receptors (α7nAChR, using the ischemia-reperfusion model of focal cerebral ischemia in rats. Further, we investigated the role of high mobility group box 1 (HMGB1 in neuroprotection mediated by the α7nAChR and EA. Methods Rats were treated with EA at the acupoint "Baihui (GV 20" 24 h before focal cerebral ischemia which was induced for 120 min by middle cerebral artery occlusion. Neurobehavioral scores, infarction volumes, neuronal apoptosis, and HMGB1 levels were evaluated after reperfusion. The α7nAChR agonist PHA-543613 and the antagonist α-bungarotoxin (α-BGT were used to investigate the role of the α7nAChR in mediating neuroprotective effects. The roles of the α7nAChR and HMGB1 release in neuroprotection were further tested in neuronal cultures exposed to oxygen and glucose deprivation (OGD. Results Our results showed that the expression of α7nAChR was significantly decreased after reperfusion. EA pretreatment prevented the reduction in neuronal expression of α7nAChR after reperfusion in the ischemic penumbra. Pretreatment with PHA-543613 afforded neuroprotective effects against ischemic damage. Moreover, EA pretreatment reduced infarct volume, improved neurological outcome, inhibited neuronal apoptosis and HMGB1 release following reperfusion, and the beneficial effects were attenuated by α-BGT. The HMGB1 levels in plasma and the penumbral brain tissue were correlated with the number of apoptotic neurons in the ischemic penumbra. Furthermore, OGD in cultured neurons triggered HMGB1 release into the culture medium, and this effect was efficiently suppressed by PHA-543,613. Pretreatment with α-BGT reversed the inhibitory effect

  7. Analyzing the Correlation between the Level of Serum Markers and Ischemic Cerebral Vascular Disease by Multiple Parameters

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    Laibin Dong

    2015-01-01

    Full Text Available Objective. To explore the serum markers associated with ischemic cerebral vascular disease (ICVD and discuss their diagnostic value. Methods. Two hundred and eighty-eight patients with ICVD and one hundred and eighty healthy persons were enrolled as the case group and the control group, respectively. This paper then carried out the univariate and multivariate logistic regression analyses of their respective levels of serum markers, made combined analysis of related factors, and detected the diagnostic value. Results. Meta-analysis results showed that for ICVD patients the levels of CRP, S-100, TNF-α, HCY, NSE, and IL-6 were higher than those of the healthy persons, while the level of HDL was obviously lower than that of the healthy persons. The multivariate regression analysis indicated that the association between the level of HDL and TNF-α and the occurrence of ICVD was statistically significant (P<0.05. The area under the curves (AUC of receiver operating characteristic (ROC curve of HDL and TNF-α was 0.916, with sensitivity of 90.91% and specificity of 76.47%. Conclusion. HDL has negative correlation with the occurrence of ICVD, while TNF-α was positively correlated with it. The combination test of HDL and TNF-α could raise the accuracy of ICVD diagnosis.

  8. Cerebral small vessel disease: targeting oxidative stressas a novel therapeutic strategy?

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    Alyson Anne Miller

    2016-03-01

    Full Text Available Cerebral small vessel disease (SVD is a major contributor to stroke, and a leading cause of cognitive impairment and dementia. Despite the devastating effects of cerebral SVD, the pathogenesis of cerebral SVD is still not completely understood. Moreover, there are no specific pharmacological strategies for its prevention or treatment. Cerebral SVD is characterized by marked functional and structural abnormalities of the cerebral microcirculation. The clinical manifestations of these pathological changes include lacunar infarcts, white matter hyperintensities, and cerebral microbleeds. The main purpose of this review is to discuss evidence implicating oxidative stress in the ateriopathy of both non-amyloid and amyloid (cerebral amyloid angiopathy forms of cerebral SVD and its most important risk factors (hypertension and aging, as well as its contribution to cerebral SVD-related brain injury and cognitive impairment. We also highlight current evidence of the involvement of the NADPH oxidases in the development of oxidative stress, enzymes that are a major source of reactive oxygen species in the cerebral vasculature. Lastly, we discuss potential pharmacological strategies for oxidative stress in cerebral SVD, including some of the historical and emerging NADPH oxidase inhibitors.

  9. CT and MRI findings of cerebral ischemic lesions in the cortical and perforating arterial system

    Energy Technology Data Exchange (ETDEWEB)

    Kameyama, Masakuni; Udaka, Fukashi; Nishinaka, Kazuto; Kodama, Mitsuo; Urushidani, Makoto; Kawamura, Kazuyuki; Inoue, Haruhisa; Kageyama, Taku [Sumitomo Hospital, Osaka (Japan)

    1995-07-01

    It is clinically useful to divide the location of infarction into the cortical and perforating arterial system. Computerized tomography (CT) and magnetic resonance imaging (MRI) now make the point of infarction a simple and useful task in daily practice. The diagnostic modality has also demonstrated that risk factors and clinical manifestations are different for infarction in the cortical as opposed to the perforating system. In this paper, we present various aspects of images of cerebral ischemia according to CT and/or MRI findings. With the advance of imaging mechanics, diagnostic capability of CT or/and MRI for cerebral infarction has markedly been improved. We must consider these points on evaluating the previously reported results. In addition, we always consider the pathological background of these image-findings for the precise interpretation of their clinical significance. In some instances, dynamic study such as PET or SPECT is needed for real interpretations of CT and/or MRI images. We paid special reference to lacunar stroke and striatocapsular infarct. In addition, `branch atheromatous disease (Caplan)` was considered, in particular, for their specific clinical significances. Large striatocapsular infarcts frequently show cortical signs and symptoms such as aphasia or agnosia in spite of their subcortical localization. These facts, although have previously been known, should be re-considered for their pathoanatomical mechanism. (author).

  10. 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

  11. Disruption of rich club organisation in cerebral small vessel disease.

    Science.gov (United States)

    Tuladhar, Anil M; Lawrence, Andrew; Norris, David G; Barrick, Thomas R; Markus, Hugh S; de Leeuw, Frank-Erik

    2017-04-01

    Cerebral small vessel disease (SVD) is an important cause of vascular cognitive impairment. Recent studies have demonstrated that structural connectivity of brain networks in SVD is disrupted. However, little is known about the extent and location of the reduced connectivity in SVD. Here they investigate the rich club organisation-a set of highly connected and interconnected regions-and investigate whether there is preferential rich club disruption in SVD. Diffusion tensor imaging (DTI) and cognitive assessment were performed in a discovery sample of SVD patients (n = 115) and healthy control subjects (n = 50). Results were replicated in an independent dataset (49 SVD with confluent WMH cases and 108 SVD controls) with SVD patients having a similar SVD phenotype to that of the discovery cases. Rich club organisation was examined in structural networks derived from DTI followed by deterministic tractography. Structural networks in SVD patients were less dense with lower network strength and efficiency. Reduced connectivity was found in SVD, which was preferentially located in the connectivity between the rich club nodes rather than in the feeder and peripheral connections, a finding confirmed in both datasets. In discovery dataset, lower rich club connectivity was associated with lower scores on psychomotor speed (β = 0.29, P SVD is characterized by abnormal connectivity between rich club hubs in SVD and provide evidence that abnormal rich club organisation might contribute to the development of cognitive impairment in SVD. Hum Brain Mapp 38:1751-1766, 2017. © 2017 Wiley Periodicals, Inc.

  12. Cerebral Small Vessel Disease: Cognition, Mood, Daily Functioning, and Imaging Findings from a Small Pilot Sample

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    John G. Baker

    2012-04-01

    Full Text Available Cerebral small vessel disease, a leading cause of cognitive decline, is considered a relatively homogeneous disease process, and it can co-occur with Alzheimer’s disease. Clinical reports of magnetic resonance imaging (MRI/computed tomography and single photon emission computed tomography (SPECT imaging and neuropsychology testing for a small pilot sample of 14 patients are presented to illustrate disease characteristics through findings from structural and functional imaging and cognitive assessment. Participants showed some decreases in executive functioning, attention, processing speed, and memory retrieval, consistent with previous literature. An older subgroup showed lower age-corrected scores at a single time point compared to younger participants. Performance on a computer-administered cognitive measure showed a slight overall decline over a period of 8–28 months. For a case study with mild neuropsychology findings, the MRI report was normal while the SPECT report identified perfusion abnormalities. Future research can test whether advances in imaging analysis allow for identification of cerebral small vessel disease before changes are detected in cognition.

  13. A case of spontaneous myocardial necrosis and cerebral ischemic lesions in a laboratory beagle dog.

    Science.gov (United States)

    Matsushita, Kohei; Kohara, Yukari; Ito, Yuko; Yoshikawa, Tsuyoshi; Sato, Makoto; Kitaura, Keisuke; Matsumoto, Satoshi

    2015-10-01

    A beagle dog treated with saline as a control animal in a preclinical study was euthanized due to sudden systemic deterioration. On histopathological examination, contraction band necrosis of myocardial cells was observed widely in the left ventricular wall, including the papillary muscle and apex, and observed slightly in the ventricular septum and left atrium. In the brain, necrosis was observed in neurons and glia of the cerebral cortex, hippocampal pyramidal cells, glial cells of the rostral commissure and Purkinje cells of the cerebellar vermis. It is highly probable that the marked systemic deterioration was caused by cardiac dysfunction due to the spontaneous contraction band necrosis of the myocardial cells, although the pathogenesis of the myocardial lesions remains unclear. Given the distribution of neuronal necrosis in the brain, it is likely that these lesions resulted from the ischemia responsible for acute cardiac failure.

  14. Synthesis of Lipoamino Acids and Their Activity against Cerebral Ischemic Injury

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    Yang Lu

    2009-10-01

    Full Text Available A series of lipoamino acids were synthesized and their neuroprotective effect against brain ischemia induced by oxygen-glucose deprivation (OGD on rat cerebral slices was evaluated. Among these compounds, N-stearoyl-L-tyrosine (4, N-stearoyl-L-serine (5 and N-stearoyl-L-threonine (6 exhibited good neuroprotective activity. We found that the neuroprotective activity of lipoamino acids depended on the acyl group, the presence of a free carboxylic function and a free hydroxyl group at the branched chain of the amino acids. The results also showed that 5 was the most active compound, protecting rat brain slices against OGD as well as hydrogen peroxide (H2O2 insult at the range of 1–10 M.

  15. Cerebral blood flow in small vessel disease : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-01-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that as

  16. Cerebral Small Vessel Disease in Dementia and Depression: a prospective population-based MRI study

    NARCIS (Netherlands)

    N.D. Prins (Niels)

    2004-01-01

    markdownabstract__Abstract__ Cerebral white matter lesions and asymptomatic brain infarcts are common in elderly people. These brain lesions are thought to result from cerebral small vessel disease, and their presence and severity increase with age and the presence of arterial hypertension. There i

  17. 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

  18. Efficacy and safety of rt-PA intravenous thrombolysis in the treatment of acute ischemic stroke with hyperdense middle cerebral artery sign: a systematic review

    Directory of Open Access Journals (Sweden)

    Xin TAN

    2016-01-01

    Full Text Available Objective To systematically review the efficacy and safety of recombinant tissue-type plasminogen activator (rt-PA intravenous thrombolysis in the treatment of acute ischemic stroke with hyperdense middle cerebral artery sign (HMCAS on CT images. Methods Search online databases such as PubMed, EMBASE/SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL and China Biology Medicine (CBM from January 1994 to December 2014 with key words: hyperdense middle cerebral artery sign/HMCAS/hyperdense artery sign/hyperdense cerebral artery sign, ischemic stroke/cerebral infarction/brain infarction/cerebral embolism, thrombolysis/thrombolytic therapy/rt-PA/recombinant tissue plasminogen activator both in Chinese and English, to collect randomized controlled trials (RCTs or non-RCTs about rt-PA treating patients with acute ischemic stroke and HMCAS. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Newcastle-Ottawa Scale (NOS was used for quality assessment, and Meta-analysis was performed using RevMan 5.2 software. Results A total of 8 studies were included after excluding duplicate ones and those which did not meet the inclusion criteria from 166 articles. There were 11 373 patients, including 2455 cases complicated with HMCAS (2316 treated by rt-PA and 139 treated by placebo and 8918 cases without HMCAS. Meta-analysis showed the occurrence of unfavorable outcome in rt-PA treatment was significantly decreased compared to placebo in HMCAS-positive patients (OR = 0.360,95%CI: 0.150-0.850; P = 0.020, while there was no statistical difference in the occurrence of symptomatic intracerebral hemorrhage (sICH between rt-PA and placebo treatment in HMCAS-positive patients (OR = 1.640, 95%CI: 0.380-7.040; P = 0.500. Meta-analysis also showed unfavorable outcome of rt-PA treatment was significantly higher in HMCAS-positive than in HMCAS

  19. NOC/oFQ contributes to hypoxic-ischemic impairment of N-methyl-D-aspartate-induced cerebral vasodilation.

    Science.gov (United States)

    Armstead, W M

    2000-06-16

    Previous studies in piglets show that either hypoxia, ischemia-reperfusion (I+R) or combined hypoxia-ischemia-reperfusion (H+I+R) attenuated N-methyl-D-aspartate (NMDA)-induced pial artery dilation. This study was designed to determine the contribution of the newly described opioid nociceptin orphanin FQ (NOC/oFQ) to hypoxic-ischemic impairment of NMDA induced cerebral vasodilation in piglets equipped with a closed cranial window. Global cerebral ischemia was produced via elevated intracranial pressure. Hypoxia decreased P(O(2)) to 35+/-3 mmHg with unchanged P(CO(2)). I+R elevated CSF NOC/oFQ from 67+/-4 to 266+/-29 pg/ml ( approximately 10(-10) M) while H+I+R elevated CSF NOC/oFQ to 483+/-67 pg/ml within 1 h of reperfusion. Such elevated NOC/oFQ levels returned to control within 4 h in I+R animals and within 12 h in H+I+R animals. Topical NOC/oFQ (10(-10) M) had no effect on pial artery diameter by itself but attenuated NMDA (10(-8), 10(-6) M) induced pial dilation (control, 9+/-1 and 16+/-1; coadministered NOC/oFQ, 5+/-1 and 10+/-1%). NMDA induced pial artery dilation was attenuated by I+R or H+I+R; but such dilation was partially restored by pretreatment with the putative NOC/oFQ antagonist [F/G] NOC/oFQ (1-13) NH(2) (10(-6) M) (control, 9+/-1 and 16+/-1; I+R, 3+/-1 and 5+/-1; I+R+NOC/oFQ antagonist, 6+/-1 and 11+/-1%) Similar results were obtained for glutamate. These data suggest that NOC/oFQ release contributes to impaired NMDA and glutamate-induced cerebrovasodilation following I+R or H+I+R.

  20. 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.

  1. Neuroprotective Effect of Scutellarin on Ischemic Cerebral Injury by Down-Regulating the Expression of Angiotensin-Converting Enzyme and AT1 Receptor.

    Directory of Open Access Journals (Sweden)

    Wenjuan Wang

    Full Text Available Previous studies have demonstrated that angiotensin-converting enzyme (ACE is involved in brain ischemic injury. In the present study, we investigated whether Scutellarin (Scu exerts neuroprotective effects by down-regulating the Expression of Angiotensin-Converting Enzyme and AT1 receptor in a rat model of permanent focal cerebral ischemia.Adult Sprague-Dawley rats were administrated with different dosages of Scu by oral gavage for 7 days and underwent permanent middle cerebral artery occlusion (pMCAO. Blood pressure was measured 7 days after Scu administration and 24 h after pMCAO surgery by using a noninvasive tail cuff method. Cerebral blood flow (CBF was determined by Laser Doppler perfusion monitor and the neuronal dysfunction was evaluated by analysis of neurological deficits before being sacrificed at 24 h after pMCAO. Histopathological change, cell apoptosis and infarct area were respectively determined by hematoxylin-eosin staining, terminal deoxynucleotidyl transfer-mediated dUTP nick end labeling (TUNEL analysis and 2,3,5-triphenyltetrazolium chloride staining. Tissue angiotensin II (Ang II and ACE activity were detected by enzyme-linked immunosorbent assays. The expression levels of ACE, Ang II type 1 receptor (AT1R, tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6, and interleukin-1β (IL-1β were measured by Western blot and real-time PCR. ACE inhibitory activity of Scu in vitro was detected by the photometric determination.Scu treatment dose-dependently decreased neurological deficit score, infarct area, cell apoptosis and morphological changes induced by pMCAO, which were associated with reductions of ACE and AT1R expression and the levels of Ang II, TNF-α, IL-6, and IL-1β in ischemic brains. Scu has a potent ACE inhibiting activity.Scu protects brain from acute ischemic injury probably through its inhibitory effect on the ACE/Ang II/AT1 axis, CBF preservation and proinflammation inhibition.

  2. Cerebral blood flow in small vessel disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-10-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that assessed cerebral blood flow in small vessel disease patients, performed meta-analysis and sensitivity analysis of potential confounders. Thirty-eight studies (n = 4006) met the inclusion criteria, including four longitudinal and 34 cross-sectional studies. Most cerebral blood flow data were from grey matter. Twenty-four cross-sectional studies (n = 1161) were meta-analysed, showing that cerebral blood flow was lower in subjects with more white matter hyperintensity, globally and in most grey and white matter regions (e.g. mean global cerebral blood flow: standardised mean difference-0.71, 95% CI -1.12, -0.30). These cerebral blood flow differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies (n = 1079) gave differing results, e.g., more baseline white matter hyperintensity predated falling cerebral blood flow (3.9 years, n = 575); cerebral blood flow was low in regions that developed white matter hyperintensity (1.5 years, n = 40). Cerebral blood flow is lower in subjects with more white matter hyperintensity cross-sectionally, but evidence for falling cerebral blood flow predating increasing white matter hyperintensity is conflicting. Future studies should be longitudinal, obtain more white matter data, use better age-correction and stratify by clinical diagnosis.

  3. [Ischemic stroke and the ways of compensation of cerebral circulation in patients with nonspecific aorto-arteritis with lesions of the brachiocephalic arteries].

    Science.gov (United States)

    Kazanchian, P O; Varava, B N; Todua, F I; Kuntsevich, G I; Zotikov, A E; Iudin, V I; Kon, M V; Volokina, O I; Buklina, S B

    1991-01-01

    In patients suffering from nonspecific aortoarteritis associated with impairment of the common carotid arteries, cerebral blood flow is compensated for at the expense of an increase of the volumetric blood flow in the vertebral arteries. During the first three years since the onset of the first disease symptoms, the blood content in the basin of the internal carotid arteries is reduced. Brain strokes occur most frequently within that period. They mostly develop without any preceding transitory ischemic attacks. The origin of neurological symptomatology depends to a considerable measure on the condition of the anterior and posterior communicating arteries.

  4. Evaluation of Risk Factors of Transient Ischemic Attack Progressing into Cerebral Infarction(review)%短暂性脑缺血发作进展为脑梗死的危险因素评估

    Institute of Scientific and Technical Information of China (English)

    薛嫱; 马欣

    2011-01-01

    Transient ischemic attack (TIA) is not only an ischemic cerebrovascular disease with high incidence, but also a risk warning signal of cerebral infarction. This article reviewed the correlation of TIA and cerebral infarction, risk factors of transient ischemic attack progressing into cerebral infarction and its score scale.%短暂性脑缺血发作是发病率较高的缺血性脑血管病,也是脑梗死的危险预警信号.本文就短暂性脑缺血发作与脑梗死的相关性、进展为脑梗死的危险因素及量表评估进行综述.

  5. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    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 ischemic focus...

  6. 青年缺血性脑卒中50例临床病因分析%The clinical analysis of cerebral ischemic stroke in youth in 50 cases

    Institute of Scientific and Technical Information of China (English)

    祝善尧; 方克炳; 葛伟; 张业敏

    2011-01-01

    Objective To analyze the clinical characteristics, subtypes, risk factors, and prognosis of cerebral ischemic stroke in youth. Methods The clinical data of 50 young patients with cerebral ischemic stroke were retrospectively analyzed. Results There were more males than females in the young patients with cerebral infarction, 79. 5% vs 20. 5%; The type of lacunar infarction is dominant; Hypertension, arteriosclerosis, smoking, obesity and family history were risk factors in these young patients with cerebral infarction and smoking is prominent, 67.5%. Prognosis of cerebral ischemic stroke in youth is relative good. Conclusion The incidence of cerebral ischemic stroke in youth is increasing and the number of male exceeds that of femal; Hypertension,arteriosclerosis, smoking, obesity and family history are risk factors for cerebral ischemic stroke in the young patients; Prognosis of cerebral ischemic stroke in youth is relative optimistic. More further studies are needed, measures should be actively taken to get rid of these factors in order to reduce the incidence of cerebral ischemic stroke in youth radically.%目的 分析青年缺血性脑卒中临床特点、亚型、危险因素和预后.方法 回顾性地分析50例青年缺血性脑卒中临床病例.结果 男女比例为79.5%∶ 20.5%,亚型以腔隙性脑梗死为主,青年脑梗死与高血压、动脉硬化、吸烟、肥胖及家族史相关,以吸烟为著,占67.5%.青年缺血性脑卒中预后相对比较好.结论 青年缺血性脑卒中发病率正在逐步增长且男性超过女性;高血压、动脉硬化、吸烟、肥胖和家族史是青年缺血性卒中常见的危险因素;青年卒中的预后相对较好.进一步的研究是必须的,应该积极去除这些危险因素从根本上减少青年缺血性脑卒中发病率.

  7. Granulocyte-Colony Stimulating Factor Increases Cerebral Blood Flow via a NO Surge Mediated by Akt/eNOS Pathway to Reduce Ischemic Injury

    Directory of Open Access Journals (Sweden)

    Hock-Kean Liew

    2015-01-01

    Full Text Available Granulocyte-colony stimulating factor (G-CSF protects brain from ischemic/reperfusion (I/R injury, and inhibition of nitric oxide (NO synthases partially reduces G-CSF protection. We thus further investigated the effects of G-CSF on ischemia-induced NO production and its consequence on regional cerebral blood flow (rCBF and neurological deficit. Endothelin-1 (ET-1 microinfused above middle cerebral artery caused a rapid reduction of rCBF (ischemia which lasted for 30 minutes and was followed by a gradual recovery of blood flow (reperfusion within the striatal region. Regional NO concentration increased rapidly (NO surge during ischemia and recovered soon to the baseline. G-CSF increased rCBF resulting in shorter ischemic duration and an earlier onset of reperfusion. The enhancement of the ischemia-induced NO by G-CSF accompanied by elevation of phospho-Akt and phospho-eNOS was noted, suggesting an activation of Akt/eNOS. I/R-induced infarct volume and neurological deficits were also reduced by G-CSF treatment. Inhibition of NO synthesis by L-NG-Nitroarginine Methyl Ester (L-NAME significantly reduced the effects of G-CSF on rCBF, NO surge, infarct volume, and neurological deficits. We conclude that G-CSF increases rCBF through a NO surge mediated by Akt/eNOS, which partially contributes to the beneficial effect of G-CSF on brain I/R injury.

  8. 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.

    Science.gov (United States)

    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

    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 sacrificed and right and left hippocampus and cortex were collected. Rats aged 2 and 6 months, respectively, were subjected to the same brain injury protocol, but they were not treated with melatonin. mRNA expression of interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), Bcl-2-associated death promoter (BAD), Bcl-2-associated X protein (BAX), glial fibrillary acidic protein (GFAP), B-cell lymphoma 2 (Bcl-2), and sirtuin 1 was measured by reverse transcription-polymerase chain reaction. In nontreated animals, a significant time-dependent increase in IL-1β, TNF-α, BAD, and BAX was observed in the ischemic area of both hippocampus and cortex, and to a lesser extent in the contralateral hemisphere. Hippocampal GFAP was also significantly elevated, while Bcl-2 and sirtuin 1 decreased significantly in response to ischemia. Aging aggravated these changes. Melatonin administration was able to reverse significantly these alterations. In conclusion, melatonin may ameliorate the age-dependent inflammatory and apoptotic response secondary to ischemic cerebral injury.

  9. Transplanted bone marrow stem cells relocate to infarct penumbra and co-express endogenous proliferative and immature neuronal markers in a mouse model of ischemic cerebral stroke

    Directory of Open Access Journals (Sweden)

    Liu Wei

    2010-10-01

    Full Text Available Abstract Background Several studies demonstrate that neurogenesis may be induced or activated following vascular insults, which may be important for neuronal regeneration and functional recovery. Understanding the cellular mechanism underlying stroke-associated neurogenesis is of neurobiological as well as neurological/clinical relevance. The present study attempted to explore potential homing and early development of transplanted bone marrow stem cells in mouse forebrain after focal occlusion of the middle cerebral artery, an experimental model of ischemic stroke. Results Bone marrow stem cells isolated from donor mice were confirmed by analysis of surface antigen profile, and were pre-labeled with a lipophilic fluorescent dye PKH26, and subsequently transfused into recipient mice with middle cerebral artery coagulation. A large number of PKH26-labeled cells were detected surrounding the infarct site, most of which colocalized with immunolabelings for the proliferating cell nuclear antigen (PCNA and some also colocalized with the immature neuronal marker doublecortin (DCX during 1-2 weeks after the bone marrow cells transfusion. Conclusions The present study shows that transplanted bone morrow cells largely relocate to the infarct penumbra in ischemic mouse cerebrum. These transplanted bone marrow cells appear to undergo a process of in situ proliferation and develop into putative cortical interneurons during the early phase of experimental vascular injury.

  10. 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

  11. 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

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2016-01-01

    Full Text Available 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 qEEG and NIH Stroke Scales (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 stroke.Design:Double blind randomized controlled trial.Setting and Participants:34 subjects with acute MCA ischemic stroke at university affiliated hospital intensive care unit.Interventions:Subjects were randomized into a control group treated only with aspirin (125 mg/day and a treatment group treated with aspirin (125 mg/day and a subject specific EMT. Main Outcome measures: Delta-Alpha Ratio, Power Ratio Index and the Brain Symmetry Index calculated by quantitative electroencephalograms, and NIHSS. Results:There was strong statistical and substantive significant improvement in all outcome measures for the group of stroke patients undergoing EMT. Such improvement was not observed for the control group and there were no adverse effects.Conclusions:The addition of EMT to a MCA ischemic stroke treatment paradigm has demonstrated statistically significant changes in outcome measures and is a low cost, safe and effective complement to standard treatment.

  12. Manejo da hipertensão arterial na isquemia cerebral aguda Management of arterial hypertension in patients with acute ischemic stroke

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    WALTER JOSÉ FAGUNDES-PEREYRA

    1999-12-01

    Full Text Available OBJETIVO: Avaliar o nível de conhecimento dos médicos, através de sua conduta, em paciente com quadro de hipertensão arterial na fase aguda da isquemia cerebral. Também comentamos as principais condutas nesta fase, com ênfase na tensão arterial (TA. MÉTODO: Foram entrevistados 120 médicos da clínica médica e da cirurgia geral, em dez dos maiores Hospitais de Belo Horizonte, em 1997. Todos responderam a um questionário contendo um caso clínico de paciente hipertenso leve, admitido com quadro de isquemia cerebral e tensão arterial de 186x110 mmHg. Os profissionais deveriam optar por reduzir, aumentar ou manter a TA. RESULTADOS: Dos entrevistados, 38 (31,7% responderam que reduziriam os níveis tensionais, 82 (68,3% optaram pela manutenção e nenhum aumentaria (pPURPOSE: We aimed with study to assess the current clinical practice about the management of high blood pressure in patients in the acute phase of ischemic stroke. We also comment some topics of ischemic stroke treatment. METHODS: A case report of a patient admitted 8 hours after onset of ischemic stroke and with blood pressure of 186x110 mmHg was presented to 120 surgeons and clinician. They were asked to decide the best therapeutic option: to increase, decrease or maintenance blood pressure. RESULTS: Thirty-eight physicians (31,7% considered decreasing blood pressure the best therapeutics, 82 (68,3% considered maintenance and none decided to increase it (p < 0.05. There was no difference between the two specialties conduct. The physicians, with more than 10 years of graduation, had a tendency to decrease the blood pressure (p <0.05. CONCLUSION: The maintenance of blood pressure may present a sufficient blood support to compensate brain flow. A high percentage of the physicians (31,7% do not know about the current concepts of therapeutics considering hypertension in acute ischemic stroke. The development on special units to treat these patients ("stroke units" may eventually

  13. Effects of combined ischemic postconditioning, remote ischemic postconditioning and naloxone postconditioning on focal cerebral ischemia-reperfusion injury in rats%联合应用缺血后处理、远隔缺血后处理和纳洛酮后处理对大鼠脑缺血-再灌注损伤的影响

    Institute of Scientific and Technical Information of China (English)

    刘毅; 廖旭; 薛富善; 许亚超; 熊军; 袁玉静; 王强; 刘建华; 赵嘉训

    2011-01-01

    Objective To assess the effects of ischemic postconditioning, remote ischemic postconditioning and naloxone postconditioning on focal cerebral ischemia-reperfusion injury in rats.Methods A total of 110 adult SD rats were randomly divided into 5 groups (n =22 each). The focal cerebral ischemia-reperfusion injury was induced by a 90-minute occlusion of right middle cerebral artery (MCA) and a 24-hour reperfusion sequentially. Group 1 was of ischemia-reperfusion control; Group 2 ischemic postconditioning induced by three 30-second cycles of MCA occlusion followed by a 30-second reperfusion; Group 3 remote ischemic postconditioning performed via a transient occlusion of right femoralartery at 5 min before the initiatlon of reperfusion:Group 4 naloxone posteonditioning with naloxone 10 mg/kg intraperitoneaUy injected at the initiation of reperfusion;Group 5 combined ischemic,remote ischernic & naloxone postconditioning performed simultaneously in accordance with the methods used in Groups 2,3 & 4.The neumlogie deftcit scores(NDS)were obtained at 2 h & 24 h post-reperfusion.At 24 h post-reperfusion.the anesthetized rat was sacrificed by decapitation and the brain rapidly extracted to asseSS the size ofcerebral infaret(n=10),detect the cerebral expression of microtubule-associated protein2(MAP2)(n=6),measure the plasma volume of cerebral tissues and quantify the diameter and segment artery at 5 min before the initiation of reperfusion; Group 4 naloxone postconditioning with naloxone 10 mg/kg intraperitoneally injected at the initiation of reperfusion; Group 5 combined ischemic, remote ischemic & naloxone postconditioning performed simultaneously in accordance with the methods used in Groups 2, 3 & 4. The neurologic deficit scores ( NDS) were obtained at 2 h & 24 h post-reperfusion. At 24 h post-reperfusion, the anesthetized rat was sacrificed by decapitation and the brain rapidly extracted to assess the size of cerebral infarct (n = 10), detect the cerebral expression of

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

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    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.

  15. 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...

  16. 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.

  17. 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...

  18. Anti-apoptotic effects of recombinant human granulocyte colony-stimulating factor in focal cerebral ischemic rats

    Institute of Scientific and Technical Information of China (English)

    Xia Yuan; Shiming Zhang; Wanli Dong; Qi Fang

    2011-01-01

    The neuroprotective effects of granulocyte colony-stimulating factor in cerebral ischemia/reperfusion injury are currently contentious. The present study examined the effects of subcutaneous injection of recombinant human granulocyte colony-stimulating factor (50 μg/kg) over 5 days in a model of cerebral ischemia/reperfusion with intraluminal filament occlusion in rats. The results indicated that recombinant human granulocyte colony-stimulating factor reduced brain infarct volume following cerebral ischemia/reperfusion injury in rats, down-regulated the expression of caspase-3 mRNA (a key protease for apoptosis in the cerebral ischemia zone), lowered the rate of neuronal apoptosis in the cerebral ischemia zone, and notably ameliorated neurological function. These results indicate that recombinant human granulocyte colony-stimulating factor has anti-apoptotic effects on neurons following focal cerebral ischemia/reperfusion injury, and exerts neuroprotective effects.

  19. 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

  20. Effects of Blood Pressure Fluctuations on Cerebral Perfusion after Ischemic Stroke%血压波动对脑梗死后脑灌注的影响

    Institute of Scientific and Technical Information of China (English)

    聂志余; 靳令经

    2011-01-01

    Cerebral infarction affects both cerebral autoregulation and cerebral perfusion. This review article summarizes the published evidence of cerebral autoregulation impairment and cerebral blood flow alteration after cerebral infarction, including cerebrovascular small vessel disease leading to an impairment of vasoreactivity, blood flow velocities and cerebral blood flow associated positively with systemic blood pressure, perfusion declined on the infarcted side and lower blood pressure resulting in hypoperfusion in distal area of the narrowing main cerebral artery. The question should be thought by physicians about what is the 'best blood pressure range' in patients with cerebral infarction and it will be benefit for optimal recovery.%本文主要从脑血管的自动调节与自动调节受损、脑小血管病变可导致脑血管反应性受损、脑梗死患者脑血流速度、脑血流量与血压的相关性,脑梗死侧大脑半球脑灌注降低、低血压对脑主要动脉狭窄者可导致狭窄远端脑组织局部低灌注等几个方面来讨论脑梗死后血压的变化对脑血流速度、脑血流量的影响.给临床医生提出一个思考问题,在脑梗死的急性期把血压控制在多少才是最合适的水平,对患者的功能恢复最有益.

  1. Delivery of a small for gestational age infant and greater maternal risk of ischemic heart disease.

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    Full Text Available BACKGROUND: Delivery of a small for gestational age (SGA infant has been associated with increased maternal risk of ischemic heart disease (IHD. It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. METHODS AND FINDINGS: Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999-2006, a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012. The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011 as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025. Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36 years. CONCLUSIONS: Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD.

  2. 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.

  3. Cerebral Blood Volume ASPECTS Is the Best Predictor of Clinical Outcome in Acute Ischemic Stroke: A Retrospective, Combined Semi-Quantitative and Quantitative Assessment.

    Directory of Open Access Journals (Sweden)

    Marina Padroni

    Full Text Available The capability of CT perfusion (CTP Alberta Stroke Program Early CT Score (ASPECTS to predict outcome and identify ischemia severity in acute ischemic stroke (AIS patients is still questioned.62 patients with AIS were imaged within 8 hours of symptom onset by non-contrast CT, CT angiography and CTP scans at admission and 24 hours. CTP ASPECTS was calculated on the affected hemisphere using cerebral blood flow (CBF, cerebral blood volume (CBV and mean transit time (MTT maps by subtracting 1 point for any abnormalities visually detected or measured within multiple cortical circular regions of interest according to previously established thresholds. MTT-CBV ASPECTS was considered as CTP ASPECTS mismatch. Hemorrhagic transformation (HT, recanalization status and reperfusion grade at 24 hours, final infarct volume at 7 days and modified Rankin scale (mRS at 3 months after onset were recorded.Semi-quantitative and quantitative CTP ASPECTS were highly correlated (p<0.00001. CBF, CBV and MTT ASPECTS were higher in patients with no HT and mRS ≤ 2 and inversely associated with final infarct volume and mRS (p values: from p<0.05 to p<0.00001. CTP ASPECTS mismatch was slightly associated with radiological and clinical outcomes (p values: from p<0.05 to p<0.02 only if evaluated quantitatively. A CBV ASPECTS of 9 was the optimal semi-quantitative value for predicting outcome.Our findings suggest that visual inspection of CTP ASPECTS recognizes infarct and ischemic absolute values. Semi-quantitative CBV ASPECTS, but not CTP ASPECTS mismatch, represents a strong prognostic indicator, implying that core extent is the main determinant of outcome, irrespective of penumbra size.

  4. 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

    Institute of Scientific and Technical Information of China (English)

    Eun Joo Bae; Seongkweon Hong; Dong Won Kim; Jun Hwi Cho; Yun Lyul Lee; Moo-Ho Won; Joon Ha Park; Bai Hui Chen; Bing Chun Yan; Bich Na Shin; Jeong Hwi Cho; In Hye Kim; Ji Hyeon Ahn; Jae Chul Lee; Hyun-Jin Tae

    2015-01-01

    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 ifrst compared ischemia-in-duced 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 signiifcantly 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 signiifcantly 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 signiifcantly decreased at 4 days post-ischemia;however, p63 immunoreactivity in the ischemia-operated young group was signiifcantly 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 ifndings 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.

  5. 自噬在脑缺血性损伤中的作用%Effects of autophagy in cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    丁煌; 唐映红; 黄小平

    2015-01-01

    自噬是一种细胞内成分自我降解的过程,包括自噬的诱导、自噬体膜的形成、自噬体的形成、自噬体与溶酶体的融合以及内容物的降解。自噬若适度激活,则促进细胞存活;若过度激活,则可加重细胞损伤,甚至导致细胞裂解和促进细胞死亡。该文主要从自噬的形成过程及分子机制、脑缺血后自噬的诱发因素、自噬参与脑缺血的信号转导通路及自噬在脑缺血损伤中的作用进行综述,为进一步研究自噬与脑缺血性损伤及其药物调控提供参考。%Autophagy, a process of intracellular component deg-radation, consists of initiation, vesicle membrane, vesicle ex-pansion and completion, vesicle fusion and autophagosome deg-radation. Moderate activation of autophagy may promote cell sur-vival, while excessive activation of autophagy may aggravate cell injury, or even lead to cell lysis and death. This paper mainly reviews the process and the molecular basis of autophagy, as well as trigger factors, signal transduction pathways involved in cere-bral ischemia, along with its effects on ischemic brain injury, which will provide a reference for further probe of autophagy in cerebral ischemic injury and its drug regulation.

  6. 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.

  7. Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel dissease

    NARCIS (Netherlands)

    Laat, de K.F.; Norden, van A.G.W.; Oudheusden, van L.J.B.; Uden, van I.W.M.; Norris, D.G.; Zwiers, M.P.; Leeuw, de F.E.

    2012-01-01

    Although the role of cerebral small vessel disease (SVD), including white matter lesions (WMLs) and lacunar infarcts, in mild parkinsonian signs (MPS) is increasingly being recognized, not all individuals with SVD have MPS. Using diffusion tensor imaging (DTI), we investigated whether the presence o

  8. Through the looking glass: Risk factors, radiological hallmarks and cognitive function in cerebral small vessel disease

    NARCIS (Netherlands)

    Kloppenborg, R.P.

    2014-01-01

    Cerebral small vessel disease’ (CSVD) is een ziekte van de kleine bloedvaatjes in de hersenen. In onderzoek wordt vaak gebruik gemaakt van MRI markers: witte stofafwijkingen en lacunaire infarcten. Beide markers komen vaak voor in de normale bevolking. Dit proefschrift onderzoekt 1) mogelijk andere

  9. Retinal vessel diameters and cerebral small vessel disease: the Rotterdam Scan Study

    NARCIS (Netherlands)

    Ikram, M.K.; Jong, F.J. de; Dijk, E.J. van; Prins, N.D.; Hofman, A.; Breteler, M.M.B.; de Jong, P.T.V.M.

    2006-01-01

    The direct visualization of retinal vessels provides a unique opportunity to study cerebral small vessel disease, because these vessels share many features. It was reported that persons with smaller retinal arteriolar-to-venular ratio tended to have more white matter lesions on MRI. It is unclear wh

  10. Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease

    NARCIS (Netherlands)

    Laat, Karlijn de; Berg, H.A. van den; Norden, Anouk van; Gons, R.A.R.; Olde Rikkert, M.G.M.; Leeuw, F.E. de

    2011-01-01

    BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD), including white matter lesions and lacunar infarcts, is related to gait disturbances. Microbleeds (MB) are another manifestation of SVD, but their clinical impact remains unclear. We therefore investigated the relation between the number a

  11. 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.

  12. 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

    in 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...

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

    Directory of Open Access Journals (Sweden)

    A. Jensen

    2016-01-01

    Full Text Available 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.

  14. Rehabilitation Training and Resveratrol Improve the Recovery of Neurological and Motor Function in Rats after Cerebral Ischemic Injury through the Sirt1 Signaling Pathway

    Science.gov (United States)

    Shi, Na; Zhu, Chongtian

    2016-01-01

    This study was conducted to investigate the recovery of motor function in rats through the silent information regulator factor 2-related enzyme 1 (Sirt1) signal pathway-mediated rehabilitation training. Middle cerebral artery occlusion (MACO) was used to induce ischemia/reperfusion injury. The rats were subjected to no treatment (model), rehabilitation training (for 21 days), resveratrol (5 mg/kg for 21 days), and rehabilitation training plus resveratrol treatment. 24 h later, They were assessed for neurobehavioral score and motor behavior score and expression of brain derived-nerve neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB). Compared with sham group, models had significantly higher neurobehavioral scores, balance beam, and rotary stick scores. Compared with the model group, rats in rehabilitation training and resveratrol groups had significantly reduced scores. Compared with rehabilitation training or resveratrol treatment alone, rehabilitation plus resveratrol further reduced the scores significantly. The percentage of cells expressing BDNF and TrkB and expression levels of BDNF and TrkB were similar between the model and sham groups, significantly increased in rehabilitation training and resveratrol groups, and further increased in rehabilitation training plus resveratrol group. These results indicate that rehabilitation raining plus resveratrol can significantly improve the recovery of motor function in rats after cerebral ischemic injury, which is likely related to the upregulation of the BDNF/TrkB signaling pathway. PMID:28116292

  15. Rehabilitation Training and Resveratrol Improve the Recovery of Neurological and Motor Function in Rats after Cerebral Ischemic Injury through the Sirt1 Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Na Shi

    2016-01-01

    Full Text Available This study was conducted to investigate the recovery of motor function in rats through the silent information regulator factor 2-related enzyme 1 (Sirt1 signal pathway-mediated rehabilitation training. Middle cerebral artery occlusion (MACO was used to induce ischemia/reperfusion injury. The rats were subjected to no treatment (model, rehabilitation training (for 21 days, resveratrol (5 mg/kg for 21 days, and rehabilitation training plus resveratrol treatment. 24 h later, They were assessed for neurobehavioral score and motor behavior score and expression of brain derived-nerve neurotrophic factor (BDNF and tyrosine kinase receptor B (TrkB. Compared with sham group, models had significantly higher neurobehavioral scores, balance beam, and rotary stick scores. Compared with the model group, rats in rehabilitation training and resveratrol groups had significantly reduced scores. Compared with rehabilitation training or resveratrol treatment alone, rehabilitation plus resveratrol further reduced the scores significantly. The percentage of cells expressing BDNF and TrkB and expression levels of BDNF and TrkB were similar between the model and sham groups, significantly increased in rehabilitation training and resveratrol groups, and further increased in rehabilitation training plus resveratrol group. These results indicate that rehabilitation raining plus resveratrol can significantly improve the recovery of motor function in rats after cerebral ischemic injury, which is likely related to the upregulation of the BDNF/TrkB signaling pathway.

  16. Glibenclamide for the prevention of cerebral edema and hemorrhagic transformation in ischemic stroke%格列本脲预防缺血性卒中患者脑水肿和出血性转化

    Institute of Scientific and Technical Information of China (English)

    陈红艳; 王红军

    2015-01-01

    Cerebral edema and hemorrhagic transformation(HT) are the common complications of ischemic stroke. Ischemic cerebral edema is the primary cause of death in patients w ith large infarction. The sulfonylurea receptor 1 (Sur1) transient receptor potential M4 (Trpm4) channel plays an important role in focal cerebral ischemia. Both animal experiment and clinical studies have show n that the Sur1 selective inhibitor glibenclamide provides neuroprotection for ischemic stroke, including infarct volume reduction and improvement of neurological function, especial y in attenuating cerebral edema and reducing the incidence of HT. This article review s the advances in research on glibenclamide for the prevention of cerebral edema and HT in patients w ith ischemic stroke.%脑水肿和出血性转化(hemorrhagictransformation,HT)是缺血性卒中的常见并发症。缺血性脑水肿是大面积脑梗死患者死亡的主要原因。磺脲类受体1(sulfonylurea receptor 1, Sur1)-瞬时受体电位通道M4型(transient receptor potential melastatin 4, Trpm4)通道在局灶性脑缺血中起着重要作用。动物实验和临床研究均显示,Sur1选择性抑制剂格列本脲可为缺血性卒中提供神经保护,包括缩小梗死体积和改善神经功能,特别是减轻脑水肿和降低HT 发生率。文章对格列本脲预防缺血性卒中患者脑水肿和HT的研究进展进行了综述。

  17. The Related Factors of Transient Ischemic Attack Development Cerebral Infarction and Prevention Countermeasures%短暂性脑缺血发作进展为脑梗死的相关因素及预防对策

    Institute of Scientific and Technical Information of China (English)

    翟金健

    2013-01-01

    Objective:To investigate related factors of transient ischemic attack development cerebral infarction and the preventive measures. Methods:Transient ischemic attack development cerebral infarction patients 42 cases as the observation group, randomly selected the same period transient ischemic attack without progressive cerebral infarction 42 patients as control group , two groups patients were observed in initial onset of blood pressure, fasting blood glucose, blood lipid extraction detection, early onset duration, past medical history, statistically analyzed the related factors of two groups of patients. Results:Observation group patients smoking,hyperlipidemia,diab etes,high blood pressure, heart disease higher than that of control group(P<0.05),is related factors of transient ischemic attack development cerebral infarction. Conclusion:Tansient ischemic attack development cerebral infarction is the result of many factors, the implementation of the corresponding measures to prevent transient ischemic attack of cerebral infarction.%目的:探讨短暂性脑缺血发作进展为脑梗死的相关因素及预防措施。方法:选择短暂性脑缺血发作进展为脑梗死患者42例作为观察组,随机选取同期短暂性脑缺血发作未进展性脑梗死42例做为对照组,观察两组患者初次发作时血压,抽取空腹静脉血检测血糖、血脂、初发发作持续时间、既往病史,对两组患者相关因素进行了统计分析。结果观察组吸烟患、高脂血症、糖尿病、高血压、心脏病高于对照组(P<0.05),是引起短暂性脑缺血发作发展为脑梗死相关因素。结论:短暂性脑缺血发作进展为脑梗死是多种因素作用结果,实施相应措施防止短暂性脑缺血发作进展为脑梗死。

  18. 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.)

  19. 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

  20. Does Piroxicam really protect ischemic neurons and influence neuronal firing in cerebral ischemia? An exploration towards therapeutics.

    Science.gov (United States)

    Bhattacharya, Pallab; Pandey, Anand Kumar; Paul, Sudip; Patnaik, Ranjana

    2013-09-01

    Cerebral ischemia is still one of the most confusing and enigmatic neurological disorders with least understood injuries. The EEG measures have been traditionally used to detect residual neural dysfunctions after cerebral ischemia although having several shortcomings, yielding controversial and inconsistent results. It is feasible to hypothesize that advanced EEG research can overcome these shortcomings and provide more clear information regarding the long lasting neural impairment in the subjects suffered from brain stroke. To our understanding, EEG power spectrum density measures can significantly contribute towards intervening drug administered diseased model and give us correct status of neuronal firing after an insult. On the basis of our findings we hypothesize that Piroxicam, a non-steroidal anti-inflammatory drug (NSAID) can protect neurons and improves neuronal firing after ischemia/reperfusion injury in animal model of focal cerebral ischemia. This is the first ever finding which advocates the role of Piroxicam, a NSAID in neuronal firing apart from its other neuroprotective roles. Thus, we consider the possibility of modulation of neuronal firing as a therapeutic strategy to help prevent neuronal dysfunctions in cerebral ischemia.

  1. Reduction in Cerebral Oxygenation due to Patent Ductus Arteriosus Is Pronounced in Small-for-Gestational-Age Neonates

    NARCIS (Netherlands)

    Cohen, Emily; Dix, Laura; Baerts, Willem; Alderliesten, Thomas; Lemmers, Petra; van Bel, Frank

    2016-01-01

    BACKGROUND: A haemodynamically significant patent ductus arteriosus (hsPDA) reduces cerebral oxygenation in appropriate-for-gestational-age (AGA) preterm neonates. Reduced cerebral oxygenation has been associated with brain injury. Preterm small-for-gestational-age (SGA) neonates show higher cerebra

  2. Intelligent data analysis to interpret major risk factors for diabetic patients with and without ischemic stroke in a small population

    Directory of Open Access Journals (Sweden)

    Gürgen Nurgül

    2003-03-01

    Full Text Available Abstract This study proposes an intelligent data analysis approach to investigate and interpret the distinctive factors of diabetes mellitus patients with and without ischemic (non-embolic type stroke in a small population. The database consists of a total of 16 features collected from 44 diabetic patients. Features include age, gender, duration of diabetes, cholesterol, high density lipoprotein, triglyceride levels, neuropathy, nephropathy, retinopathy, peripheral vascular disease, myocardial infarction rate, glucose level, medication and blood pressure. Metric and non-metric features are distinguished. First, the mean and covariance of the data are estimated and the correlated components are observed. Second, major components are extracted by principal component analysis. Finally, as common examples of local and global classification approach, a k-nearest neighbor and a high-degree polynomial classifier such as multilayer perceptron are employed for classification with all the components and major components case. Macrovascular changes emerged as the principal distinctive factors of ischemic-stroke in diabetes mellitus. Microvascular changes were generally ineffective discriminators. Recommendations were made according to the rules of evidence-based medicine. Briefly, this case study, based on a small population, supports theories of stroke in diabetes mellitus patients and also concludes that the use of intelligent data analysis improves personalized preventive intervention.

  3. Blood pressure and sodium: Association with MRI markers in cerebral small vessel disease

    OpenAIRE

    Heye, Anna K.; Thrippleton, Michael J; Chappell, Francesca M; Valdés Hernández, Maria del C.; Armitage, Paul A.; Makin, Stephen D.; Muñoz Maniega, Susana; Sakka, Eleni; Flatman, Peter W.; Dennis, Martin S.; Wardlaw, Joanna M.

    2016-01-01

    Dietary salt intake and hypertension are associated with increased risk of cardiovascular disease including stroke. We aimed to explore the influence of these factors, together with plasma sodium concentration, in cerebral small vessel disease (SVD). In all, 264 patients with nondisabling cortical or lacunar stroke were recruited. Patients were questioned about their salt intake and plasma sodium concentration was measured; brain tissue volume and white-matter hyperintensity (WMH) load were m...

  4. Estudo de fatores clínicos preditivos para crises epilépticas após acidente vascular cerebral isquêmico Preditive clinical factors for epileptic seizures after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Marcia Maiumi Fukujima

    1996-06-01

    Full Text Available Apresentamos aspectos clínicos de 35 pacientes com acidente vascular cerebral isquêmico que evoluíram com crises epilépticas (Grupo 1, comparando-os a 35 pacientes com AVCI sem crises epilépticas (Grupo 2. A comparação das idades entre os grupos não mostrou diferença significante. O sexo masculino e a raça branca predominaram em ambos os grupos. Diabetes melito, hipertensão arterial, ataque isquêmico transitório, acidente vascular cerebral pregresso, enxaqueca, doença de Chagas, embolia cerebral cardiogênica e uso de anticoncepcional oral não diferiram significantemente entre os grupos. Tabagismo e etilismo foram significantemente mais freqüentes no Grupo 1 (pPreditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1 were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2. The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p<0,05. Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  5. EXPLORING PATHOGENIC MECHANISMS IN ISCHEMIC CEREBRAL DEATH: A RAY OF HOPE FOR DESIGNING NEW THERAPEUTIC STRATEGIES FOR STROKE

    Directory of Open Access Journals (Sweden)

    Deshmukh A. B.

    2011-03-01

    Full Text Available In ischemic stroke, the blood supply to the brain is disrupted by cerebrovascular disease. After coronary heart disease (CHD and cancer, stroke is the third commonest cause of death worldwide which necessitates exploring key targets that can treat the disease. Long duration or severe ischemia leads to necrotic cell death. However, if ischemia is transient or incomplete, the genes executing programmed cell death may be activated that depends upon the duration and severity of the ischemic insult which further is dependent on the exact location of the arterial occlusion and whether or not reperfusion occurs. The finely tuned balance of proapoptotic and antiapoptotic is not only a key point in regulating cell death or survival but also serves as a switch between the two forms of cell death, apoptosis and necrosis. Compelling evidences from more recent studies strongly suggest the involvement of cell death/survival signaling pathways. A greater understanding and future studies of the various signaling pathways involved in the pathophysiology of stroke such as Glutaminergic excitotoxic cascade, marked increase in intracellular calcium, PPAR (peroxisome proliferator activated receptor pathways and Hsp (Heat shock protein pathways, role for leukocytes in propagating tissue damage after ischemia and reperfusion may provide novel therapeutic strategies in clinical stroke.

  6. 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.

  7. The Occurrence of Ischemic Cerebral Apoplexy Time Distribution%脑梗死的发生时间分布

    Institute of Scientific and Technical Information of China (English)

    周响玲

    2015-01-01

    We choose from June 2011 to December 2011, our hospital inpatients China-Africa progress for 66 cases of patients with cerebral infarction, the onset time and infarction types conducted a retrospective study. 46 (78%) patients were between 6 and 18 disease; 5 cases (8%) in the pathogenesis of between 0~6. Only 3 patients for watershed cerebral infarction, and had occurred during the day. This study does not support the atherosclerosis cerebral infarction mainly decided by the homodynamic factors.%选择自2011年6月至2011年12月我院住院患者中非进展性脑梗死患者66例,对发病时间和梗死类型进行了回顾性研究。46(78%)例患者6点和18点之间发病;5例(8%)在0~6点之间的发病。仅3位患者为分水岭脑梗死,并且均发生在白天。本研究结果不支持动脉粥样硬化性脑梗死主要由血液动力学因素决定。

  8. Cerebral Small Vessel Disease and Motoric Cognitive Risk Syndrome: Results from the Kerala-Einstein Study

    Science.gov (United States)

    Wang, Nan; Allali, Gilles; Kesavadas, Chandrasekharan; Noone, Mohan L.; Pradeep, Vayyattu G.; Blumen, Helena M.; Verghese, Joe

    2017-01-01

    Background The contribution of cerebral small vessel disease to cognitive decline, especially in non-Caucasian populations, is not well established. Objective We examined the relationship between cerebral small vessel disease and motoric cognitive risk syndrome (MCR), a recently described pre-dementia syndrome, in Indian seniors. Methods 139 participants (mean age 66.6 ± 5.4 y, 33.1% female) participating in the Kerala-Einstein study in Southern India were examined in a cross-sectional study. The presence of cerebral small vessel disease (lacunar infarcts and cerebral microbleeds (CMB)) and white matter hyperintensities on MRI was ascertained by raters blinded to clinical information. MCR was defined by the presence of cognitive complaints and slow gait in older adults without dementia or mobility disability. Results Thirty-eight (27.3%) participants met MCR criteria. The overall prevalence of lacunar infarcts and CMB was 49.6% and 9.4%, respectively. Lacunar infarcts in the frontal lobe, but no other brain regions, were associated with MCR even after adjusting for vascular risk factors and presence of white matter hyperintensities (adjusted Odds Ratio (aOR): 4.67, 95% CI: 1.69–12.94). Frontal lacunar infarcts were associated with slow gait (aOR: 3.98, 95% CI: 1.46–10.79) and poor performance on memory test (β: −1.24, 95% CI: −2.42 to −0.05), but not with cognitive complaints or non-memory tests. No association of CMB was found with MCR, individual MCR criterion or cognitive tests. Conclusions Frontal lacunar infarcts are associated with MCR in Indian seniors, perhaps, by contributing to slow gait and poor memory function. PMID:26757037

  9. Computational Pipeline for NIRS-EEG Joint Imaging of tDCS-Evoked Cerebral Responses—An Application in Ischemic Stroke

    Science.gov (United States)

    Guhathakurta, Debarpan; Dutta, Anirban

    2016-01-01

    Transcranial direct current stimulation (tDCS) modulates cortical neural activity and hemodynamics. Electrophysiological methods (electroencephalography-EEG) measure neural activity while optical methods (near-infrared spectroscopy-NIRS) measure hemodynamics coupled through neurovascular coupling (NVC). Assessment of NVC requires development of NIRS-EEG joint-imaging sensor montages that are sensitive to the tDCS affected brain areas. In this methods paper, we present a software pipeline incorporating freely available software tools that can be used to target vascular territories with tDCS and develop a NIRS-EEG probe for joint imaging of tDCS-evoked responses. We apply this software pipeline to target primarily the outer convexity of the brain territory (superficial divisions) of the middle cerebral artery (MCA). We then present a computational method based on Empirical Mode Decomposition of NIRS and EEG time series into a set of intrinsic mode functions (IMFs), and then perform a cross-correlation analysis on those IMFs from NIRS and EEG signals to model NVC at the lesional and contralesional hemispheres of an ischemic stroke patient. For the contralesional hemisphere, a strong positive correlation between IMFs of regional cerebral hemoglobin oxygen saturation and the log-transformed mean-power time-series of IMFs for EEG with a lag of about −15 s was found after a cumulative 550 s stimulation of anodal tDCS. It is postulated that system identification, for example using a continuous-time autoregressive model, of this coupling relation under tDCS perturbation may provide spatiotemporal discriminatory features for the identification of ischemia. Furthermore, portable NIRS-EEG joint imaging can be incorporated into brain computer interfaces to monitor tDCS-facilitated neurointervention as well as cortical reorganization. PMID:27378836

  10. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    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.)

  11. 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;

    1983-01-01

    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...

  12. 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;

    1982-01-01

    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...

  13. The time course changes in expression of aquaporin 4 and aquaporin 1 following global cerebral ischemic edema in rat

    OpenAIRE

    Gürsoy- Özdemir, Yasemin; Akdemir, G.; Kaymaz, F,; Akalan, N,; Akdemir, E.S.

    2016-01-01

    Background: The aim of this global cerebral ischemia study was to study the changes in expression levels of aquaporin 4 (AQP4) and AQP1 over time. Methods: Sprague-Dawley type male rats were divided into six groups. Sham group and ischemia/reperfusion were performed on five other groups using the four-vessel occlusion model. Reperfusion was done 30 min after the occlusion, and each group was tested at 1, 6, 12, 24, and 48 h for brain wet-dry weight ratio and AQP4 and AQP1 expression levels us...

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

    Directory of Open Access Journals (Sweden)

    I. V. Damulin

    2014-01-01

    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.

  15. Transfusion of CXCR4-primed endothelial progenitor cells reduces cerebral ischemic damage and promotes repair in db/db diabetic mice.

    Directory of Open Access Journals (Sweden)

    Ji Chen

    Full Text Available This study investigated the role of stromal cell-derived factor-1α (SDF-1α/CXC chemokine receptor 4 (CXCR4 axis in brain and endothelial progenitor cells (EPCs, and explored the efficacy of CXCR4 primed EPCs in treating ischemic stroke in diabetes. The db/db diabetic and db/+ mice were used in this study. Levels of plasma SDF-1α and circulating CD34+CXCR4+ cells were measured. Brain SDF-1α and CXCR4 expression were quantified at basal and after middle cerebral artery occlusion (MCAO. In in vitro study, EPCs were transfected with adenovirus carrying null (Ad-null or CXCR4 (Ad-CXCR4 followed with high glucose (HG treatment for 4 days. For pathway block experiments, cells were pre-incubated with PI3K inhibitor or nitric oxide synthase (NOS inhibitor for two hours. The CXCR4 expression, function and apoptosis of EPCs were determined. The p-Akt/Akt and p-eNOS/eNOS expression in EPCs were also measured. In in vivo study, EPCs transfected with Ad-null or Ad-CXCR4 were infused into mice via tail vein. On day 2 and 7, the cerebral blood flow, neurologic deficit score, infarct volume, cerebral microvascular density, angiogenesis and neurogenesis were determined. We found: 1 The levels of plasma SDF-1α and circulating CD34+CXCR4+ cells were decreased in db/db mice; 2 The basal level of SDF-1α and MCAO-induced up-regulation of SDF-1α/CXCR4 axis were reduced in the brain of db/db mice; 3 Ad-CXCR4 transfection increased CXCR4 expression in EPCs and enhanced EPC colonic forming capacity; 4 Ad-CXCR4 transfection prevented EPCs from HG-induced dysfunction (migration and tube formation and apoptosis via activation of PI3K/Akt/eNOS signal pathway; 4 Ad-CXCR4 transfection enhanced the efficacy of EPC infusion in attenuating infarct volume and promoting angiogenesis and neurogenesis. Our data suggest that Ad-CXCR4 primed EPCs have better therapeutic effects for ischemia stroke in diabetes than unmodified EPCs do.

  16. Ischemic strokes and migraine

    Energy Technology Data Exchange (ETDEWEB)

    Bousser, M.G.; Baron, J.C.; Chiras, J.

    1985-11-01

    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).

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

    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。

  18. In vivo measurements of cerebral metabolic abnormalities by proton spectroscopy after a transient ischemic attack revealing an internal carotid stenosis > 70%; Anomalies metaboliques cerebrales mesurees in vivo par la spectroscopie du proton dans les accidents ischemiques transitoires revelant une stenose de la carotide interne superieure a 70%

    Energy Technology Data Exchange (ETDEWEB)

    Giroud, M.; Becker, F.; Lemesle, M.; Walker, P.; Guy, F.; Martin, D.; Baudouin, N.; Brunotte, F.; Dumas, R. [Centre Hospitalier Universitaire, 21 -Dijon (France)

    1996-06-01

    Aims: The aim of this work is to look for cerebral metabolic abnormalities within the first 3 days after a transient ischemic attack revealing an internal carotid stenosis > 70 %. Methods: Five patients with a transient ischemic attack lasting between 30 and 180 minutes, affecting sensory and motor brachio-facial territory, with or without aphasia. Were studied. A CT-scan, an EEG, a cervical Doppler ultrasound, a standard arteriography, a magnetic resonance imaging and a proton spectroscopy were performed within the cerebral area affected by the transient ischemic attack. We measured 2 markers: N-acetyl-aspartate, the marker of the neuronal mass, and lactate, the marker of anaerobe metabolism. In each case, a contralateral internal stenosis was diagnosed by cervical Doppler ultrasound and standard arteriography. No cerebral infarction was observed. Results: With the affected cerebral area defined according to clinical and EEG features, proton spectroscopy showed a significant rise of lactate, without any change in N-acetyl-aspartate levels. Conclusions: Within the first 3 days after a transient ischemic attack, there is a significant risk of lactate inside the affected cerebral area. This change may reflect a localized and transient hypoperfusion, but long enough to induce a rise of lactate but not sufficient to produce a cerebral infarct. This area is probably at risk to induce cerebral infarct. This data lead us to study the metabolic change induced by the asymptomatic internal carotid stenosis. (authors). 18 refs.

  19. Hepatitis C and recurrent treatment-resistant acute ischemic stroke

    OpenAIRE

    Saxsena, Aneeta; Tarsia, Joseph; Dunn, Casey; Aysenne, Aimee; Shah, Basil; Moore, David F.

    2013-01-01

    Since the introduction of recombinant tissue plasminogen activator and thrombolysis, acute ischemic stroke has become a treatable disorder if the patient presents within the 4.5-hour time window. Typically, sporadic stroke is caused by atherosclerotic disease involving large or small cerebral arteries or secondary to a cardioembolic source often associated with atrial fibrillation. In the over-65-year age group, more rare causes of stroke, such as antiphospholipid syndromes, are unusual; such...

  20. The Effects of Different Repetitive Transcranial Magnetic Stimulation (rTMS) Protocols on Cortical Gene Expression in a Rat Model of Cerebral Ischemic-Reperfusion Injury.

    Science.gov (United States)

    Ljubisavljevic, Milos R; Javid, Asma; Oommen, Joji; Parekh, Khatija; Nagelkerke, Nico; Shehab, Safa; Adrian, Thomas E

    2015-01-01

    Although repetitive Transcranial Magnetic Stimulation (rTMS) in treatment of stroke in humans has been explored over the past decade the data remain controversial in terms of optimal stimulation parameters and the mechanisms of rTMS long-term effects. This study aimed to explore the potential of different rTMS protocols to induce changes in gene expression in rat cortices after acute ischemic-reperfusion brain injury. The stroke was induced by middle cerebral artery occlusion (MCAO) with subsequent reperfusion. Changes in the expression of 96 genes were examined using low-density expression arrays after MCAO alone and after MCAO combined with 1Hz, 5Hz, continuous (cTBS) and intermittent (iTBS) theta-burst rTMS. rTMS over the lesioned hemisphere was given for two weeks (with a 2-day pause) in a single daily session and a total of 2400 pulses. MCAO alone induced significant upregulation in the expression of 44 genes and downregulation in 10. Two weeks of iTBS induced significant increase in the expression of 52 genes. There were no downregulated genes. 1Hz and 5Hz had no significant effects on gene expression, while cTBS effects were negligible. Upregulated genes included those involved in angiogenesis, inflammation, injury response and cellular repair, structural remodeling, neuroprotection, neurotransmission and neuronal plasticity. The results show that long-term rTMS in acute ischemic-reperfusion brain injury induces complex changes in gene expression that span multiple pathways, which generally promote the recovery. They also demonstrate that induced changes primarily depend on the rTMS frequency (1Hz and 5Hz vs. iTBS) and pattern (cTBS vs. iTBS). The results further underlines the premise that one of the benefits of rTMS application in stroke may be to prime the brain, enhancing its potential to cope with the injury and to rewire. This could further augment its potential to favorably respond to rehabilitation, and to restore some of the loss functions.

  1. Ischemic stroke in children: a study of the associated alterations Acidente vascular cerebral isquêmico na infância: estudo das alterações associadas

    Directory of Open Access Journals (Sweden)

    Josiane Ranzan

    2004-09-01

    Full Text Available Arterial ischemic stroke (AIS in children is a relatively rare disease, not yet clearly understood and with a multifactored etiology. It can cause a severe impact on the child and be the first manifestation of a systemic disease. Delayed diagnosis is still common and research on the subject in our field practically does not exist. Prothrombotic disorders have been described as important causative factors of the ischemic event in children. Forty-six patients from zero to 18 years of age diagnosed with AIS were studied in the period between March 2002 and September 2003. Laboratory tests were realised including coagulation proteins and echocardiogram. AIS of the newborn occurred in 37% of the cases. Focal seizures and hemiparesis were the most frequent symptoms; 40% of the patients presented prior pathologies. Abnormalities of the S and C proteins occurred in 22% and 17%. Associated alterations, particularly those that generate a hypercoagulability state, indicate more than one risk factor for this disease in childhood.Acidente vascular cerebral Isquêmico (AVCI na infância é relativamente raro, de conhecimento ainda obscuro, e com etiologia multifatorial. Pode causar grave impacto na criança e ser a primeira manifestação de doença sistêmica. O subdiagnóstico ainda é comum e são praticamente inexistentes as pesquisas sobre o assunto no nosso meio. Desordens protrombóticas têm sido descritas como importantes fatores causais do evento isquêmico na infância. Foram estudados 46 pacientes de zero a 18 anos, com diagnóstico de AVCI, no período de março/2002 a setembro/2003. Exames laboratoriais, incluindo proteínas de coagulação e ecocardiograma foram realizados. AVCI neonatal ocorreu em 35% dos casos. Crise focal e hemiparesia foram os sintomas iniciais mais freqüentes; 40% dos casos apresentaram patologia prévia. Anormalidades nas proteínas S e C ocorreram em 22% e 17% da amostra. Alterações associadas, principalmente as que

  2. Multimodal nanoprobes evaluating physiological pore size of brain vasculatures in ischemic stroke models.

    Science.gov (United States)

    Zheng, Shuyan; Bai, Ying-Ying; Changyi, Yinzhi; Gao, Xihui; Zhang, Wenqing; Wang, Yuancheng; Zhou, Lu; Ju, Shenghong; Li, Cong

    2014-11-01

    Ischemic stroke accounts for 80% strokes and originates from a reduction of cerebral blood flow (CBF) after vascular occlusion. For treatment, the first action is to restore CBF by thrombolytic agent recombinant tissue-type plasminogen activator (rt-PA). Although rt-PA benefits clinical outcome, its application is limited by short therapeutic time window and risk of brain hemorrhage. Different to thrombolytic agents, neuroprotectants reduce neurological injuries by blocking ischemic cascade events such as excitotoxicity and oxidative stress. Nano-neuroprotectants demonstrate higher therapeutic effect than small molecular analogues due to their prolonged circulation lifetime and disrupted blood-brain barrier (BBB) in ischemic region. Even enhanced BBB permeability in ischemic territories is verified, the pore size of ischemic vasculatures determining how large and how efficient the therapeutics can pass is barely studied. In this work, nanoprobes (NPs) with different diameters are developed. In vivo multimodal imaging indicates that NP uptakes in ischemic region depended on their diameters and the pore size upper limit of ischemic vasculatures is determined as 10-11 nm. Additionally, penumbra defined as salvageable ischemic tissues performed a higher BBB permeability than infarct core. This work provides a guideline for developing nano-neuroprotectants by taking advantage of the locally enhanced BBB permeability in ischemic brain tissues.

  3. 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.

  4. 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.

  5. 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.

  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. Electroacupuncture Pretreatment Attenuates Cerebral Ischemic Injury via Notch Pathway-Mediated Up-Regulation of Hypoxia Inducible Factor-1α in Rats.

    Science.gov (United States)

    Zhao, Yu; Deng, Bin; Li, Yichong; Zhou, Lihua; Yang, Lei; Gou, Xingchun; Wang, Qiang; Chen, Guozhong; Xu, Hao; Xu, Lixian

    2015-11-01

    We have reported electroacupuncture (EA) pretreatment induced the tolerance against focal cerebral ischemia through activation of canonical Notch pathway. However, the underlying mechanisms have not been fully understood. Evidences suggest that up-regulation of hypoxia inducible factor-1α (HIF-1α) contributes to neuroprotection against ischemia which could interact with Notch signaling pathway in this process. Therefore, the current study is to test that up-regulation of HIF-1α associated with Notch pathway contributes to the neuroprotection of EA pretreatment. Sprague-Dawley rats were treated with EA at the acupoint "Baihui (GV 20)" 30 min per day for successive 5 days before MCAO. HIF-1α levels were measured before and after reperfusion. Then, HIF-1α antagonist 2ME2 and γ-secretase inhibitor MW167 were used. Neurologic deficit scores, infarction volumes, neuronal apoptosis, and Bcl2/Bax were evaluated. HIF-1α and Notch1 intracellular domain (NICD) were assessed. The results showed EA pretreatment enhanced the neuronal expression of HIF-1α, reduced infarct volume, improved neurological outcome, inhibited neuronal apoptosis, up-regulated expression of Bcl-2, and down-regulated expression of Bax after reperfusion in the penumbra, while the beneficial effects were attenuated by 2ME2. Furthermore, intraventricular injection with MW167 efficiently suppressed both up-regulation of NICD and HIF-1α after reperfusion. However, administration with 2ME2 could only decrease the expression of HIF-1α in the penumbra. In conclusion, EA pretreatment exerts neuroprotection against ischemic injury through Notch pathway-mediated up-regulation of HIF-1α.

  8. Correlation between carotid artery vulnerable plaques and recurrent ischemic cerebral stroke%颈动脉易损斑块与缺血性脑卒中复发的相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘国荣; 王大力; 张文丽; 安亚臣; 郑德松; 姚林

    2012-01-01

    目的 对颈动脉斑块进行评价,分析斑块性质、形态及其危险因素与缺血性脑卒中复发的相关性.方法 选择经头颅CT和(或)MRI确诊为缺血性脑卒中复发患者209例,应用CT血管造影联合彩色多普勒超声检查证实122例有颈动脉斑块,根据斑块性质分为易损斑块组86例,稳定斑块组36例,分析斑块性质、形态,观察发生缺血性脑血管事件相关因素,比较2组缺血性脑卒中复发的时间、分布及狭窄的关系,Cox风险比例模型分析缺血性脑卒中复发与颈动脉斑块等危险因素间的相关性.结果 209例患者中,颈动脉斑块122例,占58.4%.与稳定斑块组比较,易损斑块组年龄更高,高血压和冠心病的比例更多(P<0.05).Cox回归分析显示,易损斑块与冠心病是缺血性脑卒中复发的危险因素.结论 颈动脉斑块性质、形态和冠心病是缺血性脑卒中复发的危险因素.%Objective To assess the carotid artery plaques (CAP) and analyze the correlation of their nature, morphology and risk factors with recurrent ischemic cerebral stroke. Methods Of the 209 patients with recurrent ischemic cerebral stroke established by head CT and/or MRI in this study, 122 were diagnosed with CAP by combined CT angiography and carotid artery ultra-sonography,86 were diagnosed with vulnerable CAP and 36 were diagnosed with stable CAP according to their nature. The nature and morphology of CAP were analyzed and related factors for ischemic cerebrovascular events were observed. Relation of recurrent time of vulnerable and non-vulnerable ischemic ischemic cerebrovascular events with their distribution and stenosis was compared. Correlation between recurrent ischemic cerebrovascular events and risk factors for CAP was analyzed using the Cox risk model. Results CAP were detected in 122 patients(58. 4%). The age of patients with stable CAP was higher than that of those with vulnerable CAP. The proportion of hypertention and coronary

  9. [The relationship between placental lesions and early hemorrhagic-ischemic cerebral injury in very low birth weight infants].

    Science.gov (United States)

    Vaihinger, Mara; Mazzitelli, Nancy; Balanian, Nora; Grandi, Carlos

    2013-01-01

    Introducción: El examen histopatológico de la placenta es trascendente para evidenciar desordenes relacionados con el embarazo que se asocian a lesiones isquémico hemorrágicas cerebrales (LIHC) en recién nacidos prematuros (RNPT). Objetivo: Estudiar la asociación entre lesiones placentarias y LIHC precoces detectadas con ecografía en RNPT ≤ 1500 g y 32 semanas. Material y Métodos: diseño caso – control. Criterios de inclusión: RNPT ≥ 24 y ≤ 32 semanas, ≥ 500 y ≤ 1500 g, nacidos en la Maternidad Sardá entre años 2006 y 2012. Criterios de exclusión: RNPT gemelares, con malformaciones o infecciones intrauterinas específicas y los fallecidos antes de las 24 horas de vida. Resultados: fueron incluidos 198 RNPT, 49 con LIHC (casos) y 149 sin LIHC (controles). No se encontraron diferencias en las lesiones histopatológicas placentarias entre los dos grupos, aunque se apreció una clara tendencia de lesiones inflamatorias en los casos (67.3%) en comparación con los controles (48 %, p = 0.018). La ruptura prematura de las membranas (p = 0.027) y la corioamnionitis clínica fueron más frecuentes en los casos. Complicaciones fuertemente asociadas a prematurez fueron estadísticamente más evidentes entre los casos. La hemorragia intraventricular fue la lesión cerebral más hallada. El 50% de los casos persistieron con LIHC a las 36-40 semanas, mientras que a mayor edad gestacional el riesgo de LIHC fue menor . Conclusiones: las lesiones histopatológicas placentarias no estuvieron asociadas independientemente a mayor riesgo de LIHC, aunque se observó un predominio de lesiones inflamatorias en los casos.

  10. 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

    2016-03-01

    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 1h and reperfusion for 2h with and without rapamycin (20mg/kg once daily for two days prior to ischemia). Regional cerebral blood flow was determined using a C(14)-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.

  11. 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

  12. 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.

  13. Relation of cerebral small-vessel disease and brain atrophy to mild Parkinsonism in the elderly.

    Science.gov (United States)

    Reitz, Christiane; Trenkwalder, Claudia; Kretzschmar, Konrad; Roesler, Andreas; V Eckardstein, Arnold; Berger, Klaus

    2006-11-01

    The association between cerebral small-vessel disease, brain atrophy, and the risk and severity of mild parkinsonian signs (MPS) remains unclear. The objective of this study is to examine the effect of lacunar brain infarcts, cerebral white matter lesions (WMLs), and cortical atrophy on the risk and severity of MPS. This study is a cross-sectional community-based cohort study comprising 268 subjects, 65 to 83 years of age, residing in the Augsburg region of southern Germany, and without contraindications for magnetic resonance imaging (MRI) of the brain. Main outcome measures. Subcortical and periventricular WMLs, lacunar brain infarcts, and cortical atrophy determined using a standardized MRI protocol developed for the Rotterdam Scan Study and an established rating scale. MPS, assessed in a standardized neurological examination and based on the Unified Parkinson's Disease Rating Scale motor scale. Lacunar brain infarcts and large subcortical white matter lesions were associated with an elevated risk of resting tremor. More severe cortical atrophy was related to an increased risk of rigidity and bradykinesia. In a linear regression analysis relating each individual MRI measurement with the severity of MPS, the number of lacunar brain infarcts and the degree of brain atrophy were correlated with the severity of resting tremor, whereas the size of subcortical and periventricular WMLs was correlated with the severity of rigidity. A higher degree of brain atrophy was associated with increased severity of either cardinal sign. In our study, presence and volume of lacunar brain infarcts, cerebral WMLs, and cortical atrophy were associated with the risk as well as severity of MPS. Determining the presence of these brain changes using brain imaging might contribute to identify persons at risk for MPS.

  14. Analysis of related risk factors of progressive ischemic cerebral infarction%进展性脑梗死相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王霆; 蒋纯新; 江宏杰; 张永祥; 翁翔; 黄孝飞; 沈俊

    2013-01-01

    Objective To investigate the related risk factors that caused progressive ischemic cerebral stroke. Methods 246 cases which were admissioned our hospital from May 2008 to May 2011 were studied retrospectively, according to evolving clinical course, which were labelled into progressive cerebral infarction ( PCI) group and nonprogressive cerebral infarction ( NPCI) group, studied items included age, history of hypertension, diabtes millitus, coronary heart disease, stroke, hyperlipocholemia, smoking and alcohol drinking, scores of neurological function,blood pressure of admission,the decreasing of blood pressure after admission,fever ,serum lipoprotein level , serum glucose, heamocrits, stenosis of carotid and intracranial arteries, then analysized them respectively. Results History of Diabtes Millitus, early decreasing blood pressure , temputure of admission 24 hours, leukocytes counting, serum glaucose, infarction lesion adjacent to lateral ventricals, stenosis of intracranial and internal carotid arteries were more signifiantly in statistics in PCI group than that of NPCI group ( P < 0.05 ) . Conclusion PCI is related to those risk factors of history of Diabtes Millitus,early decreasing blood pressure,fever ,leukocytes increasing,elevating serum glucose ,infarction lesion adjacent to lateral ventricals,stenosis of intracranial and internal carotid arteries.%目的 探寻引起脑梗死进展的相关危险因素.方法 对我院2008年5月-2011年5月住院的急性脑梗死患者246例,根据入院后病情演变分为进展性脑梗死组(PCI)和非进展性脑梗死组(NPCI).观察项目包括年龄、高血压史、糖尿病史、冠心病史、脑卒中病史、高脂血症史、吸烟史及饮酒史,入院时神经功能评分、入院时高血压、入院后血压降低、发热、血脂、血糖、红细胞压积、颈动脉狭窄及颅内动脉狭窄进行分析.结果 PCI组的糖尿病史、早期不适当降压治疗、颅内动脉狭窄

  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. Characterising the grey matter correlates of leukoaraiosis in cerebral small vessel disease.

    Science.gov (United States)

    Lambert, Christian; Sam Narean, Janakan; Benjamin, Philip; Zeestraten, Eva; Barrick, Thomas R; Markus, Hugh S

    2015-01-01

    Cerebral small vessel disease (SVD) is a heterogeneous group of pathological disorders that affect the small vessels of the brain and are an important cause of cognitive impairment. The ischaemic consequences of this disease can be detected using MRI, and include white matter hyperintensities (WMH), lacunar infarcts and microhaemorrhages. The relationship between SVD disease severity, as defined by WMH volume, in sporadic age-related SVD and cortical thickness has not been well defined. However, regional cortical thickness change would be expected due to associated phenomena such as underlying ischaemic white matter damage, and the observation that widespread cortical thinning is observed in the related genetic condition CADASIL (Righart et al., 2013). Using MRI data, we have developed a semi-automated processing pipeline for the anatomical analysis of individuals with cerebral small vessel disease and applied it cross-sectionally to 121 subjects diagnosed with this condition. Using a novel combined automated white matter lesion segmentation algorithm and lesion repair step, highly accurate warping to a group average template was achieved. The volume of white matter affected by WMH was calculated, and used as a covariate of interest in a voxel-based morphometry and voxel-based cortical thickness analysis. Additionally, Gaussian Process Regression (GPR) was used to assess if the severity of SVD, measured by WMH volume, could be predicted from the morphometry and cortical thickness measures. We found significant (Family Wise Error corrected p grey matter density and cortical thickness maps (Pearson's coefficients 0.80 and 0.75 respectively). We demonstrate that SVD severity is associated with regional cortical thinning. Furthermore a quantitative measure of SVD severity (WMH volume) can be predicted from grey matter measures, supporting an association between white and grey matter damage. The pattern of cortical thinning and volumetric decline is distinctive for SVD

  17. Effects of supplementing qi and activating blood circulation on piamatral microcirculation in gerbils with cerebral ischemic reperfusion%益气活血对脑缺血再灌注沙土鼠脑膜微循环的作用

    Institute of Scientific and Technical Information of China (English)

    俞国平; 戴良珏; 方敏; 谢荭

    2006-01-01

    formed in the cerebral ischemia were difficult to be removed by blood flow. Red blood cell moderately aggregated, and the number of white blood cells greatly increased. White small thrombus could be seen sometimes, while the exsudation in the periphery of microvessel was not significantly ameliorated. Great changes were found in gerbils of the medicine group after abnormal injection of supplementing qi and activating blood circulation medicine: almost all arteriolae and venulae were opened, and the rate of blood flow was accelerated with the blood flow rate remarkably increased. Deposit in the venulae began to decreased, and the thrombus was gradually dissolved. Red blood cells were moderately aggregated or normal. Blood flow in ischemic spot was improved significantly than that after reperfusion. The exudation in the periphery of microvessels was gradually lessened even dissolved. However,no obvious change was found in gerbils of the control group. ②The blood flow rate of arteriole in the medicine group was 1.04-1.50 mm, which was obviously higher than that in the control group with significant differences (P < 0.5-0.01).③The blood flow rate of veinule in the medicine group was 0.96-1.12 mm/s, which was remarkably higher than that in the control group with marked differences (P < 0.05-0.01).CONCLUSION: The effect on piamatral microcirculation of gerbil with cerebral ischemic reperfusion by supplementing qi and activating blood is exact, which is directly related with accelerated blood flow rate, expanded veinule and arteriolae as well as ameliorated blood-supply of brain.

  18. Neuroprotective effect of salvianolic acid B against cerebral ischemic injury in rats via the CD40/NF-κB pathway associated with suppression of platelets activation and neuroinflammation.

    Science.gov (United States)

    Xu, Shixin; Zhong, Aiqin; Ma, Huining; Li, Dan; Hu, Yue; Xu, Yingzhi; Zhang, Junping

    2017-04-15

    Neuroinflammation plays a critical role in the pathogenesis of ischemia/reperfusion (I/R) injury. Activated platelets are increasingly regarded as initiators and/or amplifiers of inflammatory processes in cerebral I/R injury. Salvianolic acid B (SAB) is the most abundant bioactive compound of Salviae miltiorrhizae, a well-known Chinese herb used to promote blood circulation and eliminating blood stasis. S. miltiorrhizae has been used clinically in Asia for the treatment of ischemic cerebrovascular diseases. In the present study, a rat model of transient middle cerebral artery occlusion (tMCAO) was established to investigate the neuroprotective effects and mechanisms of SAB treatment against focal cerebral I/R insult. The results showed that SAB treatment (3mg/kg, 6mg/kg and 12mg/kg, i.p.) dose-dependently decreased I/R-induced neurological deficits at 24, 48, and 72h after reperfusion and decreased plasma-soluble P-selectin and soluble CD40 ligand as early as 6h after onset of I/R insult. At 24h after reperfusion, SAB treatment significantly reduced neuronal and DNA damage in the hippocampal CA1 region and decreased neural cell loss in the ischemic core. The I/R-induced pro-inflammatory mediator mRNA and protein overexpression in the penumbra cortex, including ICAM-1, IL-1β, IL-6, IL-8, and MCP-1, were significantly inhibited by SAB in a dose-dependent manner. Further studies suggested SAB treatment attenuated CD40 expression and NF-κB activation, which involved NF-κB/p65 phosphorylation and IκBα phosphorylation and degradation. In conclusion, our findings indicated that the neuroprotective effects of SAB post cerebral I/R injury are associated with the inhibition of both platelets activation and production of pro-inflammatory mediators and the downregulation of the CD40/NF-κB pathway.

  19. Effect of Urinary Kallidinogenase for acute ischemic cerebral infarction%尤瑞克林治疗急性缺血性脑梗死的疗效

    Institute of Scientific and Technical Information of China (English)

    陈莉; 邹东华; 陈娅; 曹小丽; 秦超; 莫雪安

    2013-01-01

    目的 评价注射用尤瑞克林治疗急性缺血性脑梗死的疗效.方法 选取2011年2月~2012年7月符合条件的127例急性脑梗死患者分为常规治疗组(n=65)和尤瑞克林组(n=62),常规治疗组给予常规治疗,尤瑞克林组在常规治疗基础上加用尤瑞克林治疗,用法为每次将0.15PNA单位尤瑞克林注射液加入到100 mL注射用生理盐水中,1次/d,共治疗2周.对治疗前后神经功能缺损评分(NIHSS)、Bartherl指数进行比较,观察两组疗效.结果 尤瑞克林治疗过程中未发现有药物不良反应或副作用.尤瑞克林组患者治疗前NIHSS评分和Bartherl指数分别为(14.93±5.73)分及(32.39±5.87),治疗后NIHSS评分和Bartherl指数分别为(8.12±4.61)分及(73.28±4.92),差异均有统计学意义(P<0.05);治疗后常规治疗组NIHSS评分和Bartherl指数分别为(12.37±3.89)分及(51.78±7.52),与尤瑞克林组相比,差异均有统计学意义(P<0.05).尤瑞克林组患者治疗有效率为87%,相对常规治疗组(65%)差异有统计学意义(P<0.05) 结论 尤瑞克林治疗急性脑梗死疗效确切,安全可靠.%Objective To evaluate the clinical effect of Urinary Kallidinogenase in treating acute ischemic cerebral infarction.Methods One hundred and twenty seven qualified patients with acute ischemic cerebral infarction from February 2011 to July 2012 were divided into conventional therapy group and Urinary Kallidinogenase group, respectively treated by conventional therapy and Urinary Kallidinogenase on the basis of former.The dosage of 0.15 PNA U of Urinary Kallidinogenase Injection was added to 100 mL saline, once per day, for two weeks NIHSS score and Bartherl index before and after the treatment were compared, curative effect was observed.Results In Urinary Kallidinogenase group, there was no adverse drug reaction or side effect; the NIHSS score and Bartherl index was respectively (14.93±5.73) points and (32.39±5.87) before treatment, and (8.12±4

  20. Correlation research between serum uric acid and cerebral small vessel disease and its subtypes%血尿酸水平与脑小血管病及其亚型的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王式伟

    2016-01-01

    Objective:To investigate the correlation between serum uric acid in patients with and cerebral small vessel disease and different subtypes.Methods:The clinical data of 100 cases of patients with cerebral small vessel disease was analyzed retrospectively.The correlation between blood biochemical index,serum uric acid and cerebral small vessel disease was analyzed. Results:The levels of blood uric acid and blood glucose in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The level of serum uric acid was an independent risk factor for white matter ischemic lesion(P<0.05).Conclusion:The level of serum uric acid in patients with cerebral small vessel disease was significantly higher than that in healthy people,and the level of serum uric acid was an independent risk factor for white matter ischemic lesion.%目的:探讨脑小血管病患者血尿酸水平及其与不同亚型的相关性。方法:回顾性分析脑小血管病患者100例的临床资料,分析患者血液生化指标及血尿酸水平与脑小血管病的相关性。结果:观察组血尿酸水平以及血糖水平均显著高于对照组,差异具有统计学意义(P<0.05)。血尿酸水平是缺血性脑白质病变的独立危险因素(P<0.05)。结论:脑小血管病患者血尿酸水平显著高于健康人,血尿酸水平升高是缺血性脑白质病变的独立危险因素。

  1. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    Directory of Open Access Journals (Sweden)

    William A Copen

    Full Text Available In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured "ischemic core." The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI, but many authors suggest that maps of regional cerebral blood volume (CBV derived from computed tomography perfusion imaging (CTP can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume.58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: "objective absolute," i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9-2.5 mL/100 g, "objective relative," whose six thresholds (51%-60% were fractions of mean contralateral CBV, and "subjective," in which two radiologists (R1, R2 outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred.DWI was positive in 72% (42/58 of patients. CBV maps' sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156-699 mL for objective absolute thresholds, and 127-200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124 mL in individual patients. Inter-rater agreement

  2. Protection of electrical stimulation on cerebral ischemic injury in rats%电刺激对大鼠缺血性脑卒中的保护作用

    Institute of Scientific and Technical Information of China (English)

    刘竞辉; 李江; 马炜; 邱新毓; 崔颖; 邓剑平; 于嘉; 赵振伟

    2013-01-01

    Objective To investigate the neuroprotection of electrical stimulation on permanent middle cerebral artery occlusion model (pMCAO).Methods Adult male rats were randomly divided into two groups; control group and experimental group. Then the experimental group was further divided into four sub-groups: 2 Hz group, 20 Hz group, 100 Hz group and 100/2 Hz group. Three hours after occlusion, electrodes were implanted into the ischemic area in right cortex of the rats. Stroke animals were conducted the behavioral test at 5 h and 24 h after pMCAO. The hemispheric infarct ratio was evaluated by staining with 2,3,5-triphenyltetrazolium chloride at 24 h after pMCAO. One hour after electrical stimulation, the rats were euthanized under deep anesthesia using chloralic hydras and then Western-blot analysis was used to analyze the expressions of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF).Results Compared with other experimental groups, the hemispheric infarct ratio was significantly decreased and the function recovery was improved significantly in 2 Hz stimulation group. Furthermore, the levels of VEGF were down-regulated and there was no significant change of BDNF levels among the experimental groups. Conclusion Cortical stimulation after pMCAO can decrease the hemispheric ratio and promote the functional recovery. Cortical electric stimulation may be a potent therapeutic tool for cerebral ischemia.%目的 探讨皮层电刺激对大鼠永久性缺血性脑卒中的保护作用.方法 雄性SD大鼠随机分成对照组和实验组.实验组根据刺激频率不同分成2Hz组,20Hz组,100Hz组,100/2Hz组.建立永久性梗塞模型.梗塞3h后,电极植入右侧大脑缺血区皮层进行刺激.分别在梗塞5h和24h进行行为学评分.在梗塞24h行2%氯化三苯基四氮唑溶液染色测量脑梗死比.于刺激结束1h后取脑组织Western blot分析脑源性神经营养因子(BDNF)和血管内皮生长因

  3. Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: a systematic review and meta-analysis

    Science.gov (United States)

    van Sloten, Thomas T; Protogerou, Athanase D; Henry, Ronald MA; Schram, Miranda T; Launer, Lenore J; Stehouwer, Coen DA

    2017-01-01

    Arterial stiffness may be a cause of cerebral small vessel disease and cognitive impairment. We therefore performed a systematic review and meta-analysis of studies on the association between stiffness, cerebral small vessel disease and cognitive impairment. For the associations between stiffness (i.e. carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), carotid stiffness and pulse pressure) on the one hand and cerebral small vessel disease and cognitive impairment on the other, we identified 23 (n=15,666/22 cross-sectional/3 longitudinal) and 41 studies (n=57,671/30 cross-sectional/15 longitudinal), respectively. Pooled analyses of cross-sectional studies showed that greater stiffness was associated with markers of cerebral small vessel disease with odds ratios, per +1 SD, of 1.29 to 1.32 (P<.001). Studies on cognitive impairment could not be pooled due to large heterogeneity. Some (but not all) studies showed an association between greater stiffness and cognitive impairment, and the strength of this association was relatively weak. The present study supports the hypothesis that greater arterial stiffness is a contributor to microvascular brain disease. PMID:25827412

  4. 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)

  5. 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 ...

  6. Cerebral Microbleeds Are Associated with Worse Cognitive Function in the Nondemented Elderly with Small Vessel Disease

    Directory of Open Access Journals (Sweden)

    Kazuo Yamashiro

    2014-12-01

    Full Text Available Background: Cerebral small vessel disease (SVD is a leading cause of cognitive decline in the elderly. Cerebral microbleeds (CMBs have emerged as an important manifestation of cerebral SVD, in addition to lacunar infarcts and white matter lesions (WMLs. We investigated whether the presence and location of CMBs in elderly subjects were associated with cognitive function, independent of lacunar infarcts and WMLs. Methods: One hundred and forty-eight nondemented elderly with SVD, defined as the presence of lacunar infarcts and/or WMLs on magnetic resonance imaging (MRI, were studied. Executive function and global cognition were assessed by the Frontal Assessment Battery (FAB and Mini-Mental State Examination (MMSE, respectively. The differences in the scores for the FAB and MMSE between CMB-positive and CMB-negative subjects were calculated after adjusting for possible confounders. Results: The mean age of the subjects was 72.4 w 8.6 years. CMBs were detected in 48 subjects (32%, with a mean number of CMBs per subject of 1.6 (range 0-31. Among CMB-positive subjects, 42 (87.5% had CMBs in deep or infratentorial regions with or without lobar CMBs, and 6 (12.5% had CMBs in strictly lobar regions. The presence of CMBs was significantly associated with FAB and MMSE scores after adjustment for age, years of education, brain volume and the presence of lacunar infarcts (for the FAB or severe WMLs (for the MMSE. The presence of CMBs in the basal ganglia, in the thalamus or in the lobar regions was associated with FAB scores, while that in the lobar regions was associated with MMSE scores. However, there was no association between CMBs in the infratentorial regions and cognitive parameters. Conclusions: In nondemented elderly with SVD on MRI, the presence of CMBs was independently associated with worse executive and global cognitive functions. CMBs seemed to reflect hypertensive microangiopathy in this population, and CMBs in specific areas may play an

  7. Persistent cognitive impairment after transient ischemic attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.; Duijnhoven, D.A. van; Leeuw, F.E. de; Kessels, R.P.; Dijk, E.J. van

    2014-01-01

    BACKGROUND AND PURPOSE: By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whe

  8. Persistent Cognitive Impairment After Transient Ischemic Attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.M.M.; Duijnhoven, D.A. van; de Leeuw, F.E.; Kessels, R.P.C.; Dijk, E.J. van

    2014-01-01

    Background and Purpose—By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whet

  9. 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.

  10. 炎症小体介导脑缺血损伤的进展%State of the art of the studies on inflammasomes induced cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    何宇航; 李娟; 王强; 江涛

    2015-01-01

    Background Inflammasome initiate the innate immune system to induce sterile inflammatory response following cerebral ischemia and exacerbate the damage of neural tissue.Targeting inflammasome signaling is supposed to inhibit inflammatory response,attenuate neurological deficits and provide neuroprotective effect after stroke.Objective In order to explore detailed information,the authors reviewed the effects and mechanisms of NOD-like receptors (NLRs) pyrin domain containing 3 (NLRP3)inflammasome after cerebral ischemia,which is the most extensively studied inflammasomes.Content NLRs,the intracellular pattern recognition receptors,can detect cellular damage and "intracellcular danger signals" following stroke,including the decrease of cytosolic K+ levels,extracellular adenosine triphosphate (ATP) release,acidosis,reactive oxygen specises (ROS) elevation etc.The activation and subsequent oligomerization of the NLRs form the multi-protein complexes known as inflammasomes,activating cysteinyll aspartate specific proteinase (Caspase)-1 and interleukin (IL)-1β,which in turn mediate the inflammatory response in central nervous system (CNS) and exacerbate the damage of neural tissue and neurological impairment.In addition,the activation of Caspase-1 or IL-1 β,is expected to inhibit the inflammatory response and offer substantial neuroprotection.Vivo experiments also suggested that intracerebroventricular injection of IL-1β neutralizing polyclonal antibody decreased infarct volume and neurological deficits after stroke.Trend Inflammasomes mediate the initiation of CNS sterile inflammatory after cerebral ischemia,targeting inflammasome signaling may develop new therapeutics for ischemic stroke.%背景 炎症小体通过启动脑缺血后的无菌性炎症反应,加重对神经组织的损伤,抑制炎症小体活化具有脑保护作用. 目的 以NOD样受体热蛋白结构域相关蛋白3(NOD-like receptor pyrin domain containing 3,NLRP3)炎症小体为核心,通过阐

  11. CT脑灌注成像在短暂性脑缺血发作的应用价值探讨%To Study the Application Value of CT Cerebral Perfusion Imaging in Transient Ischemic Attack

    Institute of Scientific and Technical Information of China (English)

    杜彦挺; 夏志强; 杜光勇; 张伟; 李涛

    2016-01-01

    目的:探讨CT脑灌注成像(CT perfusion,CTP)在短暂性脑缺血发作(transient ischemic attack,TIA)的应用价值。方法收集我院从2013年4月至2015年4月收治的55例短暂性TIA患者作为研究对象,发病24h内进行CTP和CTA(CT angiography)检查,发病72h内进行头颅MRI(magnetic resonance imaging)和MRA(magnetic resonance angiography)进行检查,比较CTP与其他检查方法的检出结果差异,并对病灶侧与健康侧的脑灌注成像参数如获得达峰时间(time to peak, TTP)、平均通过时间(mean transit time, MTT)、脑血流量(cerebral blood flow, CBF)、脑血容量(cerebral blood volume, CBV)进行比较分析。结果 CTA检出35个病灶,MRI检出44个病灶,CTP检出59个病灶,CTP对病灶的检出率高于CTA和MR检查,具有统计学意义(P<0.05);CTP检出的病灶表现分型中I1期12个,I2期29个,II1期11个, II2期7个,I2期明显多于其他分型,具有统计学意义(P<0.05);CTP病灶侧的TTP值、MTT值(P<0.05);CTP病灶侧的CBV值与健康侧没有明显差异(P>0.05)。结论采用CT脑灌注成像检查短暂性脑缺血发作可以全面的诊断,对治疗短暂性脑缺血发作提供可靠的依据。%Objective To study the application value of CT cerebral perfusion imaging(CTP) in Transient ischemic attack(TIA).Methods Fifty-five cases of transient ischemic attack from April 2013 to April 2015 in our hospital were collected as research subject, all of them were performed CTP, CTA(CT angiography) in 24 hours after onset and MRI(Magnetic Resonance imaging) and MRA(Magnetic Resonance angiography) in 72 hours. The inspection results of CTA and MRI and CTP were compared, and the parameters of CTP like time to peak(TTP), mean transit time(MTT), cerebral blood flow(CBF), cerebral blood volume(CBV) were analyzed and compared between lesion side and healthy side.Results Thirty-five lesions were checked out by CTA inspection, 44 lesions by MRI, and 59

  12. Ischemic preconditioning reduces ischemic brain injury by suppressing nuclear factor kappa B expression and neuronal apoptosis

    Institute of Scientific and Technical Information of China (English)

    Songsheng Shi; Weizhong Yang; Xiankun Tu; Chunmei Chen; Chunhua Wang

    2013-01-01

    Ischemic stroke induces a series of complex pathophysiological events including blood-brain barrier disruption, inflammatory response and neuronal apoptosis. Previous studies demonstrate that ischemic preconditioning attenuates ischemic brain damage via inhibiting blood-brain barrier disruption and the inflammatory response. Rats underwent transient (15 minutes) occlusion of the bilateral common carotid artery with 48 hours of reperfusion, and were subjected to permanent middle cerebral artery occlusion. This study explored whether ischemic preconditioning could reduce ischemic brain injury and relevant molecular mechanisms by inhibiting neuronal apoptosis. Results found that at 72 hours following cerebral ischemia, myeloperoxidase activity was enhanced, malondialdehyde levels increased, and neurological function was obviously damaged. Simultaneously, neuronal apoptosis increased, and nuclear factor-κB and cleaved caspase-3 expression was significantly increased in ischemic brain tissues. Ischemic preconditioning reduced the cerebral ischemia-induced inflammatory response, lipid peroxidation, and neurological function injury. In addition, ischemic preconditioning decreased nuclear factor-κB p65 and cleaved caspase-3 expression. These results suggested that ischemic preconditioning plays a protective effect against ischemic brain injury by suppressing the inflammatory response, reducing lipid peroxidation, and neuronal apoptosis via inhibition of nuclear factor-κB and cleaved caspase-3 expression.

  13. 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

  14. The neuroprotective effect of magnesium sulfate in treatment of patients with acute cerebral ischemic stroke%硫酸镁对急性缺血性脑卒中的神经保护作用

    Institute of Scientific and Technical Information of China (English)

    麦辉

    2011-01-01

    Objective To explore the neuroprotective effect of magnesium sulfate in tretment of patients with cerebral ischemic stroke. Methods 40 patients with cerebral ischemic stroke were selected and randomly divided into experimental group(20 cases) and control group(20 cases). Among those two groups,the magnesium sulfate therapeutic measure was carried out in the experimental group and the control group was treated without magnesium sulfate. The difference rangeability of level of serum myelin basic protein pre and pro-therapy of both groups was compared. Results For the experimental group, the mean level of serum myelin basic protein in the first day pre-therapy was (8.3 + 2.5) μg/L, and (4.2 ± 1.7) μg/L in 10 days pro-therapy. the csrtrol group was ( 8.0 ± 3.0) μg/L for tite first day pre-therapy,and (6.0 ± 1.4) μg/L in 10 days pro-therapy. The difference rangeability of level of serum myelin basic protein pre and pro-therapy of both groups had statistical significance, compared with the controlled group,the experimental group had lower level of serum myelin basic protein ( t = 1. 231, P = 0. 041 ).Conclusion Magnesium sulfate could significantly decrease the serum level of myelin basic protein for patients with cerebral ischemic stroke,which irdicate that the magnesium sulfate should have neuroprotective effect on patients with cerebral ischemic stroke.%目的 探讨硫酸镁对急性缺血性脑卒中患者的神经保护作用。方法 采用髓鞘碱性蛋白量化分析方法,分析急性缺血性脑卒中患者硫酸镁治疗前后血清髓鞘碱性蛋白水平变化的幅度,并与对照组对比。结果 治疗组20例患者治疗前第1天血清髓鞘碱性蛋白平均水平为(8.3±2.5) μg/L,治疗后第10天为(4.2±1.7) μg/L;对照组20例患者治疗前第1天血清髓鞘碱性蛋白平均水平为(8.0±3.0)μg/L,治疗后第10天为(6.0±1.4) μg/L。两组患者治疗前后血清髓鞘碱性蛋白水平变化幅度的

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

    Energy Technology Data Exchange (ETDEWEB)

    Turowski, B.; Moedder, U. [Heinrich-Heine University, Institute of Diagnostic Radiology, Neuroradiology, Duesselorf (Germany); Haenggi, D.; Steiger, H.J. [Heinrich-Heine University, Department of Neurosurgery, Duesseldorf (Germany); Beck, A.; Aurich, V. [Heinrich-Heine University, Institute of Informatics, Duesseldorf (Germany)

    2007-02-15

    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.)

  16. 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.

  17. 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.

  18. 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.

  19. [Two Cases of Ruptured Cerebral Aneurysm Complicated with Delayed Coil Protrusion after Coil Embolization].

    Science.gov (United States)

    Furukawa, Takashi; Ogata, Atsushi; Ebashi, Ryo; Takase, Yukinori; Masuoka, Jun; Kawashima, Masatou; Abe, Tatsuya

    2016-07-01

    We report two cases of delayed coil protrusion after coil embolization for ruptured cerebral aneurysms. Case 1:An 82-year-old woman with a subarachnoid hemorrhage due to a ruptured small anterior communicating artery aneurysm underwent successful coil embolization. Eighteen days after the procedure, coil protrusion from the aneurysm into the right anterior cerebral artery was observed without any symptoms. Further coil protrusion did not develop after 28 days. Case 2:A 78-year-old woman with a subarachnoid hemorrhage due to a ruptured small left middle cerebral artery aneurysm underwent successful coil embolization. Twenty days after the procedure, coil protrusion from the aneurysm into the left middle cerebral artery was observed, with a transient ischemic attack. Further coil protrusion did not develop. Both patients recovered with antithrombotic treatment. Even though delayed coil protrusion after coil embolization is rare, it should be recognized as a long-term complication of coil embolization for cerebral aneurysms.

  20. 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.

  1. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  2. 醒脑静乳剂对脑缺血缺氧损伤的保护作用%Protective effect of Xingnaojing emulsions on ischemic or anoxic cerebral injury

    Institute of Scientific and Technical Information of China (English)

    魏倩; 董六一

    2009-01-01

    目的 观察醒脑静乳剂对脑缺血缺氧损伤的保护作用.方法 采用小鼠断头法、吸入氮气法和大鼠大脑中动脉阻断(MCAO)法制造脑缺血缺氧模型.实验动物随机分成生理盐水(NS)对照组及醒脑静乳剂大、中、小3个剂量组及阳性药对照(醒脑静注射液)组,共5组,每组10只.分别观察醒脑静乳剂对小鼠断头张口喘气持续时间、氮气模型小鼠存活时间的影响和对MCAO模型大鼠神经行为学、脑梗塞百分率和脑组织乳酸脱氢酶(LDH)活性,丙二醛(MDA)含量的影响.结果 醒脑静乳剂可明显延长小鼠断头后张口喘气动作的持续时间和氮气模型鼠的存活时间,降低或改善MCAO大鼠行为障碍、脑梗塞率,抑制脑组织LDH活性的下降和MDA含量的升高,并呈一定的剂量依赖性.结论 醒脑静乳剂对缺血缺氧性脑损伤具有保护作用.%Aim To observe the protective effect of Xingnaojing emulsions (XNJE) on ischemic or anoxic cerebral injury.Method We adopted the decapitated gasping,hypoxia by exposing to N2 and middle cerebral artery occlusion (MCAO) in rats as the focal cerebral ischemia or anoxic model.The experimental animals (mice or rats) were randomly assigned to 5 groups:normal saline (NS) control group,low,middle and high dose of XNJE group and positive control group treated with Xingnaojing injection,10 for each group.After treatment with different injection,the gasping time by decapitation,the survival time of mouse breathing in N2,neurological deficits scores,cerebral infarction,activity of LDH and MDA content were determined.Results XNJE obviously extended the gasping time and survival time,reduced neurological deficits scores and the rate of cerebral infarction,inhibited descended LDH activity and the increased MDA content.And all the changes mentioned above show some dose-dependent effect.Conclusion XNJE exerts a protective effect on ischemic or anoxic cerebral injury.

  3. Related Factors of Cerebral Microbleeds in Patients with Acute Ischemic Stroke%急性缺血性卒中患者脑微出血相关因素分析

    Institute of Scientific and Technical Information of China (English)

    侯晶晶; 李尧; 吴继星; 何晋涛; 唐华; 白维; 刘阳; 张娟

    2013-01-01

      目的探讨急性缺血性卒中患者合并脑微出血(cerebral microbleeds,CMB)的情况及其相关因素。  方法本研究采用单中心、前瞻性研究方法,连续收集2011年1月~2012年6月于北京市第六医院神经内科住院的急性缺血性卒中患者302例,根据有无CMB将患者分为有CMB组(83例)和无CMB组(219例),比较两组间一般临床资料、生化指标及影像学特点是否存在差异,并采用多因素逐步Logistic回归模型分析CMB发生的独立危险因素。  结果302例患者中,合并有CMB者83例(27.5%),其中年龄(t=3.67,P  结论 CMB的发生与纤维蛋白原含量、腔隙性脑梗死数目以及脑白质疏松程度相关。%Objective To investigate the prevalence and related factors of cerebral microbleeds (CMB) in patients with acute ischemic stroke. Methods Three hundred and two patients with acute ischemic stroke including all the etiological typings who were hospitalized in Department of Neurology of Beijing No.6 Hospital from January 2011 to June 2012 were successionally recruited. According to whether there were CMB, the patients were divided into two groups, CMB group (83 cases) and non-CMB group (219 cases). Then compare the difference of clinical data including general conditions, biochemical indicators and imaging features between the two groups. The independent risk factors of CMB were analyzed with the Logistic multivariable regression. Results Among a total of 302 patients, 83 (27.5%) patients had lesions of cerebral microbleeds. Compared with non-CMB group, the age (t=3.67, P Conclusion CMB had relationships with fibrinogen, number of LI and severity of LA.

  4. Roles of HIF-1α, VEGF, and NF-κB in Ischemic Preconditioning-Mediated Neuroprotection of Hippocampal CA1 Pyramidal Neurons Against a Subsequent Transient Cerebral Ischemia.

    Science.gov (United States)

    Lee, Jae-Chul; Tae, Hyun-Jin; Kim, In Hye; Cho, Jeong Hwi; Lee, Tae-Kyeong; Park, Joon Ha; Ahn, Ji Hyeon; Choi, Soo Young; Bai, Hui Chen; Shin, Bich-Na; Cho, Geum-Sil; Kim, Dae Won; Kang, Il Jun; Kwon, Young-Guen; Kim, Young-Myeong; Won, Moo-Ho; Bae, Eun Joo

    2016-10-26

    Ischemic preconditioning (IPC) provides neuroprotection against subsequent severe ischemic insults by specific mechanisms. We tested the hypothesis that IPC attenuates post-ischemic neuronal death in the gerbil hippocampal CA1 region (CA1) throughout hypoxia inducible factor-1α (HIF-1α) and its associated factors such as vascular endothelial growth factor (VEGF) and nuclear factor-kappa B (NF-κB). Lethal ischemia (LI) without IPC increased expressions of HIF-1α, VEGF, and p-IκB-α (/and translocation of NF-κB p65 into nucleus) in CA1 pyramidal neurons at 12 h and/or 1-day post-LI; thereafter, their expressions were decreased in the CA1 pyramidal neurons with time and newly expressed in non-pyramidal cells (pericytes), and the CA1 pyramidal neurons were dead at 5-day post-LI, and, at this point in time, their immunoreactivities were newly expressed in pericytes. In animals with IPC subjected to LI (IPC/LI)-group), CA1 pyramidal neurons were well protected, and expressions of HIF-1α, VEGF, and p-IκB-α (/and translocation of NF-κB p65 into nucleus) were significantly increased compared to the sham-group and maintained after LI. Whereas, treatment with 2ME2 (a HIF-1α inhibitor) into the IPC/LI-group did not preserve the IPC-mediated increases of HIF-1α, VEGF, and p-IκB-α (/and translocation of NF-κB p65 into nucleus) expressions and did not show IPC-mediated neuroprotection. In brief, IPC protected CA1 pyramidal neurons from LI by upregulation of HIF-1α, VEGF, and p-IκB-α expressions. This study suggests that IPC increases HIF-1α expression in CA1 pyramidal neurons, which enhances VEGF expression and NF-κB activation and that IPC may be a strategy for a therapeutic intervention of cerebral ischemic injury.

  5. 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.

  6. 脑梗塞患者缺血半暗带的PET检查%PET Measurement of Ischemic Penumbra in Patients with Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    刘建辉

    2001-01-01

    The role of positron emission tomography(PET) for measurement of ischemic penumbra in acute ischemic cerebrovascular diseases are reviewed.With PET,not only the location and size of penumbra can be discovered in the early stage,but also the existent status of the living tissue and its prognosis can be judeged.PET is a new,effective measuring means in the screening of the candidates for early therapy in ischemic cerebrovascular diseases and clinical study of ischemia penumbra.%对正电子发射计算机断层显像(Positron emission tomography,PET)在缺血性脑血管病早期缺血半暗带判定中的作用进行了综述。PET不但能早期发现半暗带的部位及大小,而且可以判定其中存活组织的生存状态,并能预测其转归,为缺血性脑血管病早期治疗对象的筛选及缺血半暗带的研究提供了一种新的、有效的检查手段。

  7. Free radical reaction in ischemic rat brain. ESR-CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kayama, Takamasa [Yamagata Univ. (Japan). School of Medicine

    1998-07-01

    Free radical change in images of rat brain during brain ischemia was observed by using a rapid scan L-band ESR-CT system. Male Wistar rats weighing 200 g were used. Rats were divided into three groups according to the duration of occlusion of 2, 4, and 8 hr as well as a control, sham-operated group. C-PROXYL dissolved in saline solution was used as an imaging agent and injected intraperitoneally in a volume of 3 ml at a concentration of 0.3 M at the beginning of reperfusion. ESR-CT imaging was performed 20 min after injection of C-PROXYL. In the sham-operated group, histological examination disclosed no ischemic lesion. Because C-PROXYL does not pass the blood-brain barrier, no brain image was obtained. In the 2 hr occlusion ischemic group, histological findings revealed spongioid change at the dorsal putamen. The ESR-CT image showed a small spot of uptake of nitroxide radicals in the area of the presumed left putamen which corresponded to the histological ischemic lesion. In the 8 hr occlusion group, the ischemic lesion was found even in the cerebral cortex. The image of nitroxide radical in the brain again closely corresponded to the histological ischemic area and occupied most of the left cerebral hemisphere. However, the area of ESR-CT image was wider than that of histological ischemic lesion. This may be because C-PROXYL leakage in the ischemic lesion diffuses and also because the extent of the efficiency of scavenging free radicals may decline. (K.H.)

  8. Effect of Leptomeningeal Anastomoses Compensation on Ischemic Stroke Recurrence in Cerebral Infarction Patients With Middle Cerebral Artery Occlusion%软脑膜侧支代偿对伴大脑中动脉粥样硬化性闭塞脑梗死患者缺血性脑卒中复发的影响

    Institute of Scientific and Technical Information of China (English)

    杨燕; 张临洪

    2015-01-01

    Objective To investigate the effect of leptomeningeal anastomoses ( LMA ) compensation on the recurrence of ischemic stroke within one year after onset in cerebral infarction patients with middle cerebral artery( MCA ) atherosclerotic occlusion. Methods We enrolled 112 cerebral infarction patients with unilateral MCA atherosclerotic occlusion who accorded with the inclusion standard and were admitted into the Department of Neurology of Central Hospital of Wuhan from January 2010 to January 2013. The MCA occlusion and LMA compensation were evaluated by MRA. According to the results of one-year follow-up and the compensation degree,the subjects were divided into LAM positive group and LMA negative group;according to the number of compensation pathway,the subjects were also divided into double-pathway compensation group,one-pathway compensation group and no-pathway compensation group. The recurrence of ischemic stroke in follow-up period was compared among all the groups. Results Among the 112 subjects,76 subjects were in LMA positive group,36 subjects were in LMA negative group. There were 10 cases of ipsilateral ischemic stroke recurrence within 1-year follow-up,with a recurrence rate of 8. 9%. Of the 10 cases of recurrence,3 cases( cerebral infarction)were in the LAM positive group,with a recurrence rate of 3. 9%(3/76),and 7 cases(3 cases of cerebral infarction and 4 cases of TIA)were in the LAM negative group,with a recurrence rate of 19. 4%(7/36). The two groups were significantly different in one-year recurrence rate of ischemic stroke (χ2 =7. 220,P=0. 007). There were 34 subjects in double-pathway compensation group,with a recurrence rate of 2. 9%(1/34);there were 42 subjects in one-pathway compensation group,among which 14 subjects were of ACA compensation and 28 were of PCA compensation, with a recurrence rate of 4. 8% ( 2/42 );there were 36 subjects in the no - pathway compensation group, with a recurrence rate of 19. 4% ( 7/36 ). The subjects with

  9. 急性脑梗死动脉溶栓血管再通后的脑水肿研究%A clinical study on cerebral edema of intra-arterial thrombolytic recanalization in acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    马海; 任亚静; 张锡铎; 刘静; 郝锋利

    2013-01-01

    Objective To observe the cerebral edema occurrence ,evolution and prognosis of intra-arterial thrombolytic recanali-zation in patients with acute ischemic stroke .Methods From October 2010 to October 2012 ,36 patients who underwent the intra-arterial thrombolytic therapy were cerebral recanalization .They were randomly divided into two groups :1-3 h group and >3-6 h group .The alteration of brain edema was observed by cranial CT .Their mRS .NHISS and BI were scaled and recorded before and after intra-arterial thrombolytic therapy .Results After intra-arterial thrombolytic therapy ,the occurrence rate of cerebral edema was 94% ,appeared at the onset of more than 1 hours in all patients .Long-term follow-up showed ,cerebral edema location appeared obvious cerebromalacia .Cerebral edema and clinical outcome had not significant difference between 1-3 h group and 3-6 h group . Conclusion Cerebral edema and loss of cerebral tissue occurred almost inevitability in patients who received intra-artery thromboly-sis and recanalized their cerebral artery .It indicates that good local circulation and general condition may be favorable factors that can gradually reduce brain edema .%目的:观察急性缺血性脑卒中动脉溶栓血管再通后脑水肿的发生、演变及转归。方法2010年10月至2012年10月于该院就诊,通过动脉溶栓血管再通的患者共36例。将患者分为1~3 h组、>3~6 h组。头颅C T监测、随访脑水肿情况。记录溶栓前、术后1周及1年的美国国立卫生研究院卒中量表(NIHSS)、溶栓后1年改良蓝金评分(MRS)及巴塞尔指数(BI)。结果动脉溶栓血管再通后脑水肿的发生率为94%,出现在1~3 h组、>3~6 h组的所有患者中,长期随访表明,脑水肿局部出现了明显的软化灶。两组患者脑水肿及临床结局比较差异无统计学意义(P>0.05)。结论动脉溶栓血管再通后脑水肿的发生及其脑组织缺失几乎不可

  10. Causes of cerebral small vessel disease : a prospective population-based MRI study

    NARCIS (Netherlands)

    E.J. van Dijk (Ewoud)

    2004-01-01

    markdownabstract__Abstract__ In the 1970s, the introduction of computed tomography (CT) and magnetic resonance imaging (MRI) in medicine, made it possible to image the living brain. These images showed that cerebral white matter lesions and asymptomatic lacunar brain infarcts are extremely common i

  11. 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

    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.%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。

  12. 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

  13. 脑缺血性疾病的临床研究进(一)%Clinical research progress in cerebral ischemic diseases

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ 第一节短暂性脑缺血 发作的临床及治疗的现代概念(上) 短暂性脑缺血发作(transient ischemic attack,TIA)是一种短暂的反复发作的脑局部供血障碍,导致短暂性神经功能缺失.脑缺血发作的局部性、短暂性及反复性是本病主要的临床特点.

  14. 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

  15. 氨基胍对大鼠缺血性脑损伤的保护作用及其机制%Mechanism of protective effect of aminoguanidine on experimental cerebral ischemic injury in rats

    Institute of Scientific and Technical Information of China (English)

    张会欣; 张建新; 李兰芳; 李永辉

    2006-01-01

    目的 观察选择性一氧化氮合酶抑制剂氨基胍(AG)保护大鼠缺血性脑损伤的可能机制.方法 采用线栓法复制大鼠大脑中动脉梗塞模型,缺血后2, 6或12 h 开始给予AG(100 mg·kg-1,ip,每天2次,给药3 d)治疗.测定脑梗死体积,脑线粒体肿胀度和呼吸链的完整性,脑线粒体内NO和丙二醛(MDA)含量,总ATP酶、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)活性;培养大鼠神经元细胞,观察AG(10,20和100 μmol·L-1)对神经元细胞形态、活力及乳酸脱氢酶(LDH)释放和NO含量的影响. 结果 AG显著降低脑缺血后脑梗死体积,改善缺血后神经元超微结构变化,减轻脑线粒体肿胀度和呼吸链损伤;降低NO和MDA含量,增加总ATP酶、SOD和GSH-Px活性.AG使体外培养的缺血神经细胞损伤程度明显减轻,NO含量降低,LDH释放减少,细胞活力增加.结论 AG可能通过抑制氧自由基生成,增加线粒体抗氧化作用,改善线粒体能量代谢和保护线粒体形态与功能的完整而对大鼠脑缺血损伤产生保护作用.%AIM To investigate the beneficial effects of aminoguanidine(AG), a selective inducible nitric oxide synthase (iNOS) inhibitor, on cerebral ischemic injury of rats and the possible mechanism. METHODS The middle cerebral artery occlusion model was prepared with thread embolism. AG 100 mg·kg-1 was injected ip first at 2, 6 and 12 h, respectively, after ischemia, then 2 times a day for 3 consecutive days. The infarct volume of brain tissue was determined with tetrazolium chloride staining. The mitochondria in brain tissue were isolated for measuring integrity of electron transport chain (ETC), mitochondrial swelling, NO and malondialdehyde (MDA) contents, ATPase, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities. In addition, the neuronal cells of newborn rats were cultured in glucose-free medium with sodium hydrosulfite for cell viability, lactate dehydrogenease (LDH) and NO

  16. Unruptured Cerebral Aneurysm Detected after Intravenous Tissue Plasminogen Activator for Stroke

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    Yukihiro Yoneda

    2009-06-01

    Full Text Available Therapeutic guidelines of intravenous thrombolysis with tissue plasminogen activator (tPA for hyperacute ischemic stroke are very strict. Because of potential higher risk of bleeding complications, the presence of unruptured cerebral aneurysm is a contraindication for systemic thrombolysis with tPA. According to the standard CT criteria, a 66-year-old woman who suddenly developed aphasia and hemiparesis received intravenous tPA within 3 h after ischemic stroke. Magnetic resonance angiography during tPA infusion was performed and the presence of a small unruptured cerebral aneurysm was suspected at the anterior communicating artery. Delayed cerebral angiography confirmed an aneurysm with a size of 7 mm. The patient did not experience any adverse complications associated with the aneurysm. Clinical experiences of this kind of accidental off-label thrombolysis may contribute to modify the current rigid tPA guidelines for stroke.

  17. AQP4 expression of the cerebral ischemic tissue following its mRNA silence in rat%基因沉默对缺血脑组织水通道蛋白4表达的影响

    Institute of Scientific and Technical Information of China (English)

    鲁宏; 胡惠; 何占平; 涂蓉; 舒庆杰

    2012-01-01

    To investigate the effect of RNA interference targeting AQP4 on its expression in the cerebral ischemic tissues. Methods: Total 108 Wistar rats were divided into three groups randomly: ischemic groups (MCAO), control group (shRNA-AQP4 + MCAO) and interference groups (siRNA-AQP4 + MCAO). Each group was subdivided into six sub groups according to the different interval of time points: 0. 25 h, 0. 5 h, 1 h, 2 h, 4 h and 6 h (n = 6 for each group). The right middle cerebral artery of rats was unilaterally occluded (MCAO) in ischemic groups. The reagent including nonsense short hairpin (shRNA) liposomes and short interference (siRNA)-AQP4 liposomes were injected to the right basal ganglia of the rats of MCAO served as a control group and an interference group, respectively. The animals were sacrificed and per fused with the mixture solution consisting formalin. The right basal ganglia tissues were examined with pathology, immuno histochemistry, real time fluorescence quantitative reverse transcript polymerase chain reaction (RT-PCR) and Western blot ting. Results: There was no significant change in AQP4 expression between the control group and the ischemic group. The expression of AQP4 increased rapidly within 2 h, and then increased slowly during 4-6 h. Whereas, there was no significant change in AQP4 expression between the control group and the interference group at 0. 25 h and 6 h after MCAO. But there was significant change in AQP4 expression between the control group and the interference group during 0. 5-4 h. The AQP4 expression could be inhibited efficiently by RNA silencing technique during 0. 5-4 h, but it became unconspicuous during 4-6 h. The corresponding histological changes within 4 h were intracellular edema in the ischemic group and the control group, but this pathological change was obviously mitigated in the interference group during the same period of time. With the pro gress of the time (4-6 h), The vasogenic brain edema was mostly observed in

  18. Recovery of neurological function of ischemic stroke by application of conditioned medium of bone marrow mesenchymal stem cells derived from normal and cerebral ischemia rats

    OpenAIRE

    2014-01-01

    Background Several lines of evidence have demonstrated that bone marrow-derived mesenchymal stem cells (BM-MSC) release bioactive factors and provide neuroprotection for CNS injury. However, it remains elusive whether BM-MSC derived from healthy donors or stroke patients provides equal therapeutic potential. The present work aims to characterize BM-MSC prepared from normal healthy rats (NormBM-MSC) and cerebral ischemia rats (IschBM-MSC), and examine the effects of their conditioned medium (C...

  19. 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

  20. The effect of ischemic postconditioning on cerebral ischemia-reperfusion injury in diabetic rats%缺血后处理对糖尿病大鼠局灶性脑缺血再灌注损伤的影响

    Institute of Scientific and Technical Information of China (English)

    卢英云; 王翠兰; 刘颖; 李燕

    2008-01-01

    Objective To observe the effect of ischemic postconditioning on cerebral ischemia-reperfusion (I/R)injury in diabetic rats. Methods A rat model of diabetes was established using a single intraperitoneal injection of streptozotocin in 40 male Spragne-Dawley rats.Focal ischemia was induced by transient middle cerebral artery occlusion(MCAO)using a thread.The rats were randomly assigned to a control group,a sham-operated group,an I/R group and an Ⅰ-Post group.The animals in the I/R group were subjected to MCAO for 90 min and then reperfusion.Those in the Ⅰ-post group were subjected to MCAO and 3 cycles of transient ischemia-reperfusion(15 seconds ischemia then 15 seconds reperfusion)before persistent reperfusion.Neurological deficit scores,infarct volume,histological changes in the brain and the number of apoptotic cells were measured 6 hours later.Results There was no significant difference in neurological deficit scores between the I/R group and the Ⅰ-post group.The histological changes and apoptotic cells were significantly less in the Ⅰ-post group compared with the I/R group.Conclusion Ischemic postconditioning can inhibit cell apoptosis and reduce cerebral I/R injury after focal cerebral ischemia-reperfusion in diabetic rats.%目的 探讨缺血后处理(Ⅰ-Post)对糖尿病大鼠局灶性脑缺血再灌注(L/R)损伤的影响.方法 采用链脲佐菌(STZ)腹腔注射方式建立糖尿病大鼠模型,将制模成功的糖尿病大鼠随机分为4组,即空白对照组、假手术组、缺血再灌注组(Ⅰ/R组)及缺血后处理组(Ⅰ-Post组).Ⅰ/R组及Ⅰ-Post组均通过线栓法制作大鼠大脑中动脉阻塞(MCAO)模型,并且Ⅰ-Post组于大脑中动脉阻塞90 min后,反复进行3次短暂再灌注干预(灌注15 s后缺血15 s);假手术组手术步骤同上,但不插入线栓;空白对照组不给予任何处理.于缺血90 min、再灌注6 h后对所有大鼠进行神经功能评分(NDS)、脑梗死体积测定、观察脑组织神经

  1. Neurovascular Regulation in the Ischemic Brain

    Science.gov (United States)

    Jackman, Katherine

    2015-01-01

    Abstract Significance: The brain has high energetic requirements and is therefore highly dependent on adequate cerebral blood supply. To compensate for dangerous fluctuations in cerebral perfusion, the circulation of the brain has evolved intrinsic safeguarding measures. Recent Advances and Critical Issues: The vascular network of the brain incorporates a high degree of redundancy, allowing the redirection and redistribution of blood flow in the event of vascular occlusion. Furthermore, active responses such as cerebral autoregulation, which acts to maintain constant cerebral blood flow in response to changing blood pressure, and functional hyperemia, which couples blood supply with synaptic activity, allow the brain to maintain adequate cerebral perfusion in the face of varying supply or demand. In the presence of stroke risk factors, such as hypertension and diabetes, these protective processes are impaired and the susceptibility of the brain to ischemic injury is increased. One potential mechanism for the increased injury is that collateral flow arising from the normally perfused brain and supplying blood flow to the ischemic region is suppressed, resulting in more severe ischemia. Future Directions: Approaches to support collateral flow may ameliorate the outcome of focal cerebral ischemia by rescuing cerebral perfusion in potentially viable regions of the ischemic territory. Antioxid. Redox Signal. 22, 149–160. PMID:24328757

  2. 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.

  3. Ischemic preconditioning

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    Ristić-Anđelkov Anđelka

    2005-01-01

    Full Text Available Background. Ischemic preconditioning is a phenomenon during which myocardium, subjected to brief episodes of ischemia followed by reperfusion, tolerates better the subsequent, more prolonged episode of this ischemia, thus reducing the infarction size substantially. Case report. Two patients with acute left anterior descendent artery occlusion received fibrinolytic therapy (alteplase within 6 hours of the onset of chest pain, but developed myocardial infarctions of different sizes. The first patient, without the history of preinfarction angina, developed large anterior infarct, because there was no time either for ischemic preconditioning or for the coronary collateral vessels development. In the second patient, with 4-day history of preinfarction angina, the more favorable outcome was seen he developed smaller apical necrosis, with the great degree of myocardial viability in the infarct-related area. Conclusion. Ischemic preconditioning in patients with acute myocardal infarction results in the reduction of mortality, infarction size, as well as in the frequency of malignant arrhythmias.

  4. 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.

  5. Total Cerebral Small Vessel Disease MRI Score Is Associated With Cognitive Decline In Executive Function In Patients With Hypertension

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    Renske Uiterwijk

    2016-12-01

    Full Text Available Objectives: Hypertension is a major risk factor for white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD. Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a total SVD score was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of white matter hyperintensities, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0-4 in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p=0.017, executive functioning (p<0.001 and information processing speed (p=0.037, but not with memory (p=0.911. The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group and baseline cognitive performance.Conclusions: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

  6. Cortical changes in cerebral small vessel diseases: a 3D MRI study of cortical morphology in CADASIL

    Energy Technology Data Exchange (ETDEWEB)

    Jouvent, E.; Bousser, M.G.; Chabriat, H. [CHU Lariboisiere, AP HP, INSERM, UMR 740, Dept Neurol, Lariboisiere (France); Jouvent, E.; Bousser, M.G.; Chabriat, H. [Univ Paris 07, F-75221 Paris 05 (France); Porcher, R. [Hop St Louis, AP-HP, Dept Biostat, St Louis (France); Viswanathan, A. [Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 (United States); Viswanathan, A. [Massachusetts Gen Hosp, Clin Trials Unit, Boston, MA 02114 (United States); Viswanathan, A. [Harvard Univ, Sch Med, Boston, MA (United States); O' Sullivan, M.; Dichgans, M. [Univ Munich, Klinikum Grosshadern, Dept Neurol, D-81377 Munich (Germany); Guichard, J.P. [CHU Lariboisiere, AP-HP, Dept Neuroradiol, Lariboisiere (France)

    2008-07-01

    Brain atrophy represents a key marker of disease progression in cerebrovascular disorders. The 3D changes of cortex morphology occurring during the course of small vessel diseases of the brain (SVDB) remain poorly understood. The objective of this study was to assess the changes affecting depth and surface area of cortical sulci and their clinical and radiological correlates in a cohort of patients with cerebral autosomal dominant arteriolopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a genetic SVDB. Data were obtained from a series of 69 CADASIL patients. Validated methods were used to determine depth and surface area of four cortical sulci. The ratio of brain to intracranial cavity volumes (brain parenchymal fraction-BPF), volume of lacunar lesions (LL) and of white matter hyper-intensities, number of cerebral micro-haemorrhages, and mean apparent diffusion coefficient were also measured. Association between depth and surface area of the cortical sulci and BPF, clinical status and subcortical MRI lesions were tested. Depth and surface area of cortical sulci obtained in 54 patients were strongly correlated with both cognitive score and disability scales. Depth was related to the extent of subcortical lesions, surface area was related only to age. In additional analyses, the depth of the cingular sulcus was independently associated with the volume of LL (P 0.001), and that of the superior frontal sulcus with the mean apparent diffusion coefficient (P 0.003). In CADASIL, important morphological changes of cortical sulci occur in association with clinical worsening,extension of subcortical tissue damage and progression of global cerebral atrophy. These results suggest that the examination of cortical morphology may be of high clinical relevance in SVDB. (authors)

  7. Complications of hemorrhagic and ischemic stroke : a CT perfusion evaluation

    NARCIS (Netherlands)

    Dankbaar, J.W.

    2010-01-01

    In this thesis the use of CT-perfusion (CTP) imaging in the evaluation of the most severe complications of subarachnoid hemorrhage (SAH)) and ischemic stroke was explored. These complications are delayed cerebral ischemia (DCI) after SAH and damage to the blood-brain barrier (BBB) after ischemic str

  8. Safety of Thrombolytic Agents for Acute Cerebral Ischemic Stroke%急性脑梗死溶栓药物及安全性研究

    Institute of Scientific and Technical Information of China (English)

    鲍宇

    2013-01-01

    Acute cerebral infarction is recognized as the disease of high mortality, high morbidity and high recurrence rate. The most effective method to the acute cerebral infarction is thrombolytic therapy. But thrombolysis has side effects of bleeding,neurotoxicity, allergy etc. , which impact the security of the treatment, bring limitations to the clinical application. Here is make a summary of the safety of commonly used thrombolytic drugs, including streptokinase, urokinase, rt-PA, and hot new thrombolytic drugs, including monteplase,desmoteplase,tenecteplase,nattokinase etc. ,and a prospect of thrombolytic drugs' development.%急性脑梗死是公认的高致死率、高致残率、高复发率疾病.目前治疗急性脑梗死最有效的方法是溶栓治疗,但溶栓具有出血、神经毒性、过敏等不良反应,影响治疗安全性,给临床应用带来了局限性.该文就国内部分常用的溶栓药物(链激酶、尿激酶、重组组织型纤溶酶原激活剂)以及热点新型溶栓药物(孟替普酶、替奈普酶、去氨普酶、纳豆激酶等)的安全性进行总结,并展望溶栓药物的发展方向.

  9. Influence of Electroacupuncture on the Expressions of BDNF and TrkB in Ischemic Cortex of Rats With Local Cerebral Ischemia%电针对局灶性脑缺血模型大鼠皮层BDNF、TrkB的影响

    Institute of Scientific and Technical Information of China (English)

    王彦春; 陈剑明; 梁少荣; 马骏; 甘水咏; 王述菊; 姜拯坤; 雷俊; 王培峻; 许永海

    2012-01-01

    Objective: To observe the influence of dectroacupuncture( EA)on the expressions of BDNF and its receptor TrkB in ischemic cortex of rats with local cerebral ischemia. Methods : The model of focal cerebral ischemia was set up by blocking up the middle cerebral artery(MCA) with filament in rats. The expressions of BDNF and TrkB positive neurons in ischemic cortex was observed with the method of immunocytochemistry SABC. Results: BDNF and TrkB positive neurons were mainly distributed in cortex around the ischemic focus. In pseudo - operation groups ,BDNF and TrkB positive neurons were few and low - expression in identical area. The expressions of BDNF and TrkB around ischemic cortex of model groups were significantly higher than that of pseudo - operation group( P < 0. 05); BDNF and TrkB positive neurons in EA group were more than that of model group(P<0. 05). Conclusion ;EA at Fengfu has a protective effect on ischemic brain injury by increasing the BDNF and its receptor TrkB expressions in cortex around the ischemic focus.%目的:观察电针对不同时间点局灶性脑缺血模型大鼠缺血区皮层BDNF、TrkB的影响.方法:采用线栓改良法复制大脑中动脉缺血模型(MCAO),采用免疫组化SABC法观察缺血皮层BDNF、TrkB表达情况.结果:BDNF、TrkB阳性神经元主要分布在梗死灶周围皮质区.假手术组大鼠相应区域可见少量阳性神经元表达,且强度较弱;模型组各时间点梗死周围皮质BDNF、TrkB阳性神经元比假手术组明显增多,差异有统计学意义(P<0.05);电针组各时间点梗死周围皮质BDNF、TrkB比相同时间点模型组显著增多,差异有统计学意义(P<0.05).结论:电针风府穴可以增加急性脑缺血后缺血周围皮质BDNF、TrkB阳性神经元,对缺血性脑损伤起修复和保护作用.

  10. Interfering effect of neuregulin upon cerebral ischemic reperfusion injury in rhesus monkeys%神经调节素对猕猴脑缺血再灌注损伤的干预作用

    Institute of Scientific and Technical Information of China (English)

    张睿; 李琴; 王涛; 杜芳; 郭云良

    2009-01-01

    Objective To study the interfering effect of neuregulin-1β(NRG-1β)on the cerebral ischemic reperfusion injury in monkeys.Methods The models with middle cerebral artery occlusion reperfusion (MCAO/R) were established by inserting a micro-balloon catheter intra-arterially into MCA from femoral artery in 12 adult healthy monkeys. The NRG-1β was injected into MCA from micro-balloon catheter in the animals of treatment group at 2 h post-ischemia while the normal saline was simultaneously injected in the animals of control group. Then the micro-balloon catheter was withdrawn from the MCA to perfuse for 22 h. The nervous behavioral function was evaluated by task-oriented score and the infarct volume measured by TTC and MRI.Results The animals of control group had an onset of nervous functional disorders at 2 h post-ischemia and had no significant difference at reperfusion 22 h (59.8±15.7); the nervous function of monkeys had no improvement after NFG-1β treatment (61.3±16.2) (P>0.05). The diffuse weight imaging (DWI) showed a high signal area but T1 and T2 imaging had no significant changes at 2 h post-ischemia in control group animals; while the T1 and T2 imaging showed a typical high signal areas, DWI high signal area expanded and TTC staining ischemic area appeared at reperfusion 22 h. The T1, T2 and DWI abnormal signal areas and TTC cerebral infarct volume did not shrink significantly in NFG-1β treatment group (P>0.05).Conclusion The neuroprotective effects of NRG-1β upon cerebral ischemic reperfusion injury needs to be further studied.%目的 探讨神经调节素-1β(NRG-1β)对猕猴脑缺血再灌注损伤的保护作用.方法 成年健康猕猴12只,经股动脉介入手术,将微球囊导管插入大脑中动脉阻断其血流,建立大脑中动脉缺血再灌注(MCAO/R)模型.治疗组动物于缺血2 h再灌注前经微球囊导管注射NRG-1β,对照组同步给予等量的生理盐水,然后退出微球囊导管实现再灌注22 h.应用Task

  11. 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

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    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

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

    Institute of Scientific and Technical Information of China (English)

    裴晓蕊

    2015-01-01

    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。%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.

  13. 视网膜血管异常与脑小血管病%Retinal vascular abnormalities and cerebral small vessel disease

    Institute of Scientific and Technical Information of China (English)

    李華; 吴丹紅

    2014-01-01

    Cerebral small vessel disease is common and is gradually being understood,but it is difficult to visualize directly in the body.The retinal vessels share the similar anatomic,physiological,and embryological characteristics with the cerebral small vessels.Their changes may reflect the changes of cerebral small vessels in a certain extent.Studies in recent years have shown that retinal vascular abnormalities are associated with lacunar infarction and white matter lesions.This article summarizes the research evidence of the correlation of between retinal vascular abnormalities and cerebral small vessel disease.%脑小血管病很常见并逐渐被认识,但在体内很难直接观察.视网膜血管与脑小血管具有相似的解剖学、生理学和胚胎学特征,其改变可能在一定程度上能反映脑小血管改变.近年来的研究显示,视网膜血管异常与腔隙性梗死和脑白质病变相关.文章对视网膜血管异常与脑小血管病相关性的研究证据进行了总结.

  14. Angiotensin-Converting Enzyme Gene Insertion/Deletion Polymorphism and Small Vessel Cerebral Stroke in Indian Population

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    Puttachandra Prabhakar

    2014-01-01

    Full Text Available Background. Hypertension is an established risk factor for small-vessel cerebral stroke and the renin-angiotensin system plays an important role in the maintenance of blood pressure. We aimed at evaluating the contribution of the angiotensin-converting enzyme (ACE gene insertion/deletion (I/D polymorphism to the risk of small-vessel stroke in south Indian population. Materials and Methods. We investigated 128 patients diagnosed with small-vessel stroke and 236 age, and gender-matched healthy controls. ACE I/D polymorphism was detected by polymerase chain reaction. Results. Hypertension was significantly more prevalent in the patient group and was associated with 6-fold increase in risk for stroke. ACE genotypes were in Hardy-Weinberg equilibrium in both patients and controls. Prevalence of DD, ID, and II genotypes in cases (34.4%, 43.7%, and 28% did not differ significantly from controls (31.8%, 43.2%, and 25%. The polymorphism was not associated with small-vessel stroke (OR: 1.34; 95% CI: 0.52–1.55. However, diastolic blood pressure was associated with the ACE I/D genotypes in the patients. (DD; 90.2±14.2> ID; 86.2±11.9> II; 82.3±7.8 mm Hg,  P=0.047. Conclusion. Our study showed that hypertension, but not ACE I/D polymorphism, increased the risk of small-vessel stroke.

  15. Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    XU Fang-hong; CHEN Wei-jian; YANG Yun-jun; DUAN Yu-xia; FU Feng-li

    2008-01-01

    Objective: To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction. Methods: MSCTA was performed on 10 patients who were initiailly diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (Rcbf), regional cerebral blood volume (Rcbv), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained. Results: Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from steno sis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA. Conclusion: The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral

  16. LYUBERTSY STUDY ON MORTALITY RATE IN PATIENTS AFTER CEREBRAL STROKE OR TRANSIENT ISCHEMIC ATTACK (LIS-2. DESIGN AND MEDICAL TREATMENT ESTIMATION

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    S. A. Boytsov

    2013-01-01

    Full Text Available Aim. Estimation of social, demographic and anamnestic characteristics of patients survived cerebral stroke as well as the medical treatment received by the patients before the reference stroke in the hospital and at discharge within the framework of the stroke register LIS-2 (study of mortality among patients survived stroke in Lyubertsy district.Material and methods. All the patients (637 persons admitted to the Lyubertsy regional hospital №2 due to stroke from 01.01.2009 to 31.12.2010 were enrolled into the study.Results. 36% were men and 64% were women with mean age of 70.99Ѓ}9.6 years old. 554 (87.0% patients had history of arterial hypertension and 155 (24.3% – of atrial fibrillation.147 (23.1% patients had previous stroke. In-hospital mortality made up 21.8% (mean age of 139 deceased patients was 72.7Ѓ}9.6 years old. 374 (75% patients were prescribed ACE inhibitors, 421 (85% - antiplatelet agents, 4 (1% – warfarin. Statins intake was recommended to 3 (1% patients. Conclusion. We revealed low frequency of prescription of drugs with proven positive prognostic value in patients after stroke.

  17. Depressive Symptoms and Amygdala Volume in Elderly with Cerebral Small Vessel Disease: The RUN DMC Study

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    I. W. M. van Uden

    2011-01-01

    Conclusion. Lower left amygdala volume is associated with LODS, independent of SVD. This may suggest differential mechanisms, in which individuals with a small amygdala might be vulnerable to develop LODS.

  18. 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

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

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    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

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

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    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.

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

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    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

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

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    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.

  3. 针灸联合通络扶正汤在老年缺血性脑卒中偏瘫早期干预中的临床疗效%Clinical Therapeutic Effect of Acupuncture and Moxibustion Combined With Tongluo Fuzheng Decoction in Early Intervention for Hemiplegic Cerebral Ischemic Stroke in the Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    孔立滨

    2015-01-01

    Objective To investigate the clinical therapeutic effect of acupuncture combined with Tongluo Fuzheng Decoction on early intervention hemiplegic cerebral ischemic stroke in the elderly. Methods Selected 80 cases of senile patients with cerebral ischemic stroke,randomly divided them into observation group and control group. Patients received routine treatment in the control group. Patients added acupuncture combined with Tongluo Fuzheng decoction treatment on the basis of routine treatment in the observation group. Then we compared the treatment effect. Results the total effective rate was significantly higher in the observation group than that of patients in the control group (P<0.05). Conclusion Acupuncture combined with Fuzheng Decoction has good clinical effect on early intervention hemiplegic cerebral ischemic stroke in the elderly.%目的:探讨针灸联合通络扶正汤在老年缺血性脑卒中偏瘫早期干预中的临床疗效。方法选取老年缺血性脑卒中偏瘫患者80例,将其随机分为观察组与对照组。对照组患者行常规治疗,观察组患者在此基础上加以针灸联合通络扶正汤进行治疗,对两组患者的治疗效果进行对比。结果观察组患者的治疗总有效率明显高于对照组患者,组间差异具有统计学意义(P<0.05)。结论针灸联合通络扶正汤治疗早期老年缺血性脑卒中偏瘫具有较好的临床效果。

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

    NARCIS (Netherlands)

    Kwa, V.I.H.

    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

  5. Application of dual-source 4D-CTA combined with CT perfusion imaging in diagnosis of acute cerebral ischemic diseases%双源CT 4D- CTA联合灌注成像在急性脑缺血性疾病中的应用价值

    Institute of Scientific and Technical Information of China (English)

    程有根; 杨光钊; 茅国群; 楼明芳; 魏福全

    2013-01-01

    Objective To investigate the application of dual- source four- dimensional CT angiography (4D- CTA) com-bined with CT perfusion imaging (CTPI) in diagnosis of acute cerebral ischemic diseases. Methods Thirty patients with clinical y suspected acute cerebral ischemic disease underwent head plain CT scan and whole brain CTPI examination 2~16h after onset, the images of CBF, CBV, MTT, TTP and 4D- CTA were obtained. Patients also underwent MRI examination in 1~3 d. The findings of plain CT scan, CTPI, 4D- CTA and MRI were analyzed. Results Plain CT scan found 16 ischemic lesions in 12 cases, CTPI found 32 ischemic lesions in 26 cases, MRI found 28 ischemic lesions in 25 cases, and 4D- CTA demonstrated various degree of stenosis or occlusion in supplying vessels in 20 cases. Conclusion Dual- source 4D- CTA combined with CT perfusion imaging provides comprehensive and detailed imaging information, so that has important value for early diagnosis and treatment in pa-tients with acute cerebral ischemia.%目的:探讨双源CT 4维血管造影(4D- CTA)及灌注成像(CTPI)在急性脑缺血性疾病中的应用价值。方法对30例临床拟诊为急性脑缺血性疾病的患者于发病2~24h内行头颅CT平扫和全脑CTPI检查,获得脑血流量、脑血容量、平均通过时间、达峰时间等参数图,同时获得4D- CTA图像;于发病的1~3d后行MRI检查,分析CT平扫、CTPI、4D- CTA、MRI表现。结果 CT平扫发现12例有16个缺血病灶,CTPI发现26例32个缺血病灶,MRI发现25例28个缺血病灶,4D- CTA显示有20例责任血管有不同程度的狭窄或闭塞。结论双源CT 4D- CTA联合灌注成像能为急性脑缺血患者提供全面、详细的影像学信息,对急性缺血性脑梗死的早期诊断和治疗有重要价值。

  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

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    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. Changes of Serum HMGB1 and ENA-78 Levels in Elderly Patients with Cerebral Ischemic Stroke%老年急性脑梗死患者血清高迁移率蛋白-1和中性粒细胞激活肽-78的变化

    Institute of Scientific and Technical Information of China (English)

    徐梅华; 蔡克银

    2012-01-01

    Objective: To investigate the dynamic changes of serum high mobility group box-1 (HMGB1) and epithelial neutrophil-1 activating peptide-78 (ENA-78) levels in elderly patients with cerebral ischemic stroke. Methods: Serum HMGB1 and ENA-78 levels were measured by enzyme-linked immunosorbent assay (ELISA) in 112 elderly patients with cerebral ischemic stroke(stoke group) and 100 health contrds(control group). Results:Serum HMGB1 and ENA-78 levels in the stroke group were significantly higher than those in the control group (P< 0. 01,respectively). With the severity of cerebral ischemic stroke,the serum HMGB1 and ENA-78 levels increased. Serum HMGB1 and ENA-78 levels in the poor outcome patients were significantly higher than those in the satisfied outcome patients and the control group(P<0. 01,respectively). Serum HMGB1 level were significantly relevant to serum ENA-78 levels (r=0. 62,P< 0. 01). Conclusion: The changes in serum HMGB1 and ENA-78 levels may be associated with severity of strokes and could be used as markers for outcomes of cerebral ischemic stroke in elderly patients.%目的:探讨老年急性脑梗死患者血清高迁移率蛋白-1(HMGB1)和中性粒细胞激活肽-78(ENA-78)的动态变化.方法:采用酶联免疫吸附法(ELISA)测定112例老年脑梗死患者(梗死组)与100例老年健康对照者(对照组)血清HMGB1与ENA-78水平.结果:梗死组不同病情程度患者的 HMGB1与ENA-78水平均显著高于对照组(P均<0.01),并且随着病情程度的加重而逐渐升高.预后不良患者的血清HMGB1与ENA-78水平显著高于预后良好患者及对照组(P<0.01).梗死组血清HMGB1水平与ENA-78水平呈显著正相关(r=0.62,P<0.01).结论:血清HMGB1与ENA-78水平监测对于判断老年急性脑梗死患者病情严重程度及评估预后有重要意义.

  8. Characteristics of Misclassified CT Perfusion Ischemic Core in Patients with Acute Ischemic Stroke.

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    Ralph R E G Geuskens

    Full Text Available CT perfusion (CTP is used to estimate the extent of ischemic core and penumbra in patients with acute ischemic stroke. CTP reliability, however, is limited. This study aims to identify regions misclassified as ischemic core on CTP, using infarct on follow-up noncontrast CT. We aim to assess differences in volumetric and perfusion characteristics in these regions compared to areas that ended up as infarct on follow-up.This study included 35 patients with >100 mm brain coverage CTP. CTP processing was performed using Philips software (IntelliSpace 7.0. Final infarct was automatically segmented on follow-up noncontrast CT and used as reference. CTP and follow-up noncontrast CT image data were registered. This allowed classification of ischemic lesion agreement (core on CTP: rMTT≥145%, aCBV<2.0 ml/100g and infarct on follow-up noncontrast CT and misclassified ischemic core (core on CTP, not identified on follow-up noncontrast CT regions. False discovery ratio (FDR, defined as misclassified ischemic core volume divided by total CTP ischemic core volume, was calculated. Absolute and relative CTP parameters (CBV, CBF, and MTT were calculated for both misclassified CTP ischemic core and ischemic lesion agreement regions and compared using paired rank-sum tests.Median total CTP ischemic core volume was 49.7ml (IQR:29.9ml-132ml; median misclassified ischemic core volume was 30.4ml (IQR:20.9ml-77.0ml. Median FDR between patients was 62% (IQR:49%-80%. Median relative mean transit time was 243% (IQR:198%-289% and 342% (IQR:249%-432% for misclassified and ischemic lesion agreement regions, respectively. Median absolute cerebral blood volume was 1.59 (IQR:1.43-1.79 ml/100g (P<0.01 and 1.38 (IQR:1.15-1.49 ml/100g (P<0.01 for misclassified ischemic core and ischemic lesion agreement, respectively. All CTP parameter values differed significantly.For all patients a considerable region of the CTP ischemic core is misclassified. CTP parameters significantly

  9. 颈内动脉系统TIA型脑梗死与高同型半胱氨酸血症关系的临床研究%Hyperhomocysteinemia and the cerebral infarction of internal carotid artery accompaniment by transient ischemic attack

    Institute of Scientific and Technical Information of China (English)

    孙文君; 贾建平

    2012-01-01

    Objective To investigate the relationship between hyperhomocysteinemia ( HHcy) and cerebral infarction of internal carotid artery accompaniment by transient ischemic attack and internal carotid artery TIA. Methods Plasm Hey were tested in 40 patients with cerebral infarction of internal carotid artery accompaniment by transient ischemic attack, 40 patients with internal carotid artery TIA and 40 healthy people only for physical examination. Results The patients with internal carotid artery accompaniment by transient ischemic attack and patients with internal carotid artery TIA had higher level of plasma concentration of Homocysteine than the control group (P<0. 05). The level of plasma concentration of Homocysteine in the patients with internal carotid artery accompaniment by transient ischemic attack were different from the ones in TIA by internal carotid artery (P<0. 05). Conclusions Hyperhomocysteinemia is significantly correlated with internal carotid artery accompaniment by transient ischemic attack and internal carotid artery TIA.%目的 探讨血同型半胱氨酸水平与颈内动脉系统短暂性脑缺血发作(transient ischemic attack,TIA)及颈内动脉系统短暂性脑缺血发作(TIA型)脑梗死的关系.方法 对颈内动脉系统TIA及颈内动脉系统TIA型脑梗死的患者血同型半胱氨酸水平进行分析.结果 颈内动脉系统TIA型脑梗死患者血同型半胱氨酸水平高于颈内动脉系统TIA患者,且两组患者的血同型半胱氨酸水平水平均高于对照组.结论 高同型半胱氨酸血症与颈内动脉系统短暂性脑缺血发作相关,且其升高水平与是否进展为脑梗死有关.

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

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    Gruber, O.; Cramon, D.Y. von [Day-Care Clinic for Cognitive Neurology, University of Leipzig (Germany); Max Planck Institute of Cognitive Neuroscience, Leipzig (Germany); Wittig, I. [Day-Care Clinic for Cognitive Neurology, University of Leipzig (Germany); Wiggins, C.J. [Max Planck Institute of Cognitive Neuroscience, Leipzig (Germany)

    2000-08-01

    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. 尤瑞克林对大鼠局灶性脑缺血再灌注损伤后APE/Ref-1表达的影响%Effect of Urinary kallikrein on the expression of apurinic apyrimidinic endonuclease/redox factor 1(APE/Ref-1) in cerebral tissue of rats subjected to cerebral ischemic-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    王言理; 陈晓兵; 许锁; 刘克喜; 石远峰

    2014-01-01

    ObjectiveTo investigate the effect of Urinary kallikrein on the expression of apurinic apyrimidinic endonuclease/redox factor 1 (APE/Ref-1) in rats which were subjected to reperfusion after middle cerebral artery occlusion (MCAO) for two hours. To explore the protective mechanism of Urinary kallikrein against ischemic/reperfusion brain injury.Methods 54 male Sprague-Dawley rats were randomly divided into three groups with 18 mice each group: control group (Con group), ischemic/reperfusion group (Model group), ischemic/reperfusion plus Urinary kallikrein group (URK group). Six rats from each group randomly selected were respectively subjected to the detection of APE/Ref-1 positive cell count in CA1 region of hippocampus by immunohistochernistry, the detection of cerebral infarct volume by TTC staining and the detection of the expression of protein APE/Ref-1 in hippocampus by Western blot.ResultsCompared with Con group, the levels of protein of expression of APE/Ref-1 in hippocampus significantly decreased (P<0.05), with the APE/Ref-1 positive cell count in CA3 region of hippocampus significantly lower (P<0.05), Urinary kallikreincan increase the protein of expression of APE/Ref-1 and the APE/Ref-1 positive cell count in CA1 region of hippocampus, but lower than that of Con group, Urinary kallikrein can decrease thecerebral infarct volume induced by the reperfusion after middle cerebral occlusion (MCAO).ConclusionUrinary kallikreincan increase the protein of expression of APE/Ref-1 after focal cerebral ischemia/reperfusion, that may be the other protective mechanism of Urinary kallikrein against ischemic/reperfusion brain injury.%目的:探讨尤瑞克林对大鼠局造性脑缺血再灌注损伤(I/R)后无嘌呤/无嘧啶核酸内切酶/氧化还原因子1(APE/Ref-1)表达的影响,进一步探讨尤瑞克林脑保护作用的机制。方法健康成年雄性SD大鼠54只,采用随机数字表法分为3组:空白对照组(Con组)(n=18),

  12. Application of Whole-brain Perfusion CT with 320-detector Row CT System in Staging of Cerebral Ischemic Penumbra%320排动态容积CT全脑灌注成像在脑梗死缺血半暗带分期中的应用

    Institute of Scientific and Technical Information of China (English)

    向永华; 王波; 金科; 杨伟; 汪春红

    2012-01-01

    Purpose To investigate the feasibility of staging cerebral ischemic penumbra using 320-detector row CT whole-brain perfusion imaging. Materials and Methods The values of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were measured in infarct core area, ischemic penumbra, and mirror area in 18 cases with ischemic penumbra. The staging of the ischemic penumbra was made according to the criteria of pre-infarction period staging. Results In 18 cases with ischemic penumbra, MTT and TTP were delayed; CBF was decreased; CBV was slightly decreased, normal or slightly increased. Compared with infarct core area, CBV and CBF were increased, MTT was delayed and TTP was shortened in ischemic penumbra (P 0.05). In 18 cases, three cases were in stage I 2, nine cases in stage Ⅱ1, six cases in stage Ⅱ2. Conclusion Application of whole-brain perfusion CT with 320-detector row CT system can identify the area of cerebral lesions and the existence of ischemic penumbra.%目的 应用320排动态容积CT全脑灌注成像探讨脑梗死缺血半暗带分期的可行性.资料与方法 测量18例存在缺血半暗带脑梗死患者的梗死核心区、缺血半暗带区及其镜像对侧脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)及达峰时间(TTP),按脑梗死前期分期标准对缺血半暗带进行分期.结果 18例缺血半暗带区表现为MTT、TTP延长,CBF降低,CBV轻度升高、正常或轻度降低.与梗死核心区比较,缺血半暗带区CBV、CBF升高,MTT延长,TTP缩短(P<0.05);与健侧对应区比较,CBF降低,MTT及TTP延长(P<0.05),而CBV无显著差异(P>0.05).缺血半暗带分期:Ⅰ2期3例,Ⅱ1期9例,Ⅱ2期6例.结论 应用320排动态容积CT全脑灌注成像可明确脑梗死患者的病变部位、范围以及有无缺血半暗带存在,并可对缺血半暗带进行分期.

  13. 缺血后处理对全脑缺血损伤后神经元结构可塑性及记忆的影响%Effects of ischemic postconditioning on neuron structure plasticity and memory after global cerebral ischemia injury in rats

    Institute of Scientific and Technical Information of China (English)

    李鑫; 秦新月; 郭振委; 吴小慧

    2010-01-01

    目的 观察缺血后处理(Ischemic postconditioning)对全脑缺血损伤后神经元结构可塑性及记忆的影响,从形态学的角度对缺血后处理的保护作用机制进行探讨.方法 SD成年雄性大鼠36只,随机数字表法分为为假手术组、全脑缺血15 min组、全脑缺血+后处理组,每组12只,处理方式为缺血/再灌注各15 s,循环3次.每组6只以Morris水迷宫观察学习记忆,重复性方差分析处理数据,另外6只以高尔基(golgi)银染观察神经元形态与树突棘密度变化,使用方差分析进行统计分析.结果 缺血后处理组逃避潜伏期较全脑缺血组明显缩短(第3天P=0.014,第4天P=0.040第5天P=0.001),缺血后处理组树突棘密度较全脑缺血组明显增多(F=562.820,P<0.01) 结论缺血后处理对脑缺血所致的记忆损伤有明显的保护作用,其机制可能与减少树突棘的损伤有关.%Objective To observe the effect of ischemic postconditioning on neuron structure plasticity and memory after global cerebral ischemia injury in rats and discuss the protection mechanism from aspect of Morphology. Methods A total of 36 SD male rats were randomly divided into sham operation group, global cerebral ischemia for 15 min group and global cerebral ischemia plus postconditioning group, 12 rats per group. The pullsinelli 4 vessel occlusion was applied to produce the models of global cerebral ischemia reperfusion injury, common carotid arteries (CCA) occlusion with 15 min and postconditioning with three cycles, of 15 sec release and 15 sec occlusion (15s/15s). Six rats from each group were evaluated by Morris Maze test for the ability of space learning and memory and the other six rats were evaluated by golgi stain for morphologic change of neuron. Results The ischemic postcondtioning group showed significant shorter mean escape latency compared with the sham operated group ( at day 3, P =0. 014; at day 4, P =0.040; at day 5, P =0.001 ). The density of dendritic

  14. 双源CT全脑灌注对短暂性脑缺血发作脑血流动力学变化的评价%The evaluation of cerebral hemodynamic changes of transient ischemic attack in dual source CT perfusion

    Institute of Scientific and Technical Information of China (English)

    卞力勇

    2015-01-01

    Objective To explore cerebral hemodynamic changes of transient ischemic attack(TIA)in dual source CT perfusion(CTP). Method Twenty patients with suspected TIA underwent plain CT and CTP within 24h of the onset of symptoms. The results of the abnormal regions of the cerebral blood flow and the contralatcral normal region were comparatively analyzed. Result Lacunar infarction were found in 15 out of 20 patients who were all with abnormal perfusion area. The imaging results demonstrated that significantly larger time to peak(TTP) delay in 20 patients with abnormal perfusion area was found compared with that in contralateral normal region(P 0.05),and no significant change of cerebral blood flow(CBF) was found.Conclusion CTP with dual source CT can accurately display cerebral hemodynamic changes of transient ischemic attack(TIA) and provides objective evidence for early diagnosis and treatment.%目的:探讨双源CT全脑灌注对短暂性脑缺血发作(transient ischemic attack, TIA)血流动力学改变的临床价值。方法临床拟诊TIA患者20例,均在症状出现24小时内行头颅CT平扫及CT Perfusion检查,将脑血流异常区与健侧对应区的情况做对比分析。结果20例患者中,15例患者出现腔梗改变。20例患者均出现灌注异常区,患侧达峰时间(time to peak,TTP)时间较健侧明显延长(P0.05),所有患者脑血流量(cerebral blood flow,CBF)无明显改变。结论双源CT全脑灌注能较好地反映TIA脑血流动力学变化,为早期诊断、治疗提供客观依据。

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

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    Eva Anna Zeestraten

    Full Text Available 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.

  17. Improvement of intraluminal suture method for establishment of focal cerebral ischemic rat models%线栓法建立大鼠局灶性脑缺血模型的改进

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    包新杰; 赵浩; 魏俊吉; 冯铭; 杜世伟; 李桂林; 窦万臣; 王任直

    2011-01-01

    Objectives To improve the procedures for establishment of focal cerebral ischemic rat models with the intraluminal suture method and to elevate the survival rate of the models.Methods Sixty male SD rats (weight, 250 -270 g) were randomly allocated into 3 groups (n = 20 in each group ).Control group used the conventional surgical method, the pterygopalatine arteries were exposed and ligated during the procedure, and the rats had free access to food after the procedure; gavage group used the same method as the control group, but postoperative gavage was performed; protective group did not ligate the pterygopalatine arteries, but the carotid arteries and vagus nerves were carefully separated.Trying to avoid stretching the vagus nerves during the procedure and postoperative gavage was performed.The body weight of the rats in each group was weighed continuously before and after modeling, and the neurological deficit scores were measured; the survival rate of rats in each group was calculated at day 3, 14, and 28, respectively after modeling; the brain infarct volume in each group was calculated at day 28 after modeling.Results ①The mean time of model production was 19.5 min in the protective group, and it was shorter than that in the control and gavage groups.The differences were statistically significant ( P < 0.05 ); ②At day 3 after modeling, the survival rate of the rats in the protective group was higher than that in the control and gavage groups.The differences were statistically significant ( P < 0.05 ); ③After modeling, the body weight of the rats in the 3 groups were all decreased.The body weight of the rats in each group began to increase from day 7 after modeling.The body weight of the rats in the protective group was all higher than that in the control and gavage groups at day 7, 14, 21, and 28 after the procedure.The differences were statistically significant ( P < 0.05 ); ④there were no significant differences comparing the neurological

  18. Clinical research of edaravone combined with citicoline for the treatment of acute ischemic cerebral infarction%依达拉奉联合胞二磷胆碱治疗急性脑梗死临床效果观察

    Institute of Scientific and Technical Information of China (English)

    黄连铭

    2015-01-01

    目的 观察依达拉奉联合胞二磷胆碱治疗急性脑梗死的临床效果.方法 选取2012年3月至2013年8月在我院治疗的82例急性脑梗死患者进行单盲法研究,按照入院先后顺序分为干预组和对照组,每组各41例.对照组在常规治疗方法基础上给予奥扎格雷钠80 mg,2次/d,静脉滴注,连续14d.干预组应用依达拉奉30 mg,2次/d,静脉滴注,连续14 d;外加胞二磷胆碱1 000mg,静脉滴注,连续14 d.对比观察两组的治疗效果.结果 干预组治疗前、后神经功能缺损(NIHSS)评分分别为(14.1±3.2)分、(5.1±1.6)分、日常生活能力(Barthel)指数分别为(51.6±13.5)、(73.1±15.9)、血清超氧化物歧化酶(SOD)分别为(145.3±32.6) U/L、(226.9±39.7)U/L,对照组治疗前后NIHSS评分分别为(13.7±3.3)分、(10.2±3.0)分、Barthel指数分别为53.4±13.8、59.9±14.1、血清SOD浓度分别为(143.6±33.8) U/L、(179.4±35.7) U/L,两组治疗后均较治疗前有显著改善,差异有统计学意义(干预组:t值分别为16.108、6.600、10.171,P均<0.01,对照组:t值分别为5.025、2.110、4.663,P均<0.05或P<0.01),且干预组治疗后与对照组比较差异有统计学意义(t值分别为0.605,3.977,5.697,P均<0.01).干预组总有效率97.6%(40/41)显著高于对照组80.5%(33/41),差异有统计学意义(x2=4.49,P<0.05).结论 依达拉奉联合胞二磷胆碱治疗急性脑梗死效果良好,可以有效地保护脑组织,改善患者神经功能缺损,提高日常生活能力.%Objective To observe the clinical effect of edaravone combined with citicoline for treatment of acute ischemic cerebral infarctio.Methods Eighty-two cases patients of acute cerebral infarction were selected from March 2012 to August 2013 in the General Hospital of XingTai Mining group.According to admission order,they were randomly divided into observation group and control group,and each group of 41 cases.Single blind studies were carried out and on the basis of

  19. 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.

  20. PTEN degradation after ischemic stroke: a double-edged sword.

    Science.gov (United States)

    Li, W; Huang, R; Chen, Z; Yan, L-J; Simpkins, J W; Yang, S-H

    2014-08-22

    Tumor suppressor phosphatase and tensin homolog (PTEN) is highly expressed in neurons and PTEN inhibition has been reported to be neuroprotective against ischemic stroke in experimental models. On the other hand, PTEN deletion has been shown to lead to cognitive impairment. In the current study, we examined the expression and functions of PTEN in an ischemic stroke rodent model. We found rapid S-nitrosylation and degradation of PTEN after cerebral ischemia/reperfusion injury. PTEN degradation leads to activation of Akt. PTEN partial deletion or PTEN inhibition increased the expression of GABAA receptor (GABAAR) γ2 subunit and enhanced GABAA receptor current. After cerebral ischemia, increased expression of GABAAR γ2 subunit was observed in the ischemia region and the penumbra area. We also observed PTEN loss in astrocytes after cerebral ischemia. Astrocytic PTEN partial knockout increased astrocyte activation and exacerbated ischemic damage. We speculated that ischemic stroke induced neuronal PTEN degradation, hence enhanced GABAA receptor-medicated neuronal activity inhibition which could attenuate excitotoxicity and provide neuroprotection during the acute phase after stroke, while inhibiting long-term functional recovery and contributing to vascular cognitive impairment after stroke. On the other hand, ischemic stroke induced astrocytic PTEN loss and enhanced ischemic damage and astrogliosis. Taken together, our study indicates that ischemic stroke induces rapid PTEN degradation in both neurons and astrocytes which play both protective and detrimental action in a spatiotemporal- and cell-type-dependent manner. Our study provides critical insight for targeting PTEN signaling pathway for stroke treatment.

  1. Transient cerebral arteriopathy: a disorder recognized by serial angiograms in children with stroke.

    Science.gov (United States)

    Chabrier, S; Rodesch, G; Lasjaunias, P; Tardieu, M; Landrieu, P; Sébire, G

    1998-01-01

    Repeated clinical evaluation and cerebral arteriography during the evolution of ischemic strokes of idiopathic origin allowed us to characterize a transient cerebral arteriopathy. We retrospectively studied the clinical characteristics, course, and neuroimaging features of this disorder in nine children. Of 34 children with ischemic strokes seen consecutively between 1984 and 1995, 9 (26%) were diagnosed as having transient attack of the cerebral arterial wall, termed transient cerebral arteriopathy. All of these patients had previously been in good health. The mean age at the time of the first stroke was 6 years (range, 2 9/12 years to 13 4/12 years). All children presented with acute hemiplegia. A recurrence of the stroke took place 3 months at the latest after the initial infarct in three children (mean clinical follow-up 2 7/12 years). Cerebral imaging in all the patients showed small subcortical infarcts located in basal ganglia or internal capsule. Arteriography revealed multifocal lesions of the arterial wall (focal stenosis or segmental narrowing), mostly located in the initial parts of basal arteries of the carotid system. Longitudinal arteriographic follow-up showed initial worsening of these arterial lesions (n = 5) for a maximum duration of 7 months followed by complete regression (n = 2), improvement (n = 5), or stabilization of the lesions (n = 2). Five patients had a complete clinical recovery. Further studies are necessary to confirm a presumed inflammatory cause of this arteriopathy.

  2. 脑血流灌注显像、CT以及MRI用于缺血性脑卒诊断结果比较%The Comparison of Cerebral Blood Flow Imaging, CT and MRI in the Diag-nosis of Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    李颖

    2016-01-01

    Objective On cerebral blood flow perfusion imaging, CT and MRI in the diagnosis of ischemic stroke results were compared. Methods Convenient selection from July 2013 to March2016 in our hospital accepted treatment of 203 cas-es of ischemic stroke patients were analyzed, in patients after admission of patients of cerebral blood flow perfusion imaging, CT and MRI examination, record and compare the imaging parameters of ischemic stroke in patients with ipsilateral and contralateral, assessment of cerebral blood flow perfusion imaging, CT and MRI in the diagnosis of results. Results Showed cerebral blood flow perfusion imaging, CT and MRI in the diagnosis of image data found: for patients into Diagnosis when cerebral blood flow perfusion imaging detection rate of negative 89.16% and negative MRI detection rate of 88.18% were higher than those of CT 66.01%. brain perfusion SPECT and MRI diagnosis rate had no significant difference. Secondly, cerebral blood flow perfusion imaging detected negative NIHSS score for 0.631. MRI detected negative NIHSS score for 0.470 were lower than CT 2.321. difference was statistically significant, P< 0.05. Conclusion The ischemic stroke patients with cerebral perfusion imaging, CT and MRI diagnosis of node Fruit for comparison, according to the patient's condition to choose the best method of inspection, the clinical value.%目的:对脑血流灌注显像、CT以及MRI应用于缺血性脑卒的诊断结果进行比较。方法方便收集自2013年7月—2016年3月在该院所接受治疗的203例缺血性脑卒中患者进行分析,在患者入院后对患者进行脑血流灌注显像、CT以及MRI的检查,记录和比较缺血性脑卒患者的病灶侧和健侧的显像参数,评估脑血流灌注显像、CT以及MRI的诊断结果。结果观察脑血流灌注显像、CT以及MRI的诊断图像数据发现:①对患者进行诊断时脑血流灌注显像的阴性检出率89.16%,MRI的阴性检出率为88.18%,均高于CT的66

  3. Influences of ischemic preconditioning on autophagy in rats with cerebral ischemia reperfusion injury%缺血预处理对大鼠脑缺血再灌注自噬的影响

    Institute of Scientific and Technical Information of China (English)

    石秋艳; 刘冰; 张春阳; 范亚霞; 孙原; 杨斌

    2014-01-01

    Objective To observe the effect of ischemic preconditioning ( IPC) effect on cerebral ischemia reperfusion in rat hippocampus of autophagy .Methods According to method of Zea-Longa filamene , rats middle cerebral artery ischemi-a-reperfusion model were established , the experimental animal were randomly divided into 3 groups: sham operation group (Sham group, n =10), ischemia reperfusion group (I/R group, n =10), IPC treatment group (IPC group, n =30), in IPC group, according to ischemic preconditioning time , rats were divided into 1 d, 3 d, 5 d subgroups, 10 rats in each group.Af-ter ischemia 2 h and reperfusion 24 h, immunohistochemical method was used to detect the autophagy associated protein BEC -LIN L, LC3-II expression, transmission electron microscope in nerve cell autophagy and lysosomal activation and cell ultra -structure changes .Results ( 1 ) Neurological dysfunction score: compared with Sham group , I/R group and IPC group showed varying degrees of nerve dysfunction ( P <0.01), I/R group of symptoms in IPC subgroups ( P <0.05).(2) The volume of cerebral infarction:compared with Sham group , I/R group and IPC group had different degree of infarction ( P <0.01);IPC group was lower than that in I/R group ( P <0.01), 3 d subgroup was less than 1 d and 5 d subgroup ( P <0.01).(3) Immunohistochemical staining:compared with Sham group , I/R group and IPC group, the number of BECLIN 1 and LC3-II positive cells ( P <0.01), the expression of IPC positive cells was significantly lower than that of I /R group (P <0.01), IPC 3 d subgroup was less than 1 d, 5 d subgroup ( P <0.01).(4) The change of brain tissue ultrastructure morphology of cells:Sham group was normal;I/R group and IPC group showed varying amounts of autophagy , in different peri-od and or autophagic lysosome , mitochondria swelling, rupture of membranes, vesicles, lysosomes increased significantly ,visi-ble deformation of secondary lysosomes ,Golgi fragmentation;IPC group autophagy and the number

  4. 三七三醇皂苷与脑缺血耐受对脑自体神经干细胞增殖的作用%Research about panaxtrial saponins on the relationship between cerebral ischemic tolerance and proliferation of endogenous neural stem cells

    Institute of Scientific and Technical Information of China (English)

    姜晓锋; 张杰文; 罗祖明

    2014-01-01

    BACKGROUND:Cerebral ischemia tolerance can promote proliferation of autologous neural stem cells in the hippocampus of cerebral infarction rats, but panaxtrial saponins effects on the proliferation of autologous neural stem cells in the brain have not been reported. OBJECTIVE:To explore the relationship of panaxtrial saponins, ischemic preconditioning and proliferation of endogenous neural stem cells in the hippocampus of rats at 7 days after cerebral infarction, and to observe the effect on neurobehavioral scores of rats after cerebral infarction. METHODS:Fifty Sprague-Dawley rats were included and randomly divided into five groups:sham group, ischemia group, ischemic control group, ischemic preconditioning group, and panaxtrial saponins group. In the latter four groups, acute models of cerebral infarction were established using Zea-Longa method. In the sham group, only an incision was made on the neck. The focal-focal ischemic tolerance models were established with twice suture method in the ischemic preconditioning and panaxtrial saponins groups. Sham operation was instead of ischemic preconditioning in the ischemic control group. In the panaxtrial saponins group, rats were given intraperitoneal injection of 100 mg/kg panaxtrial saponins at 7 days before modeling. RESULTS AND CONCLUSION:After 7 days of cerebral infarction, the neurobehavioral score and the number of neural stem cells in the hippocampus were significantly increased in the ischemia group (P0.05). In addition, differences in the neurobehavioral scores and the number of neural stem cells in the hippocampus were insignificant between the ischemic control group and ischemia group (P>0.05). These findings indicate that panaxtrial saponins can play a role similar to ischemic tolerance, and thus improve neurologic impairment in rats with cerebral infarction.%背景:脑缺血耐受可促进大鼠脑梗死后海马区自体神经干细胞的增殖,但传统中药三七通舒对脑自体神经干细

  5. Association of reduced folate carrier-1 (RFC-1) polymorphisms with ischemic stroke and silent brain infarction.

    Science.gov (United States)

    Cho, Yunkyung; Kim, Jung O; Lee, Jeong Han; Park, Hye Mi; Jeon, Young Joo; Oh, Seung Hun; Bae, Jinkun; Park, Young Seok; Kim, Ok Joon; Kim, Nam Keun

    2015-01-01

    Stroke is the second leading cause of death in the world and in South Korea. Ischemic stroke and silent brain infarction (SBI) are complex, multifactorial diseases influenced by multiple genetic and environmental factors. Moderately elevated plasma homocysteine levels are a major risk factor for vascular diseases, including stroke and SBI. Folate and vitamin B12 are important regulators of homocysteine metabolism. Reduced folate carrier (RFC), a bidirectional anion exchanger, mediates folate delivery to a variety of cells. We selected three known RFC-1 polymorphisms (-43C>T, 80A>G, 696T>C) and investigated their relationship to cerebral infarction in the Korean population. We used the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to analyze associations between the three RFC-1 polymorphisms, disease status, and folate and homocysteine levels in 584 ischemic stroke patients, 353 SBI patients, and 505 control subjects. The frequencies of the RFC-1 -43TT, 80GG, and 696CC genotypes differed significantly between the stroke and control groups. The RFC-1 80A>G substitution was also associated with small artery occlusion and SBI. In a gene-environment analysis, the RFC-1 -43C>T, 80A>G, and 696T>C polymorphisms in the ischemic stroke group had combined effects with all environmental factors. In summary, we found that the RFC-1 -43C>T, 80A>G, and 696T>C polymorphisms may be risk factors for ischemic stroke.

  6. Intracranial transplantation of monocyte-derived multipotential cells enhances recovery after ischemic stroke in rats.

    Science.gov (United States)

    Hattori, Hidenori; Suzuki, Shigeaki; Okazaki, Yuka; Suzuki, Norihiro; Kuwana, Masataka

    2012-02-01

    Cell transplantation has emerged as a potential therapy to reduce the neurological deficits caused by ischemic stroke. We previously reported a primitive cell population, monocyte-derived multipotential cells (MOMCs), which can differentiate into mesenchymal, neuronal, and endothelial lineages. In this study, MOMCs and macrophages were prepared from rat peripheral blood and transplanted intracranially into the ischemic core of syngeneic rats that had undergone a left middle cerebral artery occlusion procedure. Neurological deficits, as evaluated by the corner test, were less severe in the MOMC-transplanted rats than in macrophage-transplanted or mock-treated rats. Histological evaluations revealed that the number of microvessels that had formed in the ischemic boundary area by 4 weeks after transplantation was significantly greater in the MOMC-transplanted rats than in the control groups. The blood vessel formation was preceded by the appearance of round CD31(+) cells, which we confirmed were derived from the transplanted MOMCs. Small numbers of bloodvessels incorporating MOMC-derived endothelial cells expressing a mature endothelial marker RECA-1 were detected at 4 weeks after transplantation. In addition, MOMCs expressed a series of angiogenic factors, including vascular endothelial growth factor, angiopoetin-1, and placenta growth factor (PlGF). These findings provide evidence that the intracranial delivery of MOMCs enhances functional recovery by promoting neovascularization in a rat model for ischemic stroke.

  7. Transplantation of human embryonic neural stem cells protects rats against cerebral ischemic injury%人源胚胎神经干细胞移植可对抗大鼠的脑缺血/再灌注损伤

    Institute of Scientific and Technical Information of China (English)

    刘晓燕; 王昌鹏; 刘铭; 季刚; 郭景春

    2014-01-01

    本文旨在研究人源胚胎神经干细胞(human embryonic neural stem cells,hNSCs)移植到脑缺血/再灌注损伤大鼠脑内后的迁移、分化,以及对大鼠脑卒中的疗效.我们在大脑中动脉栓塞(middle cerebral artery occlusion,MCAO)1 h的大鼠模型上,于血流再灌注后第7天注射hNSCs到缺血侧侧脑室,通过焦油紫染色测量大鼠的脑梗死体积,通过检测大鼠的感觉运动行为评估其神经功能的恢复水平,通过免疫荧光共标观察移植后的hNSCs在脑内的迁移与分化.结果显示,hNSCs移植后能够显著减小脑卒中大鼠脑梗死体积,并改善脑卒中大鼠的转棒、错步和转角等运动行为能力;侧脑室注射的hNSCs优先向胼胝体以及梗死区周边迁移,迁移到胼胝体的hNSCs可以分化成少突胶质细胞和星形胶质细胞,迁移到梗死区周边的细胞能够分化成神经元.以上这些结果提示,侧脑室移植的hNSCs可能通过向特定脑区的迁移和分化发挥对脑缺血/再灌注损伤大鼠的保护作用.%The purpose of this study is to explore the fate and effect of human embryonic neural stem cells (hNSCs) after transplantation into ipsilateral lateral ventricle of stroke rats.Adult rats were exposed to one-hour transient middle cerebral artery occlusion (MCAO),and then hNSCs were transplanted into ipsilateral lateral ventricle 7 days after reperfusion.Infarct volume was calculated by cresyl violet staining.The improvements of neural functions were assessed by behavioral tests.Immunofluorescence staining was performed to observe the migration and differentiation of transplanted hNSCs.The results showed that transplanted hNSCs significantly reduced ischemia-induced infarction in MCAO rats,and improved neural functional restoration when assessed by rotarod,footfault and comer-turn tests.The grafted cells migrated predominantly to several specific brain regions,such as corpus callosum and peri-infarct area.Furthermore,these cells

  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. An analysis of Methylenetetrahydrofolate reductase and Glutathione S-transferase omega-1 genes as modifiers of the cerebral response to ischemia

    Directory of Open Access Journals (Sweden)

    Sen Souvik

    2009-07-01

    Full Text Available Abstract Background Cerebral ischemia involves a series of reactions which ultimately influence the final volume of a brain infarction. We hypothesize that polymorphisms in genes encoding proteins involved in these reactions could act as modifiers of the cerebral response to ischemia and impact the resultant stroke volume. The final volume of a cerebral infarct is important as it correlates with the morbidity and mortality associated with non-lacunar ischemic strokes. Methods The proteins encoded by the methylenetetrahydrofolate reductase (MTHFR and glutathione S-transferase omega-1 (GSTO-1 genes are, through oxidative mechanisms, key participants in the cerebral response to ischemia. On the basis of these biological activities, they were selected as candidate genes for further investigation. We analyzed the C677T polymorphism in the MTHFR gene and the C419A polymorphism in the GSTO-1 gene in 128 patients with non-lacunar ischemic strokes. Results We found no significant association of either the MTHFR (p = 0.72 or GSTO-1 (p = 0.58 polymorphisms with cerebral infarct volume. Conclusion Our study shows no major gene effect of either the MTHFR or GSTO-1 genes as a modifier of ischemic stroke volume. However, given the relatively small sample size, a minor gene effect is not excluded by this investigation.

  10. Continuous measurement of cerebral cortical blood flow by laser-Doppler flowmetry in a rat stroke model

    Energy Technology Data Exchange (ETDEWEB)

    Dirnagl, U.; Kaplan, B.; Jacewicz, M.; Pulsinelli, W. (Cornell Univ. Medical College, New York, NY (USA))

    1989-10-01

    Laser-Doppler flowmetry (LDF), a new method allowing instantaneous, continuous, and noninvasive measurements of microcirculatory blood flow in a small tissue sample, was evaluated for its accuracy in monitoring regional cerebral blood flow (rCBF) in the cortical microcirculation after focal cerebral ischemia. Wistar and spontaneously hypertensive rats (SHR, n = 19) were subjected to permanent occlusion of the middle cerebral and common carotid arteries. Absolute rCBF in a tissue sample of the ischemic hemisphere was measured autoradiographically with ({sup 14}C)iodoantipyrine as a tracer and compared to rCBF measured by LDF. Additionally, the percent change in rCBF between baseline and ischemic values was compared for both methods. Absolute rCBF values recorded with LDF correlated poorly (r = 0.54) with ({sup 14}C)iodoantipyrine measurements. In contrast LDF readings expressed as a percentage of ischemic vs. preocclusion readings (relative LDF readings) correlated very well (r = 0.91) with the percent change in (14C)iodoantipyrine measurements. We conclude that LDF does not provide accurate measurements of absolute rCBF values but this method allows accurate measurements of changes in rCBF due to induction of focal cerebral ischemia.

  11. Continuous measurement of cerebral cortical blood flow by laser-Doppler flowmetry in a rat stroke model.

    Science.gov (United States)

    Dirnagl, U; Kaplan, B; Jacewicz, M; Pulsinelli, W

    1989-10-01

    Laser-Doppler flowmetry (LDF), a new method allowing instantaneous, continuous, and noninvasive measurements of microcirculatory blood flow in a small tissue sample, was evaluated for its accuracy in monitoring regional cerebral blood flow (rCBF) in the cortical microcirculation after focal cerebral ischemia. Wistar and spontaneously hypertensive rats (SHR, n = 19) were subjected to permanent occlusion of the middle cerebral and common carotid arteries. Absolute rCBF in a tissue sample of the ischemic hemisphere was measured autoradiographically with [14C]iodoantipyrine as a tracer and compared to rCBF measured by LDF. Additionally, the percent change in rCBF between baseline and ischemic values was compared for both methods. Absolute rCBF values recorded with LDF correlated poorly (r = 0.54) with [14C]iodoantipyrine measurements. In contrast LDF readings expressed as a percentage of ischemic vs. preocclusion readings (relative LDF readings) correlated very well (r = 0.91) with the percent change in [14C]iodoantipyrine measurements. We conclude that LDF does not provide accurate measurements of absolute rCBF values but this method allows accurate measurements of changes in rCBF due to induction of focal cerebral ischemia.

  12. [Ocular ischemic syndrome--a case report].

    Science.gov (United States)

    Zemba, M; Avram, Corina Ioana; Ochinciuc, Uliana; Stamate, Alina Cristina; Camburu, Raluca Lăcrămioara

    2013-01-01

    Ocular ischemic syndrome, also known as hypoperfusion/ hypotensive retinopathy or as ischemic oculopathy is a rare ocular disease determined by chronic arterial hypoperfusion through central retinal artery, posterior and anterior ciliary arteries. It is bilateral in 20% of the cases. Most often it appears due to severe occlusion of the carotid arteries (ICA, MCA>ECA), described in 1963 by Kearns and Hollenhorst. Occasionally it can be determined by the obstruction of ophtalmic artery or some arterities (Takayasu, giant cell arteritis). The risk factors are: age between 50-80 years, males (M:F = 2:1), arterial hypertension, diabetes, coronary diseases (5% of the cases develop ocular ischemic syndrome), vascular stroke, hemodialysis. The case we present is of an 63 years old man known with primary arterial hypertension, hypercholesterolemia, diabetes type 2 non insulin dependent and diagnosticated with ischemic cerebral stroke and bilateral obstruction of internal carotid arteries in march 2010, who is presenting for visual impairment in both eyes. The imaging investigations show important carotid occlusion and at the ophthalmologic evaluation there are ocular hypertension and rubeosis iridis at the right eye, optic atrophy at both eyes (complete in the right eye and partial in the left eye), with superior altitudinal visual field defect in left eye. The following diagnosis was established: Chronic ocular ischemic syndrome in both eyes with Neovascular glaucoma at the right eye, Anterior ischemic optic neuropathy at the left eye and laser panphotocoagulation at the right eye was started.

  13. Early life characteristics and late life burden of cerebral small vessel disease in the Lothian Birth Cohort 1936

    Science.gov (United States)

    Field, Thalia S.; Doubal, Fergus N.; Johnson, Wendy; Backhouse, Ellen; McHutchison, Caroline; Cox, Simon; Corley, Janie; Pattie, Alison; Gow, Alan J.; Shenkin, Susan; Cvoro, Vera; Morris, Zoe; Staals, Julie; Bastin, Mark; Deary, Ian J.; Wardlaw, Joanna M.

    2016-01-01

    It is unknown whether relations between early-life factors and overall health in later life apply to burden of cerebral small vessel disease (cSVD), a major cause of stroke and dementia. We explored relations between early-life factors and cSVD in the Lothian Birth Cohort, a healthy aging cohort. Participants were recruited at age 70 (N = 1091); most had completed a test of cognitive ability at age 11 as part of the Scottish Mental Survey of 1947. Of those, 700 participants had brain MRI that could be rated for cSVD conducted at age 73. Presence of lacunes, white matter hyperintensities, microbleeds, and perivascular spaces were summed in a score of 0-4 representing all MRI cSVD features. We tested associations with early-life factors using multivariate logistic regression. Greater SVD score was significantly associated with lower age-11 IQ (OR higher SVD score per SD age-11 IQ = .78, 95%CI 0.65-.95, p=.01). The associations between SVD score and own job class (OR higher job class, .64 95%CI .43-.95, p=.03), age-11 deprivation index (OR per point deprivation score, 1.08, 95%CI 1.00-1.17, p=.04), and education (OR some qualifying education, .60 95%CI .37-.98, p=.04) trended towards significance (p<.05 for all) but did not meet thresholds for multiple testing. No early-life factor was significantly associated with any one individual score component. Early-life factors may contribute to age-73 burden of cSVD. These relations, and the potential for early social interventions to improve brain health, deserve further study. PMID:27652981

  14. Neck circumference, a bedside clinical feature related to mortality of acute ischemic stroke Perímetro cervical, uma medida à beira do leito relacionada com a mortalidade no acidente vascular cerebral isquêmico

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    Camila Andrade Mendes Medeiros

    2011-10-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate clinical/demographic factors, sleep alterations and one year mortality in acute ischemic stroke. METHODS: This was a prospective study of 89 consecutive patients (mean age 64.39 ± 8.51 years with acute ischemic stroke. High risk of obstructive sleep apnea (OSA was evaluated by the Berlin questionnaire, daytime somnolence by the Epworth Sleepiness Scale (> 10 and subjective sleep quality by the Pittsburgh Sleep Quality Index (> 5. Clinical and anthropometric data including body mass index, hip-waist ratio, neck circumference (NC were obtained. Increased NC was defined if > 43 cm in men and > 38 cm in women. Stroke severity was estimated by the Barthel Index and the modified Rankin Scale. The end-point was death after 12 months follow-up. RESULT: One-year mortality was 8.9%. Non-survivors were older (p = 0.006 and had larger NC (p = 0.02. Among all cases, large NC was related to high risk of OSA, diabetes and hypertension (Fisher's exact test. Compared to men, women showed relatively larger NC. Overall, family history of stroke (74.2 %, diabetes (33.7% and hypertension (78.6% were frequent; obesity (11.2% was uncommon. Daytime sleepiness (34.8 %, poor sleep quality (65.2% and risk of OSA (58.42% were frequently found. CONCLUSION: Poor sleep quality, excessive daytime sleepiness and high risk of OSA are frequent in this sample with acute ischemic stroke. One-year mortality was related to older age and large NC. As obesity is uncommon in acute stroke patients, a large NC should be taken as a significant clinical sign related to mortality.OBJETIVO: O objetivo do estudo é avaliar em pacientes com acidente vascular cerebral (AVC isquêmico, os fatores clínico/demográficos, alterações do sono e a mortalidade após um ano. MÉTODOS: Trata-se de estudo prospectivo envolvendo 89 pacientes consecutivos (64,39 ± 8,51 anos com AVC isquêmico agudo. Foram avaliados o risco elevado de apneia obstrutiva do

  15. 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.

  16. The effect of ASK1 on vascular permeability and edema formation in cerebral ischemia.

    Science.gov (United States)

    Song, Juhyun; Cheon, So Yeong; Lee, Won Taek; Park, Kyung Ah; Lee, Jong Eun

    2015-01-21

    Apoptosis signal-regulating kinase-1 (ASK1) is the mitogen-activated protein kinase kinase kinase (MAPKKK) and participates in the various central nervous system (CNS) signaling pathways. In cerebral ischemia, vascular permeability in the brain is an important issue because regulation failure of it results in edema formation and blood-brain barrier (BBB) disruption. To determine the role of ASK1 on vascular permeability and edema formation following cerebral ischemia, we first investigated ASK1-related gene expression using microarray analyses of ischemic brain tissue. We then measured protein levels of ASK1 and vascular endothelial growth factor (VEGF) in brain endothelial cells after hypoxia injury. We also examined protein expression of ASK1 and VEGF, edema formation, and morphological alteration through cresyl violet staining in ischemic brain tissue using ASK1-small interference RNA (ASK1-siRNA). Finally, immunohistochemistry was performed to examine VEGF and aquaporin-1 (AQP-1) expression in ischemic brain injury. Based on our findings, we propose that ASK1 is a regulating factor of vascular permeability and edema formation in cerebral ischemia.

  17. 胡黄连苷Ⅱ对脑缺血损伤后神经细胞凋亡和超微结构的影响%Effect of picroside II on neuronal apoptosis and ultrastructure in cerebral ischemic injury in rats

    Institute of Scientific and Technical Information of China (English)

    王婷婷; 赵丽; 李晓丹; 张美增; 郭云良

    2015-01-01

    Aim To explore the effect of picroside II on neuronal apoptosis and ultrastructure after cerebral ischemic injury in rats. Methods The focal cerebral ischemic models were established by inserting a mono-filament thread into middle cerebral artery occlusion ( MCAO) in 60 Wistar rats and treated by injecting picroside Ⅱ ( 20 mg · kg-1 ) intraperitoneally. The neurobehavioral function was evaluated by modified neurological severity score test. The cerebral infarct volume was measured by tetrazolium chloride staining. The morphology and ultrastructure of brain tissue were observed by hematoxylin-eosin staining and transmis-sion electron microscopy respectively. The apoptotic cells were counted by terminal deoxynucleotidyl trans-ferase dUTP nick end labeling assay and the expression of p-ERK1/2 was determined by immunohistochemical assay and Western blot. Results The neurological be- havioral malfunction and the cerebral infarct appeared in rats with MCAO. In model group, the damage of neurons and blood brain barrier ( BBB) in cortex wors-ened, while the number of apoptotic cells and the ex-pression of p-ERK1/2 increased more significantly than those in control group ( P   端标记法检测细胞凋亡,免疫组织化学和Western blot检测p-ERK1/2表达水平。结果大鼠脑缺血损伤后表现出神经功能障碍和脑梗死病灶,皮质区神经元和血脑屏障结构损伤较重,皮质区凋亡细胞数量和p-ERK1/2蛋白表达较对照组明显增多(P<0.05)。治疗组大鼠mNSS评分和脑梗死体积较模型组明显降低(P<0.05),皮质区神经元和血脑屏障损伤减轻,凋亡细胞与p-ERK1/2表达水平较模型组明显降低(P<0.05)。结论胡黄连苷Ⅱ可能抑制神经细胞凋亡,改善缺血区脑组织的形态结构,促进大鼠神经行为功能恢复。

  18. Cerebrovascular arteriopathy (arteriosclerosis) and ischemic childhood stroke.

    Science.gov (United States)

    Daniels, S R; Bates, S; Lukin, R R; Benton, C; Third, J; Glueck, C J

    1982-01-01

    The aim of this report is to describe the intracranial cerebrovascular abnormalities and clinical status of 8 children who had familial lipoprotein disorders and evidence of thromboembolic cerebrovascular disease. Six of the 8 children had low levels of plasma high density lipoprotein cholesterol, two had high triglyceride levels, and all came from kindreds characterized by familial lipoprotein abnormalities and premature cardio- and/or cerebrovascular atherosclerosis. Vascular occlusion, irregularities of the arterial lumen, beading, tortuosity, and evidence of collateralization were consistently noted. We speculate that cerebrovascular arteriosclerosis in pediatric ischemic stroke victims who have familial lipoprotein abnormalities may be related to lipoprotein-mediated endothelial damage and thrombosis formation, or to the failure to restore endothelial cells' integrity following damage. The apparent association of lipoproteins and strokes in children and their families merits further exploration, particularly when assessing cerebral angiograms in pediatric ischemic stroke victims. In children with unexplained ischemic cerebrovascular accidents, the diagnostic possibility of occlusive arteriosclerosis with thrombosis must be entertained.

  19. 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.

  20. Ketogenic Diet Provides Neuroprotective Effects against Ischemic Stroke Neuronal Damages

    Directory of Open Access Journals (Sweden)

    Sheida Shaafi

    2014-12-01

    Full Text Available Ischemic stroke is a leading cause of death and disability in the world. Many mechanisms contribute in cell death in ischemic stroke. Ketogenic diet which has been successfully used in the drug-resistant epilepsy has been shown to be effective in many other neurologic disorders. The mechanisms underlying of its effects are not well studied, but it seems that its neuroprotective ability is mediated at least through alleviation of excitotoxicity, oxidative stress and apoptosis events. On the basis of these mechanisms, it is postulated that ketogenic diet could provide benefits to treatment of cerebral ischemic injuries.

  1. [Intraoperative monitoring of cerebral blood-flow and condition of cerebral at open and endovascular interventions in carotid system].

    Science.gov (United States)

    Kuntsevich, G I; Tanashian, M M; Skrylev, S I; Krotenkova, M V; Shchipakin, V L; Koshcheev, A Iu; Lagoda, O V; Gemdzhian, E G; Medvedev, R B; Kulikova, S N

    2011-01-01

    The aim of our research is to study hemodynamic and embolic situation during the carotid endarterectomy (CEA), carotid angioplastic and stenting (CAS), and to reveal the prognostic significance of the data provided by intraoperative monitoring of the brain blood flow in exposing acute ischemic lesions in brain. Intraoperative monitoring of blood flow in artery ophthalmic vas carried out with 60% of patients, in the middle cerebral artery-with 40% during the main stages of CEA, and with 64 patients in the middle cerebral artery during CAS. The comparison of the data of intraoperative monitoring of blood flow in middle cerebral artery with the result of brain diffusion-weighted magnetic resonance imaging (DW-MRI) 24 hours after the operation shows, that solid microembolic signals and vasospasm are prognostic signals (sensibility and specifics make up 95%) in the development of acute ischemic cerebral lesions. The monitoring of blood flow in artery ophthalmic is of the greatest diagnostic value in estimation of the hemodynamic situation, but it is of the lowest practical value in detecting microembolic signals. According to the data of the intraoperative blood flow monitoring in middle cerebral artery in group CEA the development of acute ischemic cerebral lesions were predicted with 11,1% of patients and the cause of postoperative stroke, developed by 2,9% of the patients, was specified. According to the result of DW-MRI, acute ischemic cerebral lesions were diagnosed with 21% of patients, that is, 18% of ischemic cerebral lesions were asymptomatic. In group CAS ischemic cerebral lesions were prognosed with 30% of patients, actually they were later detected with 40,6% of cases by means of DW-MRI. According to the data of intraoperative of blood flow monitoring the cause of the development of postoperative stroke was specified in 6,2% of cause; in 34,4% of cause the acute ischemic cerebral lesions were asymptomatic.

  2. Purine Metabolism in Acute Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ye. V. Oreshnikov

    2008-01-01

    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  3. Improvement in regional CBF by L-serine contributes to its neuroprotective effect in rats after focal cerebral ischemia.

    Directory of Open Access Journals (Sweden)

    Tao-Jie Ren

    Full Text Available To investigate the mechanisms underlying the neuroprotective effect of L-serine, permanent focal cerebral ischemia was induced by occlusion of the middle cerebral artery while monitoring cerebral blood flow (CBF. Rats were divided into control and L-serine-treated groups after middle cerebral artery occlusion. The neurological deficit score and brain infarct volume were assessed. Nissl staining was used to quantify the cortical injury. L-serine and D-serine levels in the ischemic cortex were analyzed with high performance liquid chromatography. We found that L-serine treatment: 1 reduced the neurological deficit score, infarct volume and cortical neuron loss in a dose-dependent manner; 2 improved CBF in the cortex, and this effect was inhibited in the presence of apamin plus charybdotoxin while the alleviation of both neurological deficit score and infarct volume was blocked; and 3 increased the amount of L-serine and D-serine in the cortex, and inhibition of the conversion of L-serine into D-serine by aminooxyacetic acid did not affect the reduction of neurological deficit score and infarct volume by L-serine. In conclusion, improvement in regional CBF by L-serine may contribute to its neuroprotective effect on the ischemic brain, potentially through vasodilation which is mediated by the small- and intermediate-conductance Ca(2+-activated K(+ channels on the cerebral blood vessel endothelium.

  4. 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

    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 glucose, blood lipid, smoking history, drinking history, heart disease and other clinical data, were collected. Meanwhile, the susceptibility-weighted imaging (SWI) was used to detect the CMB, silent lacunar infarction and leukodys-trophy.We compared the clinical characteristics of patients with or without CMB, different parts of CMB and different se-verity of CMB.Logistic regression was used to analyze the risk factors of CMB.Results During 135 patients, 55 cases of patients had CMB, and 80 cases had no CMB.There were 35 cases of deep/infratentorial CMB and 20 cases of lobar CMB in CMB patients.According to the severity, CMB was divided into three levels, level 1 CMB was found in 22 cases, level 2 in 26 case and level 3 in 4 cases.The age, BMI, systolic blood pressure level, the scale of white matter lesion and pro-portion of hypertension, history of stroke and lacunar infarction in deep/infratentorial CMB group were significantly higher than that of non-CMB group ( all P<0.05) .The BMI, proportion of hypertension and lacunar infarction in deep/infraten-torial CMB group were higher than lobar CMB group (all P<0.05).The age and the scale of white matter lesion in lobar CMB group were significantly higher than non-CMB group (all P <0.05).The proportion of hypertension, history of stroke, lacunar infarction and white matter lesion of patients with level 3 and level 2 CMB were significantly higher than those of patients with level 1 CMB (all P<0.05).Multivariate Logistic regression analysis showed that the age, hyperten-sion, history of stroke, asymptomatic lacunar infarction and the white matter lesion were the

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

    Energy Technology Data Exchange (ETDEWEB)

    Skranes, Jon S.; Brubakk, Ann-Mari [Norwegian University of Science and Technology, Department of Laboratory Medicine, Children' s and Women' s Health, Trondheim (Norway); Martinussen, Marit; Smevik, Olaug; Myhr, Gunnar [Norwegian University of Science and Technology, Department of Circulation and Imaging, Trondheim (Norway); Indredavik, Marit [Norwegian University of Science and Technology, Department of Neuroscience, Trondheim (Norway); Vik, Torstein [Norwegian University of Science and Technology, Department of Community Medicine and General Practice, Trondheim (Norway)

    2005-08-01

    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.)

  6. Hyperintense vessel sign on FLAIR maybe associated with cerebral collateral circulation in patients with acute ischemic stroke or transient ischemic attack: a retrospective case series study%缺血性卒中或短暂性脑缺血发作患者FLAIR序列高信号血管征可能与脑侧支循环有关:回顾性病例系列研究

    Institute of Scientific and Technical Information of China (English)

    黄显军; 周志明; 刘文华; 朱武生; 葛良; 徐格林; 刘新峰

    2014-01-01

    Objective To investigate the possible formation mechanism and imaging features of the hyperintense vessel sign (HVS) on fluid attenuated inversion recovery (FLAIR) in patients with ischemic stroke or transient ischemic attack (TIA).Methods The baseline data of the patients with middle cerebral artery (MCA) ischemic stroke or TIA with digital subtraction angiography (DSA) showing the lesions of MCA M1 segment in clinical practice were retrospectively retrieved from Nanjing Stroke Registry Program from January 2010 to July 2011.FLAIR was used to observe HVS,and DSA was used to evaluate the degree of vascular stenosis and cerebral collateral circulation.Results A total of 101 patients were enrolled,76 (75.2%) were males,and their mean age was 53.94 ± 13.47 years; 90 patients (89.1%) with ischemic stroke and 11 patients (10.9%) with TIA; 55 patients (54.5%) were HVS negative and 46 (45.5%) were HVS positive.Among the patients whose MCA stenosis <50%,50%-70%,70%-90% and ≥90%,the positive rates were 0% (0/8),25.0% (3/12),17.6% (3/17),and 62.5% (40/64),respectively.There were significant differences (Z=-4.479,P< 0.001).The leptomeningeal collateral circulation of the HVS positive group was significantly more than that of the HVS negative group (Z =-6.196,P < 0.001).Multivariate logistic regression analysis showed that the degree of MCA stenosis was an independent risk factor for influencing the formation of HVS (odds ratio 3.943,95% confidence interval 2.03-7.659; P <0.001).Conclusions The formed intracranial leptomeningeal colhteral circulation after severe intracranial vascular stenosis or occlusion is a major pathophysiological basis of HVS formation on FLAIR sequences in patients with ischemic stroke or TIA.%目的 探讨缺血性卒中或短暂性脑缺血发作(transient ischemic attack,TIA)患者液体衰减反转恢复序列(fluid-attenuated inversion recovery,FLAIR)高信号血管征(hyperintense vessel sign,HVS)的可

  7. 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.

  8. 七氟醚-瑞芬太尼麻醉对缺血型烟雾病脑血管重建术患者脑氧供需平衡的影响%Effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease

    Institute of Scientific and Technical Information of China (English)

    梁发; 崔伟华; 何颖; 焦希平; 王嵘; 张东; 韩如泉

    2013-01-01

    目的 评价七氟醚-瑞芬太尼麻醉对缺血型烟雾病脑血管重建术患者脑氧供需平衡的影响.方法 择期行颞浅动脉-大脑中动脉分支吻合术的缺血型烟雾病患者40例,性别不限,年龄19~ 59岁,BMI 19~ 25 kg/m2,ASA分级Ⅰ或Ⅱ级,Suzuki分期≥3.采用随机数字表法,将患者随机分为2组(n=20):异丙酚-瑞芬太尼组(PR组)和七氟醚-瑞芬太尼组(SR组).麻醉诱导:靶控输注异丙酚,血浆靶浓度5 μg/ml,静脉注射芬太尼3 μg/kg和罗库溴铵0.6 mg/kg.气管插管后行机械通气,麻醉维持:SR组吸入七氟醚(呼气末浓度1.0% ~ 1.7%),PR组TCI异丙酚,血浆靶浓度3~4 μg/ml,2组均TCI瑞芬太尼,血浆靶浓度3.5 ng/ml,维持BIS值40 ~ 60,间断静脉注射罗库溴铵0.3 mg/kg.分别于麻醉诱导前(T0)、血管阻断前10 min (T1)、血管阻断后10 min (T2)、血管吻合-开放后10 min (T3)时记录局部脑氧饱和度(rSO2).结果 与T0时比较,PR组T3时术侧rSO2升高,SR组T1-3时术侧和非术侧rSO2升高(P<0.05或0.01);与PR组比较,SR组T1时术侧rSO2升高(P<0.05),非术侧rSO2差异无统计学意义(P>0.05).结论 对于缺血型烟雾病脑血管重建术患者,七氟醚复合瑞芬太尼麻醉可维持良好的脑氧供需平衡状态,且与异丙酚复合瑞芬太尼麻醉的效果相似.%Objective To evaluate the effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease by monitoring regional cerebral O2 saturation (rSO2) with near infrared spectroscopy.Methods Forty patients of both sexes aged 19-59 yr with a body mass index of 19-25 kg/m2 undergoing superficial temporal artery-middle cerebral artery anastomosis were randomly allocated into 2 groups (n =20 each):propofol-remifentanil group (group PR) and sevoflurane-remifentanil group (group SR).Radial artery was cannulated for direct BP monitoring and blood sampling

  9. Effects of Cerebral Microbleeds on the Incidence of Cerebral Events in Patients with Ischemic Cerebrovas-cular Disease at the Last Stage of Antiplatelet Agent%是否伴发脑微出血对缺血性脑血管病患者应用抗血小板药后期脑血管事件发生率影响的临床分析Δ

    Institute of Scientific and Technical Information of China (English)

    刘春洁; 郑海亮; 李晓晴

    2016-01-01

    目的:比较是否合并脑微出血(CMBs)的缺血性脑血管病患者应用抗血小板药物后期脑血管事件的发生率。方法:选择首都医科大学附属北京安贞医院2013年1月-2014年1月缺血性脑血管病患者140例,根据其是否合并CMBs分为CMBs组和非CMBs组,各70例。两组患者随访(随访期间规律服用阿司匹林100 mg/d和/或氯吡格雷75 mg/d)1年后,比较其再发脑梗死及脑出血的发生率及病死率。结果:CMBs组再发脑梗死的发生率为12.9%,非CMBs组为8.6%,组间比较差异无统计学意义(P=0.412);CMBs组脑出血的发生率为10.0%,非CMBs组为1.4%,组间比较差异有统计学意义(P=0.029);CMBs组后期脑血管事件的病死率为5.7%,非CMBs组为4.3%,组间比较差异无统计学意义(P=0.698)。结论:合并CMBs的缺血性脑血管病患者应用抗血小板药物后,脑出血的风险增加。对于伴CMBs的缺血性脑血管病患者,在选择抗血小板药物时应充分权衡获益及出血风险。%OBJECTIVE:To compare the incidence of cerebral events in patients with ischemic cerebrovascular disease compli-cating with cerebral microbleeds(CMBs)at the last stage of antiplatelet agent use. METHODS:140 patients with ischemic cerebro-vascular disease were selected from Beijing Anzhen Hospital Affilicated to Capital Medical University during Jan. 2013-Jan. 2014, and then divided into CMBs group and non-CMBs group according to whether complicated with CMBs,with 70 cases in each group. After followed up for 1 year(regular use of aspirin 100 mg/d and/or clopidogrel 75 mg/d),the incidence of recurrent cere-bral infarction and cerebral bleeding and mortality were compared. RESUTLS:The incidence of recurrent cerebral infarction was 12.9% in CMBs group and 8.6% in non-CMBs group,without statistical significance(P=0.412);the incidence of cerebral bleed-ing was 10.0% in CMBs group and 1.4% in non

  10. 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)

  11. 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,

  12. Effect of niupo zhibao weiwan on neural precursor cells after focal cerebral ischemic reperfusion%牛珀至宝微丸对局灶性脑缺血再灌注后神经前体细胞的影响

    Institute of Scientific and Technical Information of China (English)

    廖欣; 杜少辉; 陈东风; 张宜; 黎晖; 魏志军

    2004-01-01

    BACKGROUND: The adult individual hippocampus and subependyma cells are able to divide and produce neoformative neurons and separate cell population which are characterized by continuous division and proliferation and multiple differential potential energyalso named as neural stem cells. But the separation and purification are very difficult, or the separation process is apt to cause injury of neural cell and affect its activity to result in death.Therefore,it is significant essentially to develop Chinese herbs so as to induce the proliferation of neural stem cells in the body in clinic. OBJECTIVE:To observe the effect of niupo zhibao weiwan(NZW) on neural precursor after focal cerebral ischemic reperfusion,and probe into its mechanism in the treatment of ischemic cerebral vascular disease. DESIGN:Randomized, controlled, single blind trial design. SETTING and MATERIALS:The experiment was performed in the Laboratory of Neural Anatomy of Basic Institute in Guanzhou University of Traditional Chinese Medicine.Twenty-four purebred SD rats were employed. INTERVENTION: Linear embolism in cerebral arteries was adopted to prepare the model of focal cerebral ischemia and the immunohistochemical technique was provided to determine the expression of neural precursor cells. MAIN OUTCOME MEASURES:Nestin positive cell counts in paraependyma, subependyma, cortex and striate body of cerebrum. RESULTS: After cerebral ischemic reperfusion,compared with the control group, in NZW group,Nestin positive cell counts in paraependyma, subependyma,cortex and striate body were significantly more and the neurology evaluation was remarkably lower(P< 0.05). CONCLUSION:NZW increases Nestin expression after cerebral ischemic reperfusion persistently,which is probably one of the mechanisms in the treatment of ischemic cerebral vascular diseases.%背景:成年个体海马和室管膜下层细胞具有分裂产生新生神经元的能力,并分离了能不断分裂增殖且具有多种分化潜能的

  13. Effect of chlorimipramine on recovery of motor function of rats with focal cerebral ischemic injury%氯丙米嗪促进局灶性脑缺血损伤大鼠运动功能恢复的特点

    Institute of Scientific and Technical Information of China (English)

    郭俊; 刘学东; 张晓梅; 周永清; 刘立

    2006-01-01

    BACKGROUND: Amfetamine, one of the levarterenols, can improve the recovery of motor function of animals after cerebral ischemia. Chlorimipramine can inhibit the re-intake of 5-serotonin and levarterenol and improve the level of them in brain. OBJECTIVE: To observe the effect of chlorimipramine on motor function of rats with focal cerebral ischemic injury.DESIGN: Randomized grouping and controlled animal study. SETTING: Neuropsychiatry Team of Aerial Clinical Medical Department of the Fourth Military Medical University of Chinese PLA. MATERIALS: The experiment was completed in the Morphological Laboratory of Aerial Aerospace Medical Department of the Fourth Military Medical University of Chinese PLA. All the 24 SD rats were divided into sham operation group, ischemia group and ischemic medication group with 8 in each group. Rats in ischemic medication group were perfused with 10 mg/kg chlorimipramine solution (2.5 g/L) once a day through mouth 24 hours after ischemia, and rats in sham operation group and ischemia group were perfused with the same volume of distilled water through mouth. METHODS: Middle cerebral artery (MCA) models of ischemia/reperfusion rats were established with inserted lining method. After modeling, the operations were performed as followed: ① holding test of net screen: Net screen was put horizontally, and then rats were put on it. One side of the screen was raised gradually; then it was turned over 125° within 2 s, and maintained at this placement. Time of holding rats on net screen was recorded. ② Test of struggling to tear off rubberized cloth: 0.5 cm2 medical rubberized cloth was adhered to the ventral of anterior claws of rats, and then rats were sent to the observing box to record the time of tearing off rubberized cloth. 1, 3, 7, 14 and 28 days after operation were the observing time points. MAIN OUTCOME MEASURES: Times of holding rats on the net screen and tearing off the rubberized cloth of rats with focal cerebral is chemia

  14. Cerebrovascular endothelin receptor upregulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, Lars

    2009-01-01

    leading to the enhanced expression of vascular endothelin receptors show that both protein kinase C (PKC) and mitogen activating protein kinase (MAPK) play important roles. The results from this work provide new perspectives on the pathophysiology of ischemic stroke, and give a possible explanation......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...... either by an embolus or by local thrombosis. Several studies have shown an involvement of the endothelin system in ischemic stroke. This review aims to examine the alterations of vascular endothelin receptor expression in ischemic stroke. Furthermore, studies of the intracellular signalling pathways...

  15. NLRP3 deficiency ameliorates neurovascular damage in experimental ischemic stroke.

    Science.gov (United States)

    Yang, Fan; Wang, Ziying; Wei, Xinbing; Han, Huirong; Meng, Xianfang; Zhang, Yan; Shi, Weichen; Li, Fengli; Xin, Tao; Pang, Qi; Yi, Fan

    2014-04-01

    Although the innate immune response to induce postischemic inflammation is considered as an essential step in the progression of cerebral ischemia injury, the role of innate immunity mediator NLRP3 in the pathogenesis of ischemic stroke is unknown. In this study, focal ischemia was induced by middle cerebral artery occlusion in NLRP3(-/-), NOX2(-/-), or wild-type (WT) mice. By magnetic resonance imaging (MRI), Evans blue permeability, and electron microscopic analyses, we found that NLRP3 deficiency ameliorated cerebral injury in mice after ischemic stroke by reducing infarcts and blood-brain barrier (BBB) damage. We further showed that the contribution of NLRP3 to neurovascular damage was associated with an autocrine/paracrine pattern of NLRP3-mediated interleukin-1β (IL-1β) release as evidenced by increased brain microvessel endothelial cell permeability and microglia-mediated neurotoxicity. Finally, we found that NOX2 deficiency improved outcomes after ischemic stroke by mediating NLRP3 signaling. This study for the first time shows the contribution of NLRP3 to neurovascular damage and provides direct evidence that NLRP3 as an important target molecule links NOX2-mediated oxidative stress to neurovascular damage in ischemic stroke. Pharmacological targeting of NLRP3-mediated inflammatory response at multiple levels may help design a new approach to develop therapeutic strategies for prevention of deterioration of cerebral function and for the treatment of stroke.

  16. Clinical analysis on neuroprotection of transient ischemic attacks

    Institute of Scientific and Technical Information of China (English)

    Dimitar Maslarov; Desislava Drenska

    2011-01-01

    Transient ischemic attack (TIA) is an acute cerebrovascular incident, and is generally considered the best opportunity for early neuroprotective treatment against cerebral ischemia. This study retrospectively analyzed 80 patients with TIA (38 males and 42 females). Among 61 patients who received neuroprotective cerebrolysin treatment within 24 hours after TIA onset, 13 (21.31%)patients suffered subsequent strokes. Among 19 patients who received neuroprotective

  17. Blood oxygenation level dependent effect of cerebral ischemic penumbra in monkey reversible middle cerebral artery occlusion model%猴可复性大脑中动脉闭塞模型脑缺血半暗带的血氧水平依赖效应

    Institute of Scientific and Technical Information of China (English)

    张敬; 陈英敏; 张云亭

    2010-01-01

    Objective To investigate the value of blood oxygenation level dependent (BOLD) MRI in detecting monkey cerebral ischemic penumbra (IP). Methods Six monkeys were used to make reversible middle cerebral artery occlusion (MCAO) model by an interventional microcatheter method. MR DWI, PWI mean transit time (MTT), T_2WI and quantitative T_2 map, T_2~* map were performed at MCAO (0 h) and 1,3,6,12,24,48 h after reperfusion. Reversible transverse relaxation rate (R_2') BOLD imaging was calculated using quantitative T_2 and T_2~* maps. Lesion volume percentage (lesion volume/bilateral hemispheres volume) were measured on 0 h DWI,48 h T_2WI and TTC staining. Ischemic area was subdivided into infracted core (high signal area on both 0 h DWI and 48 h T_2 WI), IP (high signal on 0 h DWI, iso on 48 h T_2 WI) and oligemia (0 h delayed MTT, iso signal on both 0 h DWI and 48 h T_2 WI). Relative R_2' (rR_2') was calculated to get ratio between the lesion and mirror area in contralateral healthyhemisphere. Paired t test and correlation analysis were used for comparison of lesion volume percentage. rR_2' values at each time point were compared by ANOVA. Results Reversible MCAO models were made successfully in 4 of 6 monkeys. Lesion volume porcentage on 48 h T_2 WI was reduced compared to that on Oh DWI [ (8.16±0.55)% vs (11.37±1.41)% ,t=6.472,P0.05], which showed significant positive correlation (r=0.98, P0.05),两者呈明显正相关(r=0.98,P<0.05).梗死核心、IP、低灌注区rR_2'在各时间点差异均有统计学意义,梗死核心低于IP,IP低于低灌注区(P<0.05),三者rR_2'值:0 h时分别为1.129±0.108、1.329±0.081、1.584±0.103(F=36.19,P<0.05).1 h分别为0.668±0.082、1.237±0.072、1.435±0.066(F=134.09,P<0.05).3 h分别为0.536±0.075、1.453±0.081、1.770±0.141(F=256.30,P<0.05).6 h分别为0.259±0.050、2.435±0.131、2.957±0.177(F=803.25,P<0.05).12 h分别为0.385±0.054、2.447±0.148、3.254±0.184(F=743.74,P<0.05).24 h分别为0.083±0.026、1

  18. A pharmacological screening approach for discovery of neuroprotective compounds in ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Simret Beraki

    Full Text Available With the availability and ease of small molecule production and design continuing to improve, robust, high-throughput methods for screening are increasingly necessary to find pharmacologically relevant compounds amongst the masses of potential candidates. Here, we demonstrate that a primary oxygen glucose deprivation assay in primary cortical neurons followed by secondary assays (i.e. post-treatment protocol in organotypic hippocampal slice cultures and cortical neurons can be used as a robust screen to identify neuroprotective compounds with potential therapeutic efficacy. In our screen about 50% of the compounds in a library of pharmacologically active compounds displayed some degree of neuroprotective activity if tested in a pre-treatment toxicity assay but just a few of these compounds, including Carbenoxolone, remained active when tested in a post-treatment protocol. When further examined, Carbenoxolone also led to a significant reduction in infarction size and neuronal damage in the ischemic penumbra when administered six hours post middle cerebral artery occlusion in rats. Pharmacological testing of Carbenoxolone-related compounds, acting by inhibition of 11-β-hydroxysteroid dehydrogenase-1 (11β-HSD1, gave rise to similarly potent in vivo neuroprotection. This indicates that the increase of intracellular glucocorticoid levels mediated by 11β-HSD1 may be involved in the mechanism that exacerbates ischemic neuronal cell death, and inhibiting this enzyme could have potential therapeutic value for neuroprotective therapies in ischemic stroke and other neurodegenerative disorders associated with neuronal injury.

  19. Regional cerebral blood flow during hypoxia-ischemia in immature rats

    Energy Technology Data Exchange (ETDEWEB)

    Vannucci, R.C.; Lyons, D.T.; Vasta, F.

    1988-02-01

    Immature rats subjected to a combination of unilateral common carotid artery ligation and hypoxia sustain brain damage confined largely to the ipsilateral cerebral hemisphere. To ascertain the extent and distribution of ischemic alterations in the brains of these small animals, we modified the Sakurada technique to measure regional cerebral blood flow using carbon-14 autoradiography. Seven-day-old rats underwent right common carotid artery ligation following which they were rendered hypoxic with 8% O2 at 37 degrees C. Before and during hypoxia, the rat pups received an injection of iodo(/sup 14/C)antipyrine for determination of regional cerebral blood flow. Blood flows to individual structures of the ipsilateral cerebral hemisphere were not influenced by arterial occlusion alone; flows to the contralateral hemisphere and to the brainstem and cerebellum actually increased by 25-50%. Hypoxia-ischemia was associated with decreases in regional cerebral blood flow of the ipsilateral hemisphere such that by 2 hours, flows to subcortical white matter, neocortex, striatum, and thalamus were 15, 17, 34, and 41% of control, respectively. The hierarchy of the blood flow reductions correlated closely with the distribution and extent of ischemic neuronal necrosis. However, unlike the pathologic pattern of this model, the degree of ischemia appeared homogeneous within each brain region. Blood flows to contralateral cerebral hemispheric structures were relatively unchanged from prehypoxic values, whereas flows to the brainstem and cerebellum nearly doubled and tripled, respectively. Thus, ischemia is the predominant factor that determines the topography of tissue injury to major regions of immature rat brain, whereas metabolic factors may influence the heterogeneous pattern of damage seen within individual structures.

  20. Acute Ischemic Stroke and Transient Ischemic Attack

    OpenAIRE

    Staykov, Dimitre; Schwab, Stefan

    2014-01-01

    This short review focuses on recent practically relevant studies in stroke treatment and prevention and discusses their implications on clinical practice and future research, including 3 shortly published randomized controlled trials investigating interventional treatment in acute ischemic stroke (The Interventional Management of Stroke phase III trial [IMS III], Synthesis Expansion: A Randomized Controlled Trial on Intra-Arterial Versus Intravenous Thrombolysis in Acute Ischemic Stroke, and ...

  1. 磁共振扩散张量成像在急性缺血性脑梗死时相判断中的应用%Application of diffusion tensor imaging in judging infarction time of acute ischemic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    戴真煜; 陈飞; 姚立正; 董从松; 刘洋; 侍海存; 张志平; 杨乃忠; 张明生

    2015-01-01

    Objective To evaluate the clinical application value of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTF) in judging infarction time phase of acute ischemic cerebral infarction.Methods To retrospective analysis DTI images of 52 patients with unilateral acute ischemic cerebral infarction (hyper-acute,acute and sub-acute) from the Affiliated Yancheng Hospital of Southeast University Medical College,which diagnosed by clinic and magnetic resonance imaging.Set the regions of interest (ROIs) of infarction lesions,brain tissue close to infarction lesions and corresponding contra (contralateral normal brain tissue) on DTI parameters mapping of fractional anisotropy (FA),volume ratio anisotropy (VRA),average diffusion coefficient (DCavg) and exponential attenuation (Exat),record the parameters values of ROIs and calculate the relative parameters value of infarction lesion to contra.Meanwhile,reconstruct the DTI images based on the seed points (infarction lesion and contra).The study compared each parameter value of infarction lesions,brain tissue close to infarction lesions and corresponding contra,also analysed the differences of relative parameters values in different infarction time phases.Results The DTT images of acute ischemic cerebral infarction in each time phase could show the manifestation of fasciculi damaged.The DCavg value of cerebral infarction lesions was lower and the Exat value was higher than contra in each infarction time phase (P < 0.05).The FA and VRA value of cerebral infarction lesions were reduced than contra only in acute and sub-acute infarction (P < 0.05).The FA,VRA and Exat value of brain tissue close to infarction lesions were increased and DCavg value was decreased than contra in hyper-acute infarction (P < 0.05).There were no statistic differences of FA,VRA,DCavg and Exat value of brain tissue close to infarction lesions in acute and sub-acute infarction.The relative FA and VRA value of infarction lesion to contra

  2. A Case Of Transient Ischemic Attack Presenting As Hemichroea

    Directory of Open Access Journals (Sweden)

    Hasan Hüseyin Özdemir

    2013-12-01

    Full Text Available Chorea is defined as; involuntary movements of the distal parts of limbs which have arrhythmic, rapid, bouncing or smooth, simple or complex properties. Choreiform movements occur when putamen, globus pallidus and subthalamic nucleus are affected. Chorea can be observed during the course of metabolic and vascular diseases, neurodegenerative or hereditary diseases. Chorea may be a rare symptom of cerebral hypoperfusion. Transient ischemic attack is an event that occurs in short term characterized by a temporary ischemia of brain. A wide variety of symptoms can be seen depending on the localization of cerebral hypoperfusion. Hemichorea is a very rare finding observed during transient ischemic attacks. In this article hemichorea in a case of symptomatic transient ischemic attack is discussed with relevant literature.

  3. Meta Analysis of Protective Effect of Cerebral Ischemic Preconditioning on Ischemia-Reperfusion Injury in Rats%脑缺血预处理对大鼠脑缺血再灌注损伤保护作用的 Meta 分析

    Institute of Scientific and Technical Information of China (English)

    曾晓鹏; 邹晓峰; 陈丽

    2016-01-01

    目的:系统评价脑缺血预处理对大鼠脑缺血再灌注损伤的保护作用。方法计算机检索 PubMed(1999年1月至2015年2月)、中国生物医学文献数据库(2003年1月至2015年2月)、中国期刊全文数据库(1999年1月至2015年2月)、万方数据库(2002年10月至2015年2月)获取相关随机对照实验,按照 Cochrane 系统评价的方法评价纳入研究,并使用 Cochrane 协作网提供的 RevMan5.1统计软件进行结果统计分析。结果本 Meta 分析最终纳入11个随机对照试验,均对脑缺血预处理组和脑缺血再灌注组进行了比较。随机效应模型分析结果显示,与脑缺血再灌注组比较,脑缺血预处理组脑梗死体积减少(MD=-79.70,95%CI -111.97、-47.42,P <0.05),脑梗死体积百分比降低(MD=-11.60,95%CI -16.24、-6.95,P <0.05),神经功能缺失评分降低(MD=-1.41,95%CI -1.75、-1.07,P <0.05),血清神经元特异性烯醇化酶活性降低(MD=-3.23,95%CI -3.96、-2.50, P <0.05)。2组脑组织中白细胞介素-1β、肿瘤坏死因子-α水平比较差异无统计学意义(P >0.05)。结论脑缺血预处理对大鼠脑缺血再灌注损伤具有脑保护作用,但本系统评价的不足之处在于纳入的文献数量较少,还需通过开展更多的随机对照实验来验证本研究的结论。%Objective To systematically evaluate the protective effect of cerebral ischemic pre-conditioning on cerebral ischemia reperfusion injury in rats.Methods We searched PubMed(Jan-uary 1999-February 2015 ),Chinese Biomedical Literature Database (January 2003-February 2015),China Academic Journal CNKI(January 1999-February 2015)and Wanfang Database(Oc-tober 2002-February 2015)to obtain relevant randomized controlled trials,which were included in the study according to the Cochrane systematic reviews.The RevMan5

  4. Neuroprotective effects of the immunomodulatory drug Setarud on cerebral ischemia in male rats

    Institute of Scientific and Technical Information of China (English)

    Farzaneh Vafaee; Nasser Zangiabadi; Fatemeh Mehdi Pour; Farzaneh Dehghanian; Majid Asadi-Shekaari; Hossein Karimi Afshar

    2012-01-01

    Anti-inflammatory and anti-oxidant agents can alleviate ischemic cerebral injury. The immunomodulary drug Setarud, which is composed of herbal extracts including Rosa canina, Urtica dioica and Tanacetum vulgare, supplemented with selenium exhibits anti-inflammatory and anti-oxidant properties. Therefore, we hypothesized that Setarud will have a neuroprotective effect against ischemic cerebral injury. To validate this hypothesis, rats were intraperitoneally administered with 0.66 mL/kg Setarud for 30 minutes after middle cerebral artery occlusion. Triphenyltetrazolium chloride staining showed that Setarud could reduce cerebral infarct volume of rats subjected to cerebral ischemia. Transmission electron microscopy and hematoxylin-eosin staining results showed that Setarud could alleviate the degenerative changes in cortical neurons of rats with cerebral ischemia. The inclined plate test and prehensile test showed that Setarud could significantly improve the motor function of rats with cerebral ischemia. These findings suggest that Setarud shows neuroprotective effects against ischemic brain injury.

  5. Correlation between Tissue Kallikrein and the Severity of Cerebral Ischemic Stroke%组织激肽释放酶与缺血性脑卒中严重程度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    冯忠; 汪立松; 王希佳

    2013-01-01

    Objective To explore the relationship between tissue kallikrein ( TK ) level and the severity of cerebral ischemic stroke ( CIS ). Methods A total of 324 patients visiting the Department of Neurology of our hospital during May 2009 to May 2012 were included in the study. They were divided into NIHSS ≤12 group ( n =238 ) and NIHSS > 12 group ( n = 86 ) according to the National Institute of Health Stroke Scale ( NIHSS ). The age, sex, medical history, and personal history were recorded, and BMI, blood fat, liver and kidney function, and TK level were measured. Correlation analysis was conducted on the influencing factors and multiple regression analysis was used to explore the relationship between the influencing factors and the severity of CIS. Results The TK level in the NIHSS > 12 group was significantly lower than that in the NIHSS ≤12 group ( P 12 group were significantly higher than that in the NIHSS ≤ 12 group ( P <0. 01 ). The NIHSS was negatively correlated with the TK level ( r = -0. 425 , P =0. 038 ), and positively correlated with levels of cholesterol ( r = 0. 356, P < 0. 01 ) and triglyceride ( r = 0. 277, P < 0. 01 ). Multiple regression analysis showed that the TK level was negatively correlated ( b = - 0. 735 , t = - 0. 861, P = 0. 021 ), and levels of cholesterol ( b = 1.102, t=3.221, P =0.036) and triglyceride ( b = 1. 116, t =4.216, P =0.042) were negatively correlated with the severity of CIS. Conclusion The levels of TK, cholesterol, and triglyceride may be correlated with the severity of CIS. The lower the TK level, and the higher the levels of cholesterol and triglyceride, the more severe the CIS is.%目的 探讨组织激肽释放酶(TK)与缺血性脑卒中(CIS)严重程度的关系.方法 选择2009年5月-2012年5月在我院神经内科就诊的CIS患者324例,根据美国国立卫生研究院卒中量表评分(NIHSS)将患者分为NIHSS≤12分组238例和NIHSS>12分组86例.详细记录患者的年龄

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

    DEFF Research Database (Denmark)

    Vikman, P; Edvinsson, L

    2006-01-01

    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...... 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......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...

  7. Anticoagulant Therapy In Ischemic Stroke Or TIA

    Directory of Open Access Journals (Sweden)

    Kaveh Mehrvar

    2017-02-01

    Full Text Available Stroke is the leading cause of disability and the third leading cause of death  . Anticoagulants   have been used to treat patients with acute ischemic stroke for many years. Despite their widespread use, the usefulness of emergency anticoagulation is a subject of debate. Disagreements exist about the best agent to administer, the route of administration, the use of a bolus dose to start treatment, the level of anticoagulation required, and the duration of treatment. There are 2 types of anticoagulants: Parenteral and oral. Heparin is an anticoagulant that used parenteral. Oral anticoagulants are including Warfarin and new anticoagulants such as Dabigatrn,Rivaroxaban ,Apixaban and other newer drugs. In patients with noncardioembolic  ischemic stroke or TIA antiplatelet agents are treatment of choice and preferred to anticoagulants. In cardioembolic  ischemic stroke or TIA with high risk of reembolization  anticoagulants  are considered as preferred treatment.  Warfarin, apixaban10mg/d ,Rivaroxaban20mg/d, and dabigatran 150 mg/d are all indicated for the prevention of recurrent stroke in patients with nonvalvular AF, whether paroxysmal or permanent.Also anticoagulant therapy is recommended for ischemic stroke or TIA patients in the setting of acute MI, atrial or ventricular thrombosis or dilated and restricted cardiomyopathy. Some valvular heart diseases are other indication for anticoagulant therapy in ischemic stroke or TIA patients. Ischemic  Stroke or TIA in patients with Cerebral vein thrombosis and  known hypercoagulable state specially anti phospholipid antibody syndrome are other indications for anticoagulant treatment.

  8. 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 (pdamage after ischemic stroke, which might be involved in two signal pathways: PKC-α-GLT-1-Glutamate and PI3K/Akt-GLT-1-Glutamate.

  9. Early electrocortical changes consistent with ischemic preconditioning in rat

    DEFF Research Database (Denmark)

    Zagrean, L.; Moldovan, M.; Munteanu, Ana-Maria

    2002-01-01

    Ischemic preconditioning (IPC) of the brain describes the neuroprotection induced by a short, conditioning ischemic episode (CIE) to a subsequent severe (test) ischemic episode (TIE). Most of the supporting evidence for IPC is based on histological assessment, several days after TIE. The aim...... of this study is to investigate if changes induced by IPC can be detected within 30 min of reperfusion following the ischemic episode. A rat model of "four-vessel occlusion" transient global cerebral ischemia and parametric analysis of electrocorticogram were used. A control group was subjected directly to a 10...... min TIE, and in a preconditioned group TIE was induced 48 h after a 3 min CIE. Quantitative histology was performed 48 h after TIE. Our key finding is that, 30 min after reperfusion, there is a significant increase in the electrocortical slow activity in the control group but not in the preconditioned...

  10. [Preditive clinical factors for epileptic seizures after ischemic stroke].

    Science.gov (United States)

    Fukujima, M M; Cardeal, J O; Lima, J G

    1996-06-01

    Preditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1) were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2). The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p < 0.05). Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  11. White Matter Hyperintensities Improve Ischemic Stroke Recurrence Prediction

    DEFF Research Database (Denmark)

    Andersen, Søren Due; Larsen, Torben Bjerregaard; Gorst-Rasmussen, Anders;

    2017-01-01

    -based, observational cohort study, we included 832 patients (mean age 59.6 (SD 13.9); 42.0% females) with incident ischemic stroke and no AF. We assessed the severity of white matter hyperintensities using MRI. Hazard ratios stratified by the white matter hyperintensities score and adjusted for the components......BACKGROUND: Nearly one in 5 patients with ischemic stroke will invariably experience a second stroke within 5 years. Stroke risk stratification schemes based solely on clinical variables perform only modestly in non-atrial fibrillation (AF) patients and improvement of these schemes will enhance...... their clinical utility. Cerebral white matter hyperintensities are associated with an increased risk of incident ischemic stroke in the general population, whereas their association with the risk of ischemic stroke recurrence is more ambiguous. In a non-AF stroke cohort, we investigated the association between...

  12. Acute Ischemic Stroke and Acute on Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Raja Ahsan Aftab

    2016-06-01

    Full Text Available Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled. He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis, acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition. Keywords: ischemic disease; chronic kidney disease; uncontrolled hypertension. | PubMed

  13. 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.

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

    Science.gov (United States)

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

    2014-12-01

    Endovascular surgery is advantageous in experimentally induced ischemic stroke because it causes fewer cranial traumatic lesions than invasive surgery and can closely mimic the pathophysiology 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 flow 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 flow was restored. A reversible middle cerebral artery occlusion model was identified 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 symptoms of neurological deficits. Compared with the M1 occlusion group, the M2 occlusion group had lower infarction volume and higher neurological scores. These experimental findings 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 field of brain injury research.

  15. Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

    Directory of Open Access Journals (Sweden)

    Jacek Staszewski

    2013-01-01

    Full Text Available Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

  16. Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS study.

    Directory of Open Access Journals (Sweden)

    Andrew J Lawrence

    Full Text Available Cerebral small vessel disease (SVD is a common cause of vascular cognitive impairment. A number of disease features can be assessed on MRI including lacunar infarcts, T2 lesion volume, brain atrophy, and cerebral microbleeds. In addition, diffusion tensor imaging (DTI is sensitive to disruption of white matter ultrastructure, and recently it has been suggested that additional information on the pattern of damage may be obtained from axial diffusivity, a proposed marker of axonal damage, and radial diffusivity, an indicator of demyelination. We determined the contribution of these whole brain MRI markers to cognitive impairment in SVD. Consecutive patients with lacunar stroke and confluent leukoaraiosis were recruited into the ongoing SCANS study of cognitive impairment in SVD (n = 115, and underwent neuropsychological assessment and multimodal MRI. SVD subjects displayed poor performance on tests of executive function and processing speed. In the SVD group brain volume was lower, white matter hyperintensity volume higher and all diffusion characteristics differed significantly from control subjects (n = 50. On multi-predictor analysis independent predictors of executive function in SVD were lacunar infarct count and diffusivity of normal appearing white matter on DTI. Independent predictors of processing speed were lacunar infarct count and brain atrophy. Radial diffusivity was a stronger DTI predictor than axial diffusivity, suggesting ischaemic demyelination, seen neuropathologically in SVD, may be an important predictor of cognitive impairment in SVD. Our study provides information on the mechanism of cognitive impairment in SVD.

  17. 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.

  18. 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.

  19. 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)

  20. Angiographic findings of ischemic stroke in children.

    Science.gov (United States)

    Shirane, R; Sato, S; Yoshimoto, T

    1992-12-01

    A cooperative study was undertaken in the Tohoku district of Japan to investigate the relatively rare phenomenon of cerebral infarction in children. The purpose of the present paper is to describe the cerebral angiographic findings in 48 children whose ischemic lesions were confirmed by CT scan. The majority of lesions were considered to be idiopathic. The areas of cerebral infarction appearing in the CT scans were located in the territory of the middle cerebral artery including the basal ganglia. Angiographical abnormalities were observed in 40 patients (83%). The majority occurred in the supraclinoid portion of the internal carotid artery and in the cisternal portion of the middle and anterior cerebral arteries. Multiple lesions, such as in the C1, A1, and M1 or the C1, M1, and M2 segments were observed in 22 cases. These lesions generally appeared in continuation; no bilateral intracranial lesions were observed. Repeated angiography was performed in 22 cases, and in 55% of these some recovery of the lesions was seen.

  1. 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.

  2. Influenza A (H1N1)-induced ischemic stroke in a child: case report and review of the literature

    OpenAIRE

    Chiaretti, Antonio; Calzedda, Roberta; Ceccarelli, Manuela; PRIOLO, FRANCESCA; Valentini, Piero; Ferrara, Pietro; Massimi, Luca

    2014-01-01

    Ischemic stroke is an important cause of death and long term morbidity in children. Viral respiratory infections are emerging as important risk factors responsible for ischemic stroke in this age group. The direct action of virus against cerebral vessels, autoimmune reactivity, and increased production of cytokines are advocated as the main factors for causing ischemic stroke. This study can be useful for clarifying some molecular aspects of H1N1 virus infection in children. We re...

  3. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  4. 电针百会、风府穴对脑I/R损伤大鼠海马区CPG15表达影响的实验研究%Effects of Eiectroacupuncture Bai Hui, Feng Fu on CPG15 Expression of Hippocampus in Rats with Cerebral Ischemic Reperfusion

    Institute of Scientific and Technical Information of China (English)

    唐晓敏; 秦正玉; 何宗宝; 王家琳; 吴生兵; 汪克明

    2011-01-01

    目的 探讨电针对局灶性脑缺血再灌注大鼠神经功能的恢复及海马区神经可塑性相关基因15(CPG15)表达影响的情况.方法 60只SD大鼠,雌雄各半,随机分为正常对照组、模型组、电针经穴组、电针非经穴组、西药对照组.采用线栓法制备局灶性脑缺血再灌注模型,电针经穴组电针百会、风府穴,电针非经穴组电针大鼠臀部非经非穴位置,电针以疏波2Hz,强度3 mA~5mA,持续电针30 min,每天1次,连续治疗2周.西药对照组以尼莫地平20 mg/(kg·d)灌胃,每日2次,连续灌胃2周.2周后Longa5分法对大鼠神经功能缺损评分,并取材,运用免疫组化法检测大鼠缺血侧海马区CPG15表达情况.结果 模型组大鼠神经功能缺损评分及缺血侧海马区CPG15表达显著高于正常对照组(P<0.01);电针经穴组与西药治疗组大鼠神经功能评分及海马区CPG15表达差异无统计学意义(P>0.05),而与模型组比较,电针经穴组与西药治疗组神经功能评分及海马区CPG15表达均有统计学意义(P<0.01);电针非经穴组大鼠神经功能缺损评分及缺血侧海马区CPG15表达与模型组比较差异无统计学意义(P>0.05).结论 电针可改善脑缺血再灌注大鼠神经功能,并提高海马区CPG15的表达,电针对脑缺血再灌注后脑细胞的神经可塑性有促进作用.%Objective To investigate the effects of electroacupuncture on canidate plasticity- related gene 15CCPG15) expression of hippocampus in rats with cerebral ischemic reperfusion(I/R). Methods Sixty sprague - dawley rats were randomly divided into normal group (group 1) ,cerebral ischemic reperfusion model group (group 2) .electroacupuncture on meridian acupoints group (group 3),electroacupuncture on non - meridian acupoints group (group 4) .and nimodiping group (group 5). Rat models with cerebral ischemia reperfusion were prepared by modified suture. Electroacupuncture was applied on Bai Hui(TV20) and .Feng Fu

  5. Acute Headache at Emergency Department: Reversible Cerebral Vasoconstriction Syndrome Complicated by Subarachnoid Haemorrhage and Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    M. Yger

    2015-01-01

    Full Text Available Introduction. Reversible cerebral vasoconstriction syndrome is becoming widely accepted as a rare cause of both ischemic and haemorrhagic stroke and should be evocated in case of thunderclap headaches associated with stroke. We present the case of a patient with ischemic stroke associated with cortical subarachnoid haemorrhage (cSAH and reversible diffuse arteries narrowing, leading to the diagnosis of reversible vasoconstriction syndrome. Case Report. A 48-year-old woman came to the emergency department because of an unusual thunderclap headache. The computed tomography of the brain completed by CT-angiography was unremarkable. Eleven days later, she was readmitted because of a left hemianopsia. One day after her admission, she developed a sudden left hemiparesis. The brain MRI showed ischemic lesions in the right frontal and occipital lobe and diffuse cSAH. The angiography showed vasoconstriction of the right anterior cerebral artery and stenosis of both middle cerebral arteries. Nimodipine treatment was initiated and vasoconstriction completely regressed on day 16 after the first headache. Conclusion. Our case shows a severe reversible cerebral vasoconstriction syndrome where both haemorrhagic and ischemic complications were present at the same time. The history we reported shows that reversible cerebral vasoconstriction syndrome is still underrecognized, in particular in general emergency departments.

  6. Obstruction of cerebral arteries in childhood stroke

    Energy Technology Data Exchange (ETDEWEB)

    Velkey, I.; Lombay, B. (County Teaching Hospital, Miskolc (Hungary). Child Health Center); Panczel, G. (Semmelweis Medical Univ., Budapest (Hungary). Dept. of Psychiatry)

    1992-09-01

    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.).

  7. Impact of severe extracranial ICA stenosis on MRI perfusion and diffusion parameters in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Philipp eKaesemann

    2014-12-01

    Full Text Available Purpose:The aim of this study was to investigate the impact of a coexisting internal carotid artery (ICA stenosis on lesion volumes as well as diffusion and perfusion parameters in acute ischemic stroke resulting from middle cerebral artery (MCA occlusion.Material and Methods:MRI data of 32 patients with MCA occlusion with or without additional ICA stenosis imaged within 4.5 hours of symptom onset were analyzed. Both groups consisted of 16 patients. Acute diffusion lesions were semi-automatically segmented in apparent diffusion coefficient (ADC MRI datasets. Perfusion maps of cerebral blood volume (CBV, cerebral blood flow (CBF, mean transit time (MTT and Tmax were calculated using perfusion-weighted MRI datasets. Tissue-at-risk (TAR volumes were generated by subtracting the ADC lesion from the hypoperfusion lesion defined by Tmax >6s. Median ADC and perfusion parameter values were extracted separately for the diffusion lesion and tissue-at-risk and used for statistical analysis.Results:No significant differences were found between the groups regarding the diffusion lesion and tissue-at-risk volumes. Statistical analysis of diffusion and perfusion parameters revealed CBV as the only parameter with a significant difference (p=0.009 contributing a small effect (ɛ²=0.11 to the group comparison with higher CBV values for the patient group with a coexisting ICA stenosis, while no significant effects were found for the other diffusion and perfusion parameters analyzed.Conclusion:The results of this study suggest that a coexisting ICA stenosis does not have a strong effect on tissue status or perfusion parameters in acute stroke patients except for a moderate elevation of CBV. This may reflect improved collateral circulation or ischemic preconditioning in patients with a pre-existing proximal stenosis balancing impaired perfusion from the stenosis.

  8. 12 hours after cerebral ischemia is the optimal time for bone marrow mesenchymal stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Seyed Mojtaba Hosseini

    2015-01-01

    Full Text Available 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 fluorescence 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 findings 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.

  9. 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.

  10. Clinical experience with L-lysine escinate for acute and chronic cerebral circulatory disorders

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    N. V. Pizova

    2015-01-01

    Full Text Available Cerebrovascular diseases (CVD are major causes of disability and death in Russia. Stroke is the third significant cause of higher death rates after cardiovascular disease and cancer. The prevalence of circulatory diseases, such as atherosclerosis and hypertension, is on the rise. Therapy for CVD must be aimed at the underlying disease in which vascular catastrophe (atherosclerosis, hypertension, heart disease, etc. develops, at the regression of neurological and psychopathological syndromes, and at the improvement of cerebral blood flow and metabolic processes. Neuroprotective agents, whose efficacy has been established in uncontrolled and small placebo-controlled trials, are widely used in our country. The prescription of these medications is substantiated by the important role of the pathogenetic mechanisms underlying cerebral ischemia. This paper gives data on the clinical use of L-lysine escinate for ischemic stroke (IS, hypertensive crisis, and chronic cerebral circulatory disorders and discusses the mechanism of this drug's action and the pathogenetic mechanisms of cerebrovascular lesions. A number of investigations have shown it expedient to incorporate L-lysine escinate in the combined neuroprotective therapy of patients with IS, cerebral hypertensive crisis, and hypertensive encephalopathy, which is associated with its antiedematous effect, particularly in preventing vasogenic brain edema, in enhancing the tone of cerebral veins, and in improving venous outflow. It is stated that there is a need for an individualized approach to treating CVD, by taking into consideration the existing risk factors and somatic and neurological diseases. 

  11. Modifiable risk factors for ischemic stroke

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    Alexandros Gianoulakis

    2010-07-01

    Full Text Available Ischemic stroke is the third leading cause of death after cardiac disease and cancer in the developed countries. In patients older than 65 years old, ischemic stroke is one of the main causes of disability. They are also responsible for approximately 4.5 million deaths each year globally.The aim of the present study was to review the literature about the modifiable risk factors related to the development of ischemic stroke.The method οf this study included bibliographic research from both reviews and researches from literature, mainly of the last 8 years. The words used in pub med data base, referred to the modifiable risk factors related to the development of ischemic stroke.Results: In the majority of research studies, responsible risk factors for ischemic stroke are classified according to their ability of modification, in modifiable and non–modifiable risk factors. Some of the modifiable risk factors have been fully documented whereas some others need further research. The main modifiable risk factor is hypertension because on the one hand it promotes atherosclerosis and, on the other hand, leads to deteriorative changes and constrictions of small brain vessels. Atrial fibrillation is the most significant risk factor for ischemic stroke, since it is responsible for more than 50% of thromboembolic cases. Also, patients with diabetes mellitus are in higher risk for developing ischemic stroke compared to healthy population, whereas the danger is increasing in insuline-depented individuals. Increase of lipids in blood and disorders of cholesterol are responsible for atherosclerosis in coronary vessels and carotid. More in detail, carotid stenosis >50% in individuals over than 65 years old consist a significant risk factor for ischemic stroke. Though, the relation of smoking to ischemic stroke is still not fully understood, however smokers are in high risk for developing ischemic stroke for the reason that smoking is significantly related to

  12. 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).

  13. Ischemic postconditioning alleviates rat cerebral ischemia-reperfusion injury through the phosphoinositide 3-kinase signaling pathway%缺血后处理通过PI3K信号通路抑制脑缺血再灌注损伤

    Institute of Scientific and Technical Information of China (English)

    宫利; 王志; 肖松华; 刘运林; 周海红; 邢诒刚

    2009-01-01

    Objective To investigate the neuroprotective effect of ischcmic posteonditioning (IP)against cerebral ischemia-reperfusion injury and the role of phosphoinositide 3-kinase(P13K)signaling pathway in the neuroprotection. Methods Focal cerebral ischernia was induced in 24 SD rats by permanent distal middle cerebral artery occlusion and transient bilateral comlllOn carotid artery occlusion.The rats were then randomized into 4 groups for treatment with IP,LY294002+IP,DMSO+IP,or without IP.In LY294002+IP and DMSO+IP groups,LY294002 or DMSO was injcoted into the ventricular space on the ischemic side 1 h before ischemia.The cerebral infarct sizes wgre measured in all the 4 groups at 48h after the reperfusion.Results Cerebral infarcts were observed in all the groups on theischemic side,all locating in the left neocortex and the middle cerebral artery territory.At48h after reperfusion,the infarct size was significantly smaller in rats with IP(34.02%±7.17%)than in those without IP(57.05%±10.05%)(P<0.05),and significantly larger in LY294002+IP group(73.41%±2.06%)than in DMSO+IP group(35.76%±1.51%)(P<0.05).No significant difference was found in the infarctsize between DMSO+IP group and IP group(P>0.05).Conclusion IP ameliorates cerebral reperfusion mjury in rats,and the mechanism of this neuroprotective effect involves the preservation of PI3K activity.%目的 研究缺血后处理(IP)对脑缺血再灌注损伤的影响及其机制.方法 采用开颅机械闭塞法建立SD大鼠局灶性脑缺血模型,通过开放/夹闭双侧颈总动脉实现IP.24只大鼠按照随机数字表法分为IP组、非IP组、LY294002+IP组、DMSO+IP组,每组6只,再灌注48 h后测脑梗死面积;其中LY294002、DMSO于建模前1 h侧脑室注入.结果 各组左侧大脑皮层均可见清晰梗死灶,符合血管分布范围.其中IP组腩梗死面积(34.02%±7.17%)明显小于非IP组(57.05%±10.05%),差异有统计学意义(P<0.05);LY294002+IP组脑梗死面积(73.41%±2.06%)

  14. Clinical study on cognitive function and the related factors of patients with ischemic cerebral vascular disease complicated with cerebral microbleeds%缺血性脑血管病并脑微出血相关因素分析及认知功能临床研究

    Institute of Scientific and Technical Information of China (English)

    刘军贤; 王志东; 黄润霞

    2015-01-01

    Objective To analyze cognitive function and the related factors of patients with ischemic cerebral vascular dis‐ease (ICVD) complicated with cerebral microbleeds (CMBs). Methods 240 cases of ICVD patients were selected as the re‐search objects and were divided into CMBs group and non CMBs group according to whether complicated with CMBs. 62 pa‐tients and 178 patients were included respectively. Mini Mental State Examination (MMSE) and Montreal cognitive assessment scale (MoCA) were applied to evaluate and compare the cognitive function of the patients.Results The age and proportions of patients with hypertension ,leukoaraiosis(LA) ,lacunar Infarction (LI) ,a history of previous stroke in CMBs group were sig‐nificantly higher than those in non CMBs group (P<0.05). The age (OR=1.376) ,hypertension (OR=3.965) ,and LI (OR=3.562) were the risk factors for the incidence of ICVD patients complicated with CMBs (P< 0.05). The total score of MMSE ,the total score of MoCA score and the scores of visuospatial/executive ,attention ,delayed memory items of patients in CMBs group were significantly lower than those of the patients in non CMBs group (P<0.05). The total score of MMSE ,the total score of MoCA score and the scores of visuospatial/executive ,attention ,language ,delayed memory items of patients with CMBs involving the cortico subcortical areas were significantly lower than those without involving CMBs involving the cortico subcortical areas (P<0.05).Conclusion The incidence of ICVD complicated with CMBs is associated with many factors ,and can lead to significant cognitive impairment ,which may be related with the occurrences of CMBs lesion involving the cortico subcortical areas.%目的分析缺血性脑血管病(ICVD)合并脑微出血(CMBs)的相关因素及对认知功能的影响。方法选取240例ICVD患者为研究对象,根据是否合并CMBs分为CMBs组和非CMBs组,分别纳入62例和178例患者,应用简易精神状况检查表

  15. Cardiogenic embolism producing crescendo transient ischemic attacks.

    Science.gov (United States)

    Geraghty, Patrick J; Oak, Jack; Choi, Eric T

    2005-09-01

    Lateralizing, repetitive transient ischemic attacks are characteristic of symptomatic carotid bifurcation atherosclerotic plaques. We report a case in which a cardiogenic embolus, after lodging at the left carotid bifurcation, produced crescendo episodes of expressive aphasia and mild right upper extremity weakness. Complete neurological recovery was achieved following emergent carotid embolectomy and endarterectomy. This case demonstrates that the laminar nature of internal carotid blood flow may result in the localization of embolic events to a single region of the cerebral vasculature, regardless of the source lesion in the carotid artery. The role of endoluminal techniques in the diagnosis and management of such lesions is discussed.

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

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    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.

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

    Science.gov (United States)

    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 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. PMID:20955613

  18. Mortality study for a decade: ischemic stroke in the elderly.

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    Javier J. García Zacarías

    2014-09-01

    Full Text Available Cerebrovascular diseases are among the top three causes of death in Cuba and the world, about 80 % of these patients belong to Ischemic Stroke. The objective of this paper is to describe the clinical and developmental profile of patients who died of Ischemic Stroke. A descriptive, prospective research, cross- sectional study was made, the sample included all deaths from ischemic stroke at the University Hospital "Camilo Cienfuegos" Sancti Spiritus, between January 1st, 2001 and December 31, 2010, and persons over 60 years of age with necropsy performed. Atherothrombotic stroke was the most frequent category, the highest mortality rates were observed in persons over 80 years of age and in females, hypertension, ischemic heart disease and transient ischemic attack were the main significant medical history; most patients were admitted in the stroke unit and died in Middle Progressive Care, cerebral edema and intracranial hypertension and hypostatic bronchopne umonia were complications and specific main causes of most frequent death. Value of cerebral edema and hypostatic bronchopneumonia as clinical complications and causes of death in patients investigated is confirmed.

  19. The time of maximum post-ischemic hyperperfusion indicates infarct growth following transient experimental ischemia.

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    Susanne Wegener

    Full Text Available After recanalization, cerebral blood flow (CBF can increase above baseline in cerebral ischemia. However, the significance of post-ischemic hyperperfusion for tissue recovery remains unclear. To analyze the course of post-ischemic hyperperfusion and its impact on vascular function, we used magnetic resonance imaging (MRI with pulsed arterial spin labeling (pASL and measured CBF quantitatively during and after a 60 minute transient middle cerebral artery occlusion (MCAO in adult rats. We added a 5% CO2 - challenge to analyze vasoreactivity in the same animals. Results from MRI were compared to histological correlates of angiogenesis. We found that CBF in the ischemic area recovered within one day and reached values significantly above contralateral thereafter. The extent of hyperperfusion changed over time, which was related to final infarct size: early (day 1 maximal hyperperfusion was associated with smaller lesions, whereas a later (day 4 maximum indicated large lesions. Furthermore, after initial vasoparalysis within the ischemic area, vasoreactivity on day 14 was above baseline in a fraction of animals, along with a higher density of blood vessels in the ischemic border zone. These data provide further evidence that late post-ischemic hyperperfusion is a sequel of ischemic damage in regions that are likely to undergo infarction. However, it is transient and its resolution coincides with re-gaining of vascular structure and function.

  20. The Protective Effect of Rosuvastatin on Ischemic Brain Injury and Its Mechanism

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To study the protective effect of rosuvastatin on ischemic brain injury and its mechanism,in on ischemic brain injury and its mechanism,focal cerebral ischemia/reperfusion was induced by occlusion of the middle cerebral artery (MCA)-luminal filament technique. The cerebral blood flow was monitored with laser-Doppler flowmetry (LDF). The slices of brain tissue were stained with cresyl-violet. The cerebral e quantified with ImageJ software. The expressions of endothelial NO synthase (eNOS) and activated caspase-3 were detected with Western blot. The inducible NO were immunohistochemically observed. The results demonstrated that rosuvastatin (20 mg/kg) could remarkably decrease infarct volume and cerebral edema after MCAO ots showed that the expression of eNOS in cerebral cortex before and after ischemia was (100±43.3) %, (1668.9±112.2) % respectively (P<0.001), rosuvastatin gulated the expression of eNOS in non-ischemic cortex (P<0.001), whereas in ischemic cortex of rosuvastatin group the expression of eNOS was (1678.8±121.3) %. There was no hemic cortex, nonetheless the expression of activated caspase-3 increased after ischemia, and rosuvastatin significantly diminished it (P<0.01). Immunoaled no iNOS-positive cells in non-ischemic brain area, while in ischemic brain area the number of iNOS positive cells went up, and rosuvastatin could significantly reduced them.'s neural protection on ischemic brain injury are to enhance expression of eNOS, to inhibit expression of iNOS and activated caspase-3.mia/reperfusion; NOS; caspase-3

  1. The 'silence' of silent brain infarctions may be related to chronic ischemic preconditioning and nonstrategic locations rather than to a small infarction size

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    Chao Feng

    2013-01-01

    Full Text Available OBJECTIVE: Silent brain infarctions are the silent cerebrovascular events that are distinguished from symptomatic lacunar infarctions by their 'silence'; the origin of these infarctions is still unclear. This study analyzed the characteristics of silent and symptomatic lacunar infarctions and sought to explore the mechanism of this 'silence'. METHODS: In total, 156 patients with only silent brain infarctions, 90 with only symptomatic lacunar infarctions, 160 with both silent and symptomatic lacunar infarctions, and 115 without any infarctions were recruited. Vascular risk factors, leukoaraiosis, and vascular assessment results were compared. The National Institutes of Health Stroke Scale scores were compared between patients with only symptomatic lacunar infarctions and patients with two types of infarctions. The locations of all of the infarctions were evaluated. The evolution of the two types of infarctions was retrospectively studied by comparing the infarcts on the magnetic resonance images of 63 patients obtained at different times. RESULTS: The main risk factors for silent brain infarctions were hypertension, age, and advanced leukoaraiosis; the main factors for symptomatic lacunar infarctions were hypertension, atrial fibrillation, and atherosclerosis of relevant arteries. The neurological deficits of patients with only symptomatic lacunar infarctions were more severe than those of patients with both types of infarctions. More silent brain infarctions were located in the corona radiata and basal ganglia; these locations were different from those of the symptomatic lacunar infarctions. The initial sizes of the symptomatic lacunar infarctions were larger than the silent brain infarctions, whereas the final sizes were almost equal between the two groups. CONCLUSIONS: Chronic ischemic preconditioning and nonstrategic locations may be the main reasons for the 'silence' of silent brain infarctions.

  2. Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Gang Wang; Xue Cheng; Xianglin Zhang

    2013-01-01

    Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.

  3. Nogo-A与缺血后适应脑保护作用的研究进展%Research Progress on Cerebral Protective Effect of Ischemic Postconditioning and Nogo-A

    Institute of Scientific and Technical Information of China (English)

    钱芳

    2012-01-01

    轴索过度生长抑制因子A(Nogo-A)是近年来人们在中枢神经系统髓磷脂中研究发现的一种抑制轴突生长的蛋白,对神经细胞再生有显著的抑制作用.缺血后适应是近年来发现的一种新的干预措施,作为缺氧耐受现象的一种,可以显著地减轻缺血/再灌注损伤.现就Ngoo-A与缺血后适应脑保护的研究进行综述,探讨两者与神经损伤修复的关系.%Neurite outgrowth inhibitor-A( Nogo-A )is one type of protein which inhibit the growth of axon discovered in the study of the central nervous system myelin in recent years,which obviously restrains regeneration of nerve cells. As a kind of phenomenons of hypoxia tolerance,ischemic postconditioning may lessen ischemia/reperfusion injury remarkably. Here is to make a review on Nogo-A and ischemic postconditioning in the study of brain protection to explore the relationship between them and nerve repair.

  4. 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 ...

  5. Morinda citrifolia fruit juice prevents ischemic neuronal damage through suppression of the development of post-ischemic glucose intolerance.

    Science.gov (United States)

    Harada, Shinichi; Fujita-Hamabe, Wakako; Kamiya, Kohei; Mizushina, Yoshiyuki; Satake, Toshiko; Tokuyama, Shogo

    2010-10-01

    Fruit juice of Morinda citrifolia (Noni juice) is a well-known health drink and has various pharmacological properties including antioxidant and anti-inflammatory effects. We have hitherto found the protective effect of Noni juice on brain damage caused by ischemic stress in mice. In addition, we also recently reported that regulation of post-ischemic glucose intolerance might be important for good prognosis. Here, we focused on the effect of Noni juice on the development of the post-ischemic glucose intolerance as a cerebral protective mechanism. Noni juice was obtained from the mature fruit grown in Okinawa (about 1.5 L/4 kg of fruit; 100% ONJ). Male ddY mice were given 10% ONJ in drinking water for 7 days. Then, mice were subjected to 2 h of middle cerebral artery occlusion (MCAO). Ingestion of 10% ONJ suppressed the development of neuronal damage after MCAO. Interestingly, glucose intolerance observed on the 1st day after MCAO completely disappeared after 10% ONJ administration. Furthermore, ONJ treatment significantly increased serum insulin levels much further than the control group on the 1st day, while serum adiponectin levels were not affected at all. These results suggest that ONJ could facilitate insulin secretion after ischemic stress and may attenuate the development of glucose intolerance. These mechanisms may contribute to the neuronal protective effect of ONJ against ischemic stress.

  6. Neuroimaging: biochemical principles and its application in the cerebrovascular ischemic disease.

    Directory of Open Access Journals (Sweden)

    Zenaida Milagros Hernández Díaz

    2009-07-01

    Full Text Available The knowledge of neurobiochemical principles has allowed understanding the ischemic cascade that takes place after the decrease of cerebral blood flow and the findings that are visualized in neuroimaging studies in cerebrovascular ischemic disease. The need for early diagnosis of acute events to reestablish the cerebral blood flow to reduce neurological sequels, has led to the development of advanced imaging techniques, which allows following the histochemical and morphological changes that take place within the brain in vivo, in a non-invasive way, as well as its development, extent of the cerebral damage and damaged cerebral structures. The present bibliographic review has the objective of supporting the importance of neuroimaging studies in the diagnosis of acute cerebral ischemia.

  7. Association of the Single Nucleotide Polymorphisms in microRNAs 130b, 200b, and 495 with Ischemic Stroke Susceptibility and Post-Stroke Mortality

    Science.gov (United States)

    Choi, Gun Ho; Ko, Ki Han; Kim, Jung Oh; Oh, Seung Hun; Park, Young Seok

    2016-01-01

    The microRNA (miRNA) is a small non-coding RNA molecule that modulates gene expression at the posttranscriptional level. Platelets have a crucial role in both hemostasis and thrombosis, a condition that can occlude a cerebral artery and cause ischemic stroke. miR-130b, miR-200b, and miR-495 are potential genetic modulators involving platelet production and activation. We hypothesized that single nucleotide polymorphisms (SNPs) in these miRNAs might potentially contribute to the susceptibility to ischemic stroke and post-stroke mortality. This study included 523 ischemic stroke patients and 400 control subjects. We investigated the association of three miRNA SNPs (miR-130bT>C, miR-200bT>C, and miR-495A>C) with ischemic stroke prevalence and post-stroke mortality. In the multivariate logistic regression, there was no statistically significant difference in the distribution of miR-130bT>C, miR-200bT>C, or miR-495A>C between the ischemic stroke and control groups. In the subgroup analysis based on ischemic stroke subtype, the miR-200b CC genotype was less frequently found in the large-artery atherosclerosis stroke subtype compared with controls (TT+CT vs CC; adjusted odds ratio for CC, 0.506; 95% confidence interval, 0.265–0.965). During a mean follow-up period of 4.80 ± 2.11 years after stroke onset, there were 106 all-cause deaths among the 523 stroke patients. Multivariate Cox regression analysis did not find a significant association between post-stroke mortality and three miRNA SNPs. Our findings suggest that the functional SNP of miR-200b might be responsible for the susceptibility to large-artery atherosclerotic stroke. PMID:27603512

  8. Neuronal autophagy in cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Feng Xu; Jin-Hua Gu; Zheng-Hong Qin

    2012-01-01

    Autophagy has evolved as a conserved process for the bulk degradation and recycling of cytosolic components,such as long-lived proteins and organelles.In neurons,autophagy is important for homeostasis and protein quality control and is maintained at relatively low levels under normal conditions,while it is upregulated in response to pathophysiological conditions,such as cerebral ischemic injury.However,the role of autophagy is more complex.It depends on age or brain maturity,region,severity of insult,and the stage of ischemia.Whether autophagy plays a beneficial or a detrimental role in cerebral ischemia depends on various pathological conditions.In this review,we elucidate the role of neuronal autophagy in cerebral ischemia.

  9. Therapeutic Effects of Tongxinluo Capsule(通心络胶囊) on Patients with Acute Small Cerebral Infarction and Its Influence on SPECT Brain Perfusion Image

    Institute of Scientific and Technical Information of China (English)

    周盛年; 周国钰; 刘黎青

    2004-01-01

    Objective: To investigate the influence of Tongxinluo capsule (TXL, 通心络胶囊) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography ( SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI).Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group ( n = 17) was treated with the conventional treatment, i.e. 1.0g of Citicoline added into 300 mi normal saline for intravenous dripping daily for 2 weeks and 0.8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group ( n = 17)was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (BI) at the same time. Results: After treatment, the rCBF in the treatment group was significantly improved ( P<0.01), while that in the control group remained unchanged, with the comparison of the rCBF in the two groups after treatment showing significant difference (P<0.01). In addition, the SSS score was significantly lower and BI significantly higher in the treatment group than those in the control group respectively after treatment. Conclusion: TXL could effectively improve rCBF and lessen the neurological deficit symptoms in patients with ASCI.

  10. 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.

  11. Clinical application of dynamic digital subtraction angiography in cerebrovascular ischemic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Yoshifumi; Nonaka, Nobuhito; Matsukado, Yasuhiko; Takahashi, Mutsumasa.

    1987-09-01

    Dynamic intravenous digital subtraction angiography (IV-DSA) was performed in 37 patients with cerebrovascular ischemic diseases. The time density curve of IV-DSA was analysed, and peak time, mean transit time and mode of transit time were obtained in each patient. On the basis of these values, cerebral perfusion was classified into low, normal and high perfusion patterns. Normal perfusion pattern was noted in 40% of patients with transient ischemic attack (TIA) and 7 % of patients with cerebral infarction. Low perfusion pattern was observed in 60 % of patients with TIA and 87 % of patients with cerebral infarction. High perfusion pattern was encountered only in 7 % of patients with cerebral infarction. In ischemic patients with moyamoya disease, extremely prolonged cerebral circulation time was evidenced by the presence of a flat or uphill type of the time density curve. This finding well correlated with decreased cerebral blood flow on single photon emission tomography. These findings suggest that the analysis of dynamic DSA is very important and useful in the clinical evaluation of patients with cerebrovascular ischemic diseases.

  12. Piroxicam-mediated modulatory action of 5-hydroxytryptamine serves as a "brake" on neuronal excitability in ischemic stroke

    Directory of Open Access Journals (Sweden)

    Pallab Bhattacharya

    2015-01-01

    Full Text Available Our previous studies indicated an increase in extracellular γ-aminobutyric acid (GABA in rodent′s ischemic brain after Piroxicam administration, leading to alleviation of glutamate mediated excitotoxicity through activation of type A GABA receptor (GABAA. This study was to investigate if GABAA activation by Piroxicam affects extracellular 5-hydroxytryptamine or not. High performance liquid chromatography revealed that there was a significant decrease in extracellular 5-hydroxytryptamine release in ischemic cerebral cortex and striatum in Piroxicam pre-treated rat brains. This suggests a probable role of Piroxicam in reducing extracellular 5-hydroxytryptamine release in ischemic cerebral cortex and striatum possibly due to the GABAA activation by Piroxicam.

  13. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  14. Inlfammatory response and neuronal necrosis in rats with cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Lingfeng Wu; Kunnan Zhang; Guozhu Hu; Haiyu Yang; Chen Xie; Xiaomu Wu

    2014-01-01

    In the middle cerebral artery occlusion model of ischemic injury, inlfammation primarily occurs in the infarct and peripheral zones. In the ischemic zone, neurons undergo necrosis and apop-tosis, and a large number of reactive microglia are present. In the present study, we investigated the pathological changes in a rat model of middle cerebral artery occlusion. Neuronal necrosis appeared 12 hours after middle cerebral artery occlusion, and the peak of neuronal apoptosis ap-peared 4 to 6 days after middle cerebral artery occlusion. Inlfammatory cytokines and microglia play a role in damage and repair after middle cerebral artery occlusion. Serum intercellular cell adhesion molecule-1 levels were positively correlated with the permeability of the blood-brain barrier. These ifndings indicate that intercellular cell adhesion molecule-1 may be involved in blood-brain barrier injury, microglial activation, and neuronal apoptosis. Inhibiting blood-brain barrier leakage may alleviate neuronal injury following ischemia.

  15. Selective gene expression in focal cerebral ischemia.

    Science.gov (United States)

    Jacewicz, M; Kiessling, M; Pulsinelli, W A

    1986-06-01

    Regional patterns of protein synthesis were examined in rat cortex made ischemic by the occlusion of the right common carotid and middle cerebral arteries. At 2 h of ischemia, proteins were pulse labeled with intracortical injections of a mixture of [3H]leucine, [3H]isoleucine, and [3H]proline. Newly synthesized proteins were analyzed by two-dimensional gel fluorography, and the results correlated with local CBF, measured with [14C]iodoantipyrine as tracer. Small blood flow reductions (CBF = 50-80 ml 100 g-1 min-1) were accompanied by a modest inhibition in synthesis of many proteins and a marked increase in one protein (Mr 27,000). With further reduction in blood flow (CBF = 40 ml 100 g-1 min-1), synthesis became limited to a small group of proteins (Mr 27,000, 34,000, 73,000, 79,000, and actin) including two new polypeptides (Mr 55,000 and 70,000). Severe ischemia (CBF = 15-25 ml 100 g-1 min-1) caused the isoelectric modification of several proteins (Mr 44,000, 55,000, and 70,000) and induced synthesis of another protein (Mr 40,000). Two polypeptides (Mr 27,000 and 70,000) dominated residual protein synthesis in severe ischemia. The changes in protein synthesis induced by different grades of ischemia most likely comprise a variation of the so-called "heat shock" or "stress" response found in all eukaryotic cells subjected to adverse conditions. Since heat shock genes are known to confer partial protection against anoxia and a variety of other noxious insults, their induction may be a factor in limiting the extent of ischemic tissue damage.

  16. Lubiprostone induced ischemic colitis.

    Science.gov (United States)

    Sherid, Muhammed; Sifuentes, Humberto; Samo, Salih; Deepak, Parakkal; Sridhar, Subbaramiah

    2013-01-14

    Ischemic colitis accounts for 6%-18% of the causes of acute lower gastrointestinal bleeding. It is often multifactorial and more commonly encountered in the elderly. Several medications have been implicated in the development of colonic ischemia. We report a case of a 54-year old woman who presented with a two-hour history of nausea, vomiting, abdominal pain, and bloody stool. The patient had recently used lubiprostone with close temporal relationship between the increase in the dose and her symptoms of rectal bleeding. The radiologic, colonoscopic and histopathologic findings were all consistent with ischemic colitis. Her condition improved without any serious complications after the cessation of lubiprostone. This is the first reported case of ischemic colitis with a clear relationship with lubiprostone (Naranjo score of 10). Clinical vigilance for ischemic colitis is recommended for patients receiving lubiprostone who are presenting with abdominal pain and rectal bleeding.

  17. 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 ...

  18. 脑小血管病影像标志共识指南解读%New standard of neuroimaging markers of cerebral small vessel disease

    Institute of Scientific and Technical Information of China (English)

    徐群

    2016-01-01

    常与神经退行性疾病并存,可加剧认知障碍和躯体残疾。由于在 CSVD 影像学特征术语脑小血管病(cerebral small vessel disease,CSVD)是老化的常见伴随疾病,并且的命名、定义、影像采集和分析以及科学报告等方面均缺乏一致性,因此阻碍了相关研究的发展。2012年,由全球相关领域的专家组成的神经影像研究专家组发布共识指南,确立了代表 CSVD 6种关键性损伤的神经影像标志的术语及其定义,并对影像采集及科学报告的一致性提出了指导意见。这6种 CSVD 神经影像标志包括近期皮质下小梗死、假定血管源性的腔隙灶、假定血管源性的白质高信号、血管周围间隙、脑微出血和脑萎缩。应在临床实践及相关研究中,充分应用这份共识指南,从而促进 CSVD 的影像学诊断、影像采集和分析以及科学报告的标准化。%Cerebral small vessel disease (CSVD) is a common disease accompanied by aging and is also usually concomitant with neurodegeneration diseases, exacerbating cognitive impairment and physical disability. The lack of consistency of terminology, definition, image acquisition and scientific report of CSVD hampers the further understanding of effects of CSVD on pathophysiological and clinical features of common neurodegenerative diseases. A working group of global research specialists made a comprehensive review of neuroimaging markers of CSVD. The standard of interpretation of terminology and definition of six neuroimaging markers indicating key characteristic manifestations of CSVD, minimum standard for image acquisition and analysis, agreement on scientific reporting of neuroimaging features of CSVD, and new imaging methods for early detection of CSVD, were developed in 2012. These six neuroimaging markers include recent small subcortical infarcts, lacune of presumed vascular origin, white matter hyperintensities of presumed vascular origin

  19. 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 Drug Administration-approved tissue plasminogen activator for treatment of acute ischemic stroke being the most prominent example. A large number of potential drug candidates for treatment of ischemic brain tissue have been developed and subsequently failed in clinical trials. A deeper understanding...... of 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-brain...

  20. The angiotensin type 2 receptor agonist Compound 21 elicits cerebroprotection in endothelin-1 induced ischemic stroke

    DEFF Research Database (Denmark)

    Joseph, Jason P; Mecca, Adam P; Regenhardt, Robert W;

    2014-01-01

    hypothesize that C21 may exert beneficial effects against cerebral damage and neurological deficits produced by ischemic stroke. We determined the effects of central and peripheral administration of C21 on the cerebral damage and neurological deficits in rats elicited by endothelin-1 induced middle cerebral...... artery occlusion (MCAO), a model of cerebral ischemia. Rats infused centrally (intracerebroventricular) with C21 before endothelin-1 induced MCAO exhibited significant reductions in cerebral infarct size and the neurological deficits produced by cerebral ischemia. Similar cerebroprotection was obtained...... in rats injected systemically (intraperitoneal) with C21 either before or after endothelin-1 induced MCAO. The protective effects of C21 were reversed by central administration of an AT2R inhibitor, PD123319. While C21 did not alter cerebral blood flow at the doses used here, peripheral post...

  1. Digital Ischemic Loss in Systemic Sclerosis

    Directory of Open Access Journals (Sweden)

    Umaima Marvi

    2010-01-01

    Full Text Available Digital ischemic loss is a cause of significant morbidity in patients with systemic sclerosis (SSc. Microvascular disease with intimal proliferation and luminal narrowing of small digital arteries, as well as macrovascular disease with narrowing or occlusion of larger digital arteries, contribute to the perfusion defects involved in digital ischemic loss. Immediate clinical evaluation and treatment are mandatory at the onset of critical digital ischemia to prevent digital loss. Hospitalization for medical therapies including intravenous prostacyclin therapy should be considered for all SSc patients who present with critical digital ischemia. Surgical interventions are typically reserved for patients who fail medical therapies and for those with late stage, necrotic tissue. This paper summarizes the current knowledge regarding the risk factors, pathogenesis, evaluation, and treatment of digital ischemic loss in SSc.

  2. Imaging analysis of focal cerebral flow and cellular function during the interphase of transient ischemic attacks%短暂性脑缺血发作间期局部脑血流及细胞功能影像学分析

    Institute of Scientific and Technical Information of China (English)

    王默力; 张人玲; 李坤成; 马云川

    2004-01-01

    背景:短暂性脑缺血发作( transient ischemic attack,TIA)间期的脑血流及脑功能状态的研究国内外均处于初期阶段,国外应用单光子发射电子计算机断层显像( SPECT),正电子发射计算机断层扫描( PET)等项检查手段进行了初步单一脑血流或脑功能的观察,分别提出 TIA间期存在脑血流低灌注状态;间期亦可见脑功能局部减低区,但两者之间的关系仍是未知数. 目的:通过对 TIA患者发作间期局部脑血流及脑细胞功能状态的同期观察,探讨 TIA的有效干预治疗依据. 设计:横断面观察研究. 地点和对象: 41例首都医科大学宣武医院神经内科 2001-06/2002-07诊断 TIA住院患者( TIA组), 45例同期正常体检无神经系统疾病人员(对照组),排除糖尿病及严重心肝肾疾病. 干预:距末次发作后 1~ 7 d内行 SPECT和 CTPI,PET检查. 主要观察指标:对两组 SPECT和 CTPI,PET检查结果进行对比相关分析. 结果: 41例 TIA患者 SPECT 显示放射稀疏和(或)缺损检出率为 95% (39/41), CTPI显示灌注异常检出率为 63% (26/41),提示 TIA发作间期仍有半数以上存在相应区域局部脑血流动力异常,而对于 CTPI显示脑血流正常者, SPECT仍显示有放射稀疏和(或)缺损,考虑为局部脑细胞功能减低所致,同期 PET检测结果亦显示局部脑细胞葡萄糖代谢减低异常. 结论: TIA发作间期患者虽无临床症状及体征,但脑细胞功能未完全恢复正常,部分患者仍处于脑血流低灌注异常状态.即使脑血流恢复正常者,仍存在局部脑细胞功能减低区.提示对 TIA患者的治疗,不仅要改善脑血流,亦要保护脑细胞功能状态,对于防止 TIA复发及阻止脑梗死的发生有重要作用.%BACKGROUND:Studies on focal cerebral blood flow and brain behavior during the interphase of transient ischemic attack(TIA) are still in the preliminary stage.Singlephoton emission computed tomography(SPECT) and positivephoto

  3. Inhibition of interleukin 1β converting enzyme family proteases reduces ischemic and excitotoxic neuronal damage

    OpenAIRE

    Hara, Hideaki; Robert M. Friedlander; Gagliardini, Valeria; Ayata, Cenk; Fink, Klaus; Huang, Zhihong; Shimizu-Sasamata, Masao; Yuan, Junying; Moskowitz, Michael A

    1997-01-01

    The interleukin 1β converting enzyme (ICE) family plays a pivotal role in programmed cell death and has been implicated in stroke and neurodegenerative diseases. During reperfusion after filamentous middle cerebral artery occlusion, ICE-like cleavage products and tissue immunoreactive interleukin 1β (IL-1β) levels increased in ischemic mouse brain. Ischemic injury decreased after intracerebroventricular injections of ICE-like protease inhibitors, N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylke...

  4. 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

  5. 急性缺血性脑卒中患者血清氧化型低密度脂蛋白水平与颈动脉易损斑块的关系%Relationship Between Serum Oxidized Low-density Lipoprotein Level and Carotid Vulnerable Plaque in Patients with Acute Cerebral Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    许寅宏; 徐恩; 林清原; 邱少东

    2015-01-01

    PurposeTo investigate the relationship between the serum oxidized low-density lipoprotein (ox-LDL) level and carotid vulnerable plaque in patients with acute cerebral ischemic stroke, and to evaluate the ability of serum ox-LDL in identifying vulnerable carotid plaques.Materials and Methods 181 patients with history of acute cerebral ischemic stroke were recruited. According to the results of carotid ultrasound patients were divided into non plaque group (n=48), stable plaque group (n=38) and vulnerable plaque group (n=95). The serum total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting plasma glucose and ox-LDL were measured. Carotid intima-medial thickness (CIMT), total carotid plaque area (TPA) and the characters of plaque were examined with color Doppler ultrasound.Results The serum ox-LDL and the number of patients with hypertension in plaque group were significantly higher than that in the non-plaque group (P<0.05). The serum ox-LDL and TPA in the vulnerable plaque group were significantly higher than that in the stable plaque group (P<0.05). Serum ox-LDL in patients with acute cerebral infarction was positively correlated with CIMT, serum total cholesterol and LDL-C (r1=0.154,P<0.05;r2=0.338, P<0.05;r3=0.385,P<0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid vulnerable plaque (OR=1.038, 95%CI 1.008-1.069, P<0.01).Conclusion The serum ox-LDL is independently associated with the formation of vulnerable plaque in patients with acute cerebral infarction. This study suggests that ox-LDL can be used as a biomarker in screening for vulnerable carotid plaque in clinical practice. Carotid ultrasound combined with serology can early identify carotid artery vulnerable plaque that may lead to cerebral ischemic events.%目的:探讨急性缺血性脑卒中患者血清氧化型低密度脂蛋白(ox-LDL)水平与颈动脉易损斑块的关系,评

  6. 丹参酮ⅡA对脑缺血再灌注损伤大鼠P-选择素和细胞间黏附分子-1表达的影响%Effect of tanshinone ⅡA on the expression of P-selectin and ICAM-1 after cerebral ischemic reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    李浩; 刘开祥; 俸军林; 蒋静子; 林小慧

    2008-01-01

    immunohistochemistry method. Result Compared with sham operated group, the expression of P-selectin and ICAM-1 increased after reperfusion for 24 hours in the ischemic territory(all P<0.01).Compared with I/R group, the expression of P-selectin and ICAM-1 decreased in a dose dependent manner in low and high dose Tan ⅡA treated group(P<0.01).Compared with that of I/R group, cerebral infarction volume was decreased in a dose dependent manner in low dose Tan ⅡA treated group and high dose Tan ⅡA treated group(all P<0.01).The change of ischemic impairment in low or high dose Tan ⅡA treated group was less than that in IR group, and the change of ischemic impairment in high dose Tan ⅡA treated group was less than that in low dose Tan ⅡA treated group. Conclusion Tan ⅡA may reduce cerebral ischemia-reperfusion inflammation injure by decreasing the expression of p-selectin and ICAM-1.Tan ⅡA plays protective effect on cerebral ischemia injury, especially when high dose of Tan ⅡA(30mg/kg)was used.

  7. 灯盏细辛与赤芍配伍对永久性脑缺血损伤大鼠的保护作用%Compatibility of erigeron breviscapus and radix paeoniae rubra protects rats against cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    范娅丹; 韩江全; 邓才洪

    2016-01-01

    目的:探讨灯盏细辛与赤芍配伍药对脑缺血性损伤大鼠的保护作用及可能机制。方法方法48只成年SD雄性大鼠随机分为4组:假手术组、脑缺血组、配伍药物治疗组、阻滞剂组,每组12只。采用线栓法制作大脑中动脉闭塞模型。于缺血后24 h后行神经功能缺损评分,断头取脑行TTC染色检测脑梗死面积,实时荧光定量PCR法、蛋白质免疫印记法测缺血区脑皮质SHH、Patched-1、Gli-1mRNA及蛋白的表达。结果配伍药物组缺损评分、脑组织梗死面积显著低于脑缺血组和阻滞剂组。脑组织shh、Patched-1、Gli-1 mRNA及蛋白表达量显著高于脑缺血组,阻滞剂组Gli-1mRNA及蛋白表达量显著低于配伍药物组。结论灯盏乙素与芍药苷配伍对大鼠局灶性脑缺血损伤具有一定的保护作用,其机制与上调Sonic Hedgehog ( Shh)通路关键蛋白分子表达量有关。%Objective To investigate the protective effect of the compatibility of Erigeron breviscapus and Radix Paeoniae Rubra on cerebral ischemia injury rats and its possible mechanisms .Methods Forty-eight adult male Sprague-Dawley rats were divided into four groups randomly:a sham operation group ,a cerebral ischemia group ,a treatment group and an inhibitor group,12 in each group.MCAO model was performed according to Zea-longa’s report.Neurological deficit scores were performed after 24 h of the operation .Then decapitated the rats and took out their brain .Detected infarct size by 2,3,5-triphenyltetrazolium chloride (TTC) staining,and detected the expression of the mRNA levels of Shh、Patched-1、Gli-1 by RT-PCR and assessed the proteins expression of them by Western blotting .Results The neurological deficit score and the infarct size in the treatment group were lower than that in the cerebral ischemia and inhibitors groups ,both of the differences were statistically significant .RT-PCR and Western blotting suggested that the mRNA and

  8. Demographic features and neuropsychological correlates in a cohort of 200 patients with vascular cognitive decline due to cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Thomas Gregor Issac

    2016-01-01

    Full Text Available Introduction: Vascular dementia is the second most common form of dementia and is potentially reversible. Small vessel disease (SVD closely mimics degenerative dementia in view of its sub-acute onset and progressive course. Therefore, unlike large vessel disease, Hachinski Ischemic scale score may not always reflect vascular cognitive decline resulting in diagnostic and therapeutic confusions. Therefore, there is a need for detailed neuropsychological assessment for various cognitive domains for early identification of vascular cognitive decline as it carries a very good long term prognosis for cognitive morbidity, unlike degenerative dementias. Patients and Methods: This prospective study involves thorough domain based neuropsychological assessment of patients with a radiological diagnosis of SVD involving the following parameters-digit forward and backward, category fluency, color trails, stick test, logical memory test, and bender gestalt test. Magnetic resonance imaging scans done using 3-tesla machines and SVD graded using Fazekas visual scale. Results: The mean Hachinskis score was less sensitive for differentiating vascular dementia from degenerative dementia. However, the domain based neuropsychological scores were highly sensitive showing statistically significant impairment in all 6 domains tested and compared with Fazekas 1-3 grades in imaging. Discussion and Conclusion: This study aimed at establishing an early diagnosis of vascular mild cognitive impairment using domain wise neuropsychological testing and correlating it with radiological scores. Hachinskis score is more sensitive for large vessel disease in view of acute onset and step-like progression as against steady progression in SVD. However, domain-wise testing was highly sensitive in identifying early cognitive impairment in patients with SVD, and early therapeutic interventions are highly rewarding.

  9. 大鼠局灶性脑缺血后少突胶质前体细胞激活及髓鞘再生的实验研究%Experimental research on activation of oligodendrocyte progenitor cells and myelination in the focal cerebral ischemic rat brain

    Institute of Scientific and Technical Information of China (English)

    赵红; 张拥波; 王得新; 王苏平

    2012-01-01

    目的 探讨脑缺血再灌注大鼠少突胶质前体细胞(oligodendrocyte progenitor cells,OPCs)及髓鞘的表达变化.方法 线栓法建立大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型,免疫组化方法检测脑缺血再灌注后不同时间点1d、1w和2w不同脑区(梗死中心区、梗死周边区和梗死对侧区)OPCs特异性细胞标志物NG2的阳性细胞数及和髓鞘标志物碱性髓鞘蛋白(myelin basic protein,MBP)的表达变化.结果 脑缺血后梗死中心区NG2阳性细胞数和MBP的表达随着再灌注时间延长而逐渐减少;梗死周边区NG2阳性细胞数在1w~2w增加,MBP的表达在24h~1w内降低,2w恢复到正常水平;梗死对侧区NG2阳性细胞数和MBP的表达无明显变化.梗死周边区OPCs细胞呈“单极”或“双极”分裂状,并从梗死灶的外带迁移到内带,提示OPCs细胞激活、增生并发生迁移.结论 脑缺血再灌注后梗死周边区NG2细胞增多,使得一度缺失的成熟少突胶质细胞及髓鞘得到补充,提示NG2细胞可能参与缺血损伤的修复过程.%Objective To explore the expression of oligodendrocyte progenitor cells ( OPCs) and myelin after focal . cerebral ischemic in the rat brain. Methods Transient focal ischemia was induced by middle cerebral artery occlusion (MCAO) for 120 minutes with a nylon filament. By immunohistochemistry technique, NG2 positive cells and MBP were detected at different time points in the different brain area(infarcl core,pcri-infarct area and contralateral area) after MCAO. Results The infarct core showed a progressive decrease in the number of NG2 and MBP density from 24h to 2w after MCAO. The peri-infarct area exhibited a slight increase in NG2 positive cells from 1w to 2w and showed a decrease in the myelin density from 24h to lw,then return to the normal level after 2w of recirculalion. No difference of NG2 positive cells and MBP density in the contralateral area at any time points was found after

  10. Segurança do transplante autólogo, intra-arterial, de células mononucleares da medula óssea na fase aguda do acidente vascular cerebral isquêmico Intra-arterial autologous bone marrow mononuclear cell transplantation for acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Furtado de Mendonça

    2006-01-01

    Full Text Available O acidente vascular cerebral (AVC é a terceira causa de óbito e a principal causa de incapacidade em indivíduos adultos. Embora a mortalidade do AVC esteja diminuindo em alguns países, a morbidade tem aumentado em razão do envelhecimento da população e do aumento da sobrevida dos pacientes¹. O tratamento com ativador do plasminogênio tissular recombinante (rt-PA é eficaz quando instituído em até 3 horas após o início dos sintomas², porém seu uso está limitado a cerca de 5% dos pacientes na fase aguda do AVC isquêmico. Além disso, nenhum agente para neuroproteção teve sua eficácia comprovada em estudos clínicos em humanos. Portanto, outras estratégias terapêuticas precisam ser desenvolvidas. Em modelos animais, o uso de células-tronco correlacionou-se com melhora funcional após o AVC³. Publicações recentes têm demonstrado a segurança do tratamento com células mononucleares da medula óssea (CMMO injetadas via intracoronária em pacientes portadores de cardiopatia isquêmica aguda ou crônica4,5. Baseado nesses dados iniciais, há crescente interesse no estudo do transplante com CMMO na fase aguda do AVC. Relatamos o primeiro caso de transplante autólogo de CMMO via intra-arterial na fase aguda do AVC isquêmico.Stroke is the third cause of death and the leading cause of disability in adult subjects. Although stroke mortality has been declining in some countries, stroke morbidity has been increasing due to the aging of population and patients improved survival.¹ Treatment with recombinant tissue plasminogen activator (rtPA is successful provided it is administered within 3 hours of symptoms onset,² but its use is limited to about 5% of the patients with acute ischemic stroke. Furthermore, no neuroprotective agent has yet been proven effective in human clinical trials. The development of other therapeutic strategies is, therefore, warranted. The use of stem cells in animal models has led to functional improvement

  11. Angiogenesis-regulating microRNAs and Ischemic Stroke.

    Science.gov (United States)

    Yin, Ke-Jie; Hamblin, Milton; Chen, Y Eugene

    2015-01-01

    Stroke is a leading cause of death and disability worldwide. Ischemic stroke is the dominant subtype of stroke and results from focal cerebral ischemia due to occlusion of major cerebral arteries. Thus, the restoration or improvement of reduced regional cerebral blood supply in a timely manner is very critical for improving stroke outcomes and poststroke functional recovery. The recovery from ischemic stroke largely relies on appropriate restoration of blood flow via angiogenesis. Newly formed vessels would allow increased cerebral blood flow, thus increasing the amount of oxygen and nutrients delivered to affected brain tissue. Angiogenesis is strictly controlled by many key angiogenic factors in the central nervous system, and these molecules have been well-documented to play an important role in the development of angiogenesis in response to various pathological conditions. Promoting angiogenesis via various approaches that target angiogenic factors appears to be a useful treatment for experimental ischemic stroke. Most recently, microRNAs (miRs) have been identified as negative regulators of gene expression in a post-transcriptional manner. Accumulating studies have demonstrated that miRs are essential determinants of vascular endothelial cell biology/angiogenesis as well as contributors to stroke pathogenesis. In this review, we summarize the knowledge of stroke-associated angiogenic modulators, as well as the role and molecular mechanisms of stroke-associated miRs with a focus on angiogenesis-regulating miRs. Moreover, we further discuss their potential impact on miR-based therapeutics in stroke through targeting and enhancing post-ischemic angiogenesis.

  12. 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.

  13. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebra