Abstract WP168: Association of Stenosis, Proximal Flow and Distal Perfusion in Subjects With Middle Cerebral Artery Stenosis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Xiaowei Song ◽  
Wenwen Chen ◽  
Yunduo Li ◽  
David S Liebeskind ◽  
Rui Li ◽  
...  
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Brain Tissue ◽  
Cerebral Artery ◽  
Tissue Perfusion ◽  
Artery Stenosis ◽  
Compensatory Mechanism ◽  
4D Flow ◽  
Distal Perfusion ◽  
Relative Flow

Introduction: Hemodynamic compromise caused by intracranial artery stenosis is one of the critical factors contributing to ischemic stroke. However, the association between flow and stenosis has not been well determined quantitatively, nor its correlation with distal perfusion. The purpose of this study was to investigate the association of blood flow in different grades of stenosis, as well as its association with distal brain tissue perfusion. Methods: Intracranial 4D flow and perfusion were obtained in 33 patients (mean 56 years old) with different grades of unilateral middle cerebral artery (MCA) stenosis. GTFlow was used to measure the flow at the proximal of stenosis and the symmetrical location of contralateral side (Fig 1a). Olea was accessed to calculate the perfusion parameters in MCA area. The average net flow at the proximal of stenosis was compared in patients with different grades(<30%,30-49%,50-69%, and ≥70%) of stenosis. Correlation between relative flow(stenosis/contralateral) and perfusion parameters were also compared in different pial collateral status. Results: Blood flow at the proximal of stenosis changes with the grades of stenosis increasing (Fig 1b, p =0.01). Subjects with <50% and ≥50% stenosis differ in MCA flow, rCBF and rTTP, but not in rCBV (Fig 1c).Spearman correlation analysis indicated that the relative flow was also associated with rTTP shown in distal brain tissue in subjects with poor collateral (Fig 1d, r=-0.69, p =0.02), but not in patients with good collateral. No association between relative flow and rCBF was detected in this group of population. Conclusion: In conclusion, decreased flow at the proximal of stenosis could result in the delay of perfusion in distal brain tissue in patients with poor collateral. Association of flow and stenosis, as well as its relationship with distal perfusion need further study, collateral status and potential compensatory mechanism should be considered in future study.

scholarly journals Changes in intracranial venous blood flow and pulsatility in Alzheimer’s disease: A 4D flow MRI study

2016 ◽  
Vol 37 (6) ◽  
pp. 2149-2158 ◽  
Author(s):  
Leonardo A Rivera-Rivera ◽  
Tilman Schubert ◽  
Patrick Turski ◽  
Kevin M Johnson ◽  
Sara E Berman ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Peak Flow ◽  
Superior Sagittal Sinus ◽  
4D Flow ◽  
Sagittal Sinus ◽  
Flow Mri

Cerebral blood flow, arterial pulsation, and vasomotion may be important indicators of cerebrovascular health in aging and diseases of aging such as Alzheimer’s disease. Noninvasive markers that assess these characteristics may be helpful in the study of co-occurrence of these diseases and potential additive and interacting effects. In this study, 4D flow MRI was used to measure intra-cranial flow features with cardiac-gated phase contrast MRI in cranial arteries and veins. Mean blood flow and pulsatility index as well as the transit time of the peak flow from the middle cerebral artery to the superior sagittal sinus were measured in a total of 104 subjects comprising of four groups: (a) subjects with Alzheimer’s disease, (b) age-matched controls, (c) subjects with mild cognitive impairment, and (d) a group of late middle-aged with parental history of sporadic Alzheimer’s disease. The Alzheimer’s disease group exhibited: a significant decrease in mean blood flow in the superior sagittal sinus, transverse sinus, middle cerebral artery, and internal carotid arteries; a significant decrease of the peak and end diastolic blood flow in the middle cerebral artery and superior sagittal sinus; a faster transmission of peak flow from the middle cerebral artery to the superior sagittal sinus and increased pulsatility index along the carotid siphon.

scholarly journals Brain Tissue Concentrations of ATP, Phosphocreatine, Lactate, and Tissue pH in Relation to Reduced Cerebral Blood Flow following Experimental Acute Middle Cerebral Artery Occlusion

1988 ◽  
Vol 8 (6) ◽  
pp. 866-874 ◽  
Author(s):  
T. P. Obrenovitch ◽  
O. Garofalo ◽  
R. J. Harris ◽  
L. Bordi ◽  
M. Ono ◽  
...  
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Middle Cerebral Artery Occlusion ◽  
Brain Tissue ◽  
Cerebral Artery ◽  
Artery Occlusion ◽  
Tissue Samples ◽  
Tissue Ph ◽  
Focal Ischaemia ◽  
Cerebral Artery Occlusion

Local CBF (LCBF) was compared with the corresponding local tissue concentration of ATP, phosphocreatine (PCr), and lactate in anaesthetized baboons subjected to focal ischaemia produced by middle cerebral artery occlusion (MCAO). LCBF hydrogen electrodes were implanted in cortical regions where MCAO had been previously shown to produce severe and penumbral ischaemia and in posterior regions where blood flow is not altered. Metabolites were assayed in small tissue samples collected either by cryoprobe biopsy in the regions where LCBFs were measured (series 1) or by sampling appropriate regions of the rapidly frozen brain (series 2). Subsequent topographical study of brain tissue pH with umbelliferone was performed in this latter series. The results from these two series are compared and discussed in terms of the more appropriate way to perform simultaneous electrode measurements and analysis of tissue samples for studying focal ischaemia in the primate brain. They confirm that the concentrations of ATP and PCr decrease, and that lactate level increases, with decreasing blood flow. These metabolites tended to change more rapidly below a blood flow threshold, rather than showing a steady decrease as the blood flow was reduced, although the variability of the data precluded us from establishing this with confidence. Topographical study of tissue pH often showed sharp boundaries between zones of very low pH and regions with normal pH.

scholarly journals Cerebrovascular and Neuroprotective Effects of Adamantane Derivative

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ruben S. Mirzoyan ◽  
Tamara S. Gan’shina ◽  
Denis V. Maslennikov ◽  
Georgy I. Kovalev ◽  
Ivan A. Zimin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Nmda Receptors ◽  
Middle Cerebral Artery ◽  
Brain Tissue ◽  
Cerebral Artery ◽  
Brain Ischemia ◽  
Adamantane Derivative ◽  
Neuroprotective Activity ◽  
Neuroprotective Effects ◽  
The Brain

Objectives. The influence of 5-hydroxyadamantane-2-on was studied on the rats’ brain blood flow and on morphological state of brain tissue under the condition of brain ischemia. The interaction of the substance with NMDA receptors was also studied.Methods. Study has been implemented using the methods of local blood flow registration by laser flowmeter, [3H]-MK-801binding, and morphological examination of the brain tissue. We used the models of global transient ischemia of the brain, occlusion of middle cerebral artery, and hypergravity ischemia of the brain.Results. Unlike memantine, antagonist of glutamatergic receptors, the 5-hydroxyadamantane-2-on does not block NMDA receptors but enhances the cerebral blood flow of rats with brain ischemia. This effect is eliminated by bicuculline. Under conditions of permanent occlusion of middle cerebral artery, 5-hydroxyadamantane-2-on has recovered compensatory regeneration in neural cells, axons, and glial cells, and the number of microcirculatory vessels was increased. 5-Hydroxyadamantane-2-on was increasing the survival rate of animals with hypergravity ischemia.Conclusions. 5-Hydroxyadamantane-2-on, an adamantane derivative, which is not NMDA receptors antagonist, demonstrates significant cerebrovascular and neuroprotective activity in conditions of brain ischemia. Presumably, the GABA-ergic system of brain vessels is involved in mechanisms of cerebrovascular and neuroprotective activity of 5-hydroxyadamantane-2-on.

scholarly journals Postoperative Stroke in Patients After Spinal Anesthesia and Disparate Response Patterns of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine in Rats

2021 ◽  
Author(s):  
Yan-Yuen Poon ◽  
Yueh-Wei Liu ◽  
Ya‐Hui Huang ◽  
Samuel H.H. Chan ◽  
Ching-Yi Tsai
Keyword(s):  
Blood Flow ◽  
Cerebral Cortex ◽  
Cerebral Blood Flow ◽  
Middle Cerebral Artery ◽  
Spinal Anesthesia ◽  
Phase Ii ◽  
Cerebral Artery ◽  
Tissue Perfusion ◽  
Vasomotor Tone ◽  
Sympathetic Vasomotor Tone

Abstract Spinal anesthesia is generally accepted as an effective and safe practice. Three rare incidents of postoperative cerebral infarction after surgery under spinal anesthesia with bupivacaine prompted us to assess whether spinal bupivacaine may impact carotid or cerebral blood flow and baroreflex functionality. We found that all three patients shared common pathology of stenosis or atheromatous lesions in the carotid or middle cerebral artery. In a companion animal study, we further observed that subarachnoid application of bupivacaine that reached low thoracic spinal cord in male Sprague‐Dawley rats elicited an initial (Phase I) reduction in mean arterial pressure (MAP), carotid blood flow (CBF) and baroreflexmediated sympathetic vasomotor tone, all of which returned to baseline in Phase II. Whereas heart rate (HR) exhibited sustained reduction, cardiac vagal baroreflex, baroreflex efficiency index (BEI) and tissue perfusion and oxygen in cerebral cortex supplied by middle cerebral artery remained unaltered during both phases. However, in one‐third of animals studied, Phase II gave way to a Phase III characterized by secondary hypotension and depressed baroreflex‐mediated sympathetic vasomotor tone, along with continuous decline in HR, sustained cardiac vagal baroreflex, decreased BEI, and reduction in CBF and tissue perfusion or oxygen in cerebral cortex. We conclude that carotid and cerebral blood flow can be compromised after spinal anesthesia, and impaired baroreflex‐mediated sympathetic vasomotor tone that leads to hypotension plays a contributory role.

scholarly journals A Case of Delayed Symptomatic Middle Cerebral Artery Stenosis Following Mechanical Thrombectomy

2016 ◽  
Vol 10 (3) ◽  
pp. 138-143 ◽  
Author(s):  
Sangnyon Kim ◽  
Masafumi Ohtaki ◽  
Hiroshige Tsuda ◽  
Yusuke Kimura ◽  
Ayaka Sasagawa ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Artery Stenosis ◽  
Middle Cerebral Artery Stenosis
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