The influence of the calcium antagonist nimodipine and induced hypertension on the behavior of the cerebral pial arteries, the blood-brain barrier, cerebral edema, and cerebral infarction in cats with one-hour occlusion of the middle cerebral artery

Neurosurgery ◽  
1991 ◽  
pp. 267 ◽  
Author(s):  
T Sakaki ◽  
S Tsunoda ◽  
T Morimoto
Neurosurgery ◽  
1991 ◽  
Vol 28 (2) ◽  
pp. 267-272 ◽  
Author(s):  
Toshisuke Sakaki ◽  
Shigeru Tsunoda ◽  
Tetsuya Morimoto

Abstract Thirty anesthetized cats were randomly assigned to one of three groups of 10 cats each: nimodipine treatment, nimodipine treatment combined with induced hypertension, or a control group. The behavior of the cerebral pial arteries was measured by means of microscopic observation through a cranial window. The middle cerebral artery of each cat was clipped for 1 hour via the transorbital approach. Five hours after circulation was reestablished in the middle cerebral artery. Evans blue dye was injected intravenously: 30 minutes later, the animal was killed. Administration of nimodipine or saline in the treated or control group was started 5 minutes before the middle cerebral artery was clipped and maintained until the end of the experiment. Induced hypertension was produced by administration of dopamine during the occlusion. Damage to the blood-brain barrier (BBB) was judged by extravasation of Evans blue dye. Cerebral edema and infarction were evaluated from histological findings. They were most prominent in the control group; the extent of the hemisphere affected was as follows (mean ± standard error): extravasation. 40.5 ± 8.8%: edema, 43.2 ± 5.7%: infarction, 35.5 ± 9.6%. On the other hand, the extravasation of Evans blue dye and cerebral edema were significantly more extensive in the group treated with nimodipine and induced hypertension (extravasation, 28.2 ± 9.6% of the hemisphere; edema, 30.3 ± 7.1%) than in the group treated with nimodipine alone (extravasation. 18.5 ± 8.7% of the hemisphere; edema, 19.4 ± 6.3%). but the infarction size was similar in both groups (16.6 ± 4.9% of the hemisphere in the former; 17.0 ± 6.2 in the latter). Based on these results, we arc cautious in combining calcium entry blocking agents such as nimodipine with induced hypertension in patients with acute cerebral ischemia.


2015 ◽  
Vol 36 (6) ◽  
pp. 1143-1154 ◽  
Author(s):  
Ataru Nishimura ◽  
Tetsuro Ago ◽  
Junya Kuroda ◽  
Koichi Arimura ◽  
Masaki Tachibana ◽  
...  

Pericytes are mural cells abundantly present in cerebral microvessels and play important roles, including the formation and maintenance of the blood–brain barrier. Nox4 is a major source of reactive oxygen species in cardiovascular cells and modulate cellular functions, particularly under pathological conditions. In the present study, we found that the expression of Nox4 was markedly induced in microvascular cells, including pericytes, in peri-infarct areas after middle cerebral artery occlusion stroke models in mice. The upregulation of Nox4 was greater in a permanent middle cerebral artery occlusion model compared with an ischemia/reperfusion transient middle cerebral artery occlusion model. We performed permanent middle cerebral artery occlusion on mice with Nox4 overexpression in pericytes (Tg-Nox4). Infarct volume was significantly greater with enhanced reactive oxygen species production and blood–brain barrier breakdown in peri-infarct areas in Tg-Nox4, compared with littermate controls. In cultured brain pericytes, Nox4 was significantly upregulated by hypoxia and was promptly downregulated by reoxygenation. Phosphorylation of NFκB and production of matrix metalloproteinase 9 were significantly increased in both cultured pericytes overexpressing Nox4 and in peri-infarct areas in Tg-Nox4. Collectively, Nox4 is upregulated in pericytes in peri-infarct areas after acute brain ischemia and may enhance blood–brain barrier breakdown through activation of NFκB and matrix metalloproteinase 9, thereby causing enlargement of infarct volume.


2017 ◽  
Vol 23 (6) ◽  
pp. 601-604 ◽  
Author(s):  
Jonathan Pace ◽  
Jeffrey Nelson ◽  
Abhishek Ray ◽  
Yin Hu

A middle-aged patient presented for elective embolization of an incidentally found right internal carotid aneurysm. An angiogram was performed, during which the left internal carotid artery was visualized to evaluate a second, small aneurysm. During the embolization of the right internal carotid artery aneurysm, a catheter-induced vasospasm was identified that prompted treatment with intra-arterial verapamil. The procedure was uncomplicated; a postoperative rotational flat-panel computed tomography scan was performed on the angiography table that demonstrated right hemisphere contrast staining. The patient developed a right middle cerebral artery (MCA) syndrome after extubation with repeat cerebral angiography negative for occlusion and magnetic resonance imaging negative for stroke. The patient was observed for 48 hours, during which time the patient had slowly improved. At a six-week follow up visit, the patient had fully recovered. We present an interesting case of a verapamil-induced breakdown of the blood–brain barrier and self-limited right MCA syndrome.


Sign in / Sign up

Export Citation Format

Share Document