scholarly journals Measurement of the Intracranial Arterial Wedge Pressure in Cases of Acute Cerebral Arterial Occlusion to Determine the Indication of Intraarterial Thrombolytic Therapy

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 213-215
Author(s):  
T. Terada ◽  
M. Tsuura ◽  
H. Matsumoto ◽  
O. Masuo ◽  
G. Hyotani ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Arterial Occlusion ◽  
Time Loss ◽  
Cerebral Arterial Occlusion ◽  
The Relationship ◽  
The Brain ◽  
Wedge Pressure

Wedge pressure of the occluded major cerebral artery (distal pressure beyond the occlusion) was measured to estimate the residual cerebral blood flow in thirteen patients with acute ischemic stroke. There existed the relationship that patients with higher wedge pressure tolerated longer ischemic insults than those with lower wedge pressure. Wedge pressure is measured with minimum time loss before starting thrombolytic therapy and may be a good indicator to estimate the brain tissue reversibility.

scholarly journals Cerebral Blood Flow in Low Intracranial Pressure Headaches—What Is Known?

2019 ◽  
Vol 10 (1) ◽  
pp. 2
Author(s):  
Magdalena Nowaczewska ◽  
Henryk Kaźmierczak
Keyword(s):  
Blood Flow ◽  
Cerebrospinal Fluid ◽  
Cerebral Blood Flow ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Intracranial Hypotension ◽  
Csf Pressure ◽  
Cerebral Vasodilatation ◽  
The Relationship ◽  
The Brain

Headaches attributed to low cerebrospinal fluid (CSF) pressure are described as orthostatic headaches caused by spontaneous or secondary low CSF pressure or CSF leakages. Regardless of the cause, CFS leaks may lead to intracranial hypotension (IH) and influence cerebral blood flow (CBF). When CSF volume decreases, a compensative increase in intracranial blood volume and cerebral vasodilatation occurs. Sinking of the brain and traction on pain-sensitive structures are thought to be the causes of orthostatic headaches. Although there are many studies concerning CBF during intracranial hypertension, little is known about CBF characteristics during low intracranial pressure. The aim of this review is to examine the relationship between CBF, CSF, and intracranial pressure in headaches assigned to low CSF pressure.

Catecholamines and the relationship between cerebral blood flow and glucose use

1986 ◽  
Vol 251 (4) ◽  
pp. H824-H833 ◽  
Author(s):  
U. I. Tuor ◽  
L. Edvinsson ◽  
J. McCulloch
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Moderate Hypertension ◽  
Brain Regions ◽  
Dopamine Infusion ◽  
Arterial Blood ◽  
Norepinephrine Infusion ◽  
Bbb Permeability ◽  
The Relationship ◽  
The Brain

The effects of hypertension induced by norepinephrine and dopamine infusion on the relationship between local cerebral blood flow (CBF) and local glucose use (GU) were examined in rats with the use of quantitative autoradiographic techniques. After rats recovered from anesthesia, dopamine or norepinephrine was infused at a rate that ensured moderate hypertension [mean arterial blood pressure (MABP) approximately 150 mmHg]. During dopamine infusion (approximately 200 micrograms X kg-1 X min-1), overall CBF-to-GU ratio throughout the brain was elevated (P less than 0.0001) when compared with saline controls. In contrast, during norepinephrine infusion (approximately 10 micrograms X kg-1 X min-1), the overall CBF-to-GU relationship was not altered significantly. The differential effect of the catecholamines was a consequence of the marked increases in local CBF and moderate decreases in GU observed during dopamine infusion, whereas during norepinephrine administration CBF and GU were not significantly altered in most brain regions. Blood-brain barrier (BBB) permeability was increased during moderate hypertension induced by dopamine and not when induced by norepinephrine. During extreme hypertension (MABP greater than 165 mmHg), heterogeneous increases in CBF and BBB permeability occurred (e.g., in the cerebellum and thalamus). Thus the cerebrovascular response to catecholamine infusion was critically dependent on the agent administered, the level of hypertension achieved, and the brain region examined.

scholarly journals Efficacy of Thrombolytic Therapy in Treatment of Patients with Ischemic Stroke

2017 ◽  
pp. 57-62
Author(s):  
A. I. Ikramov ◽  
N. G. Dadamyants
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Flow Velocity ◽  
Effective Treatment ◽  
Transcranial Doppler ◽  
Blood Flow Velocity ◽  
Hemorrhagic Transformation ◽  
Main Group ◽  
The Brain

The purpose: to evaluate the effectiveness of thrombolytic therapy in patients with ischemic stroke according to radiological methods.Materials and methods. The study included 60 people who were divided into two groups. The main group included 34 (56.7%) patients with ischemic stroke (20 men and 14 women) aged 22 to 78 years (mean age 62 ± 8.6 years) who were treated in Republican research center of emergency medical care. The control group consisted of 26 (43.3%) patients to estimate the parameters of normeperidine in the middle cerebral artery (MCA): the maximum blood flow velocity, linear blood flow velocity, index Gosling (PI) and coefficient overshoot (KO). Evaluation of patients included: assessment of nevrostatus according NIHSS scale, computered tomograhy of brain to exclude hemorrhagic stroke, transcranial and extracranial arteries Duplex scanning, digital subtraction angiography. Thrombolysis was performed to all patients of main group with ischemic stroke: systemic thrombolysis with streptokinase – in 17 (50%) cases, selective thrombolysis of Actilyse – 17 (50%). Thrombolysis was performed in a period from 90 minutes to 4 hours after the manifestation of symptoms. Results. Significant positive changes were observed in 22 (64.7%) patients. Asymptomatic hemorrhagic transformation of ischemic lesion was observed in 4 (11.7%). In acute occlusion of the internal carotid artery recanalization was registered only in 11.7% of cases, while the M1 MCA occlusion segment – at 52.9%. Transcranial Doppler is manifested by registration of hyperperfusion flow after thrombolysis in the presence of residual flow to thrombolysis. Re-occlusion was observed in 2 (5.8%) patients. In these cases, before and after thrombolysis TCD fixed flow hypoperfusion. Mortality was 14.7%.Conclusions. Thrombolytic therapy is effective treatment for ischemic stroke, especially in the delivery of the patient to a hospital for the first 2 hours after the manifestation of clinical symptoms. The marker of effectiveness thrombolysis is registration on the CMA normoperfusion or hyperperfusion pattern. Good functional outcome marked when a patient achieved result ≤2 points on the mRS. Asymptomatic hemorrhagic transformation can also be considered as a marker of effective thrombolysis. The combination of a CT scan of the brain with transcranial Doppler allows to assess not only the size of the lesion of the brain, but also to investigate the nature of cerebral hemodynamics. Further development of a set of measures designed to raise awareness among the population and general practitioners about the symptoms of stroke and its effective treatment in the case of delivery of the patient to a specialized hospital in which is possible to conduct thrombolysis.

scholarly journals Influence of different qualitative composition of infusion solutions on cerebral hemodynamics in patients with acute ischemic stroke

2020 ◽  
Vol 73 (2) ◽  
pp. 272-277
Author(s):  
Andrii I. Semenenko ◽  
Halyna I. Khrebtii ◽  
Svetlana L. Malyk ◽  
Dmytro V. Dmytriiev ◽  
Roksolana Ya. Bodnar ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ischemic Stroke ◽  
Cerebral Arteries ◽  
Cerebral Hemodynamics ◽  
Control Group ◽  
Qualitative Composition ◽  
Infusion Solution ◽  
Brain Substance ◽  
The Brain

The aim: Investigate the effect of 0.9% NaCl, HES 130, HAES-LX-5% and mannitol 15% on cerebral hemodynamics in patients with AIS. Materials and methods: The study included 100 patients with AIS. As the investigated solutions were used: isosmolar 0.9% NaCl, hyperosmolar mannitol 15%, colloid-isoosmolar HES 130, colloid-hyperosmolar HAES-LX-5%. The control group received only 0.9% NaCl compared: 0.9% NaCl+HES 130, 0.9% NaCl+HAES-LX-5%, 0.9% NaCl+mannitol 15%. Evaluation of cerebral hemodynamic (indexes of cerebral blood flow) was performed using doppler ultrasound of cerebral arteries. Results: The dynamics of specific volume velocity of blood flow per 100 grams of brain substance indicates that in the group of 0.9% NaCl and 0.9% NaCl+mannitol is the tendency to decrease the blood flow of the brain during 7 days of treatment, respectively: 2.8% and 7.5%. In patients with HES 130 solution cerebral blood flow increases by 14.2%, whereas when applied HAES-LX-5% during 7 days, it increases by 43.2% (p=0.004). Conclusions: The analysis of the data of treatment the patients with AIS showed the best effect (p=0.004) of improvement of the cerebral circulation in the use of the polyfunctional infusion solution HAES-LX-5% unlike the 0.9% NaCl group and group of 0.9% NaCl+mannitol where was a decrease of the dynamics of cerebral blood flow, which could lead to hypoperfusion of the brain.

scholarly journals Neuroprotection by glutamate oxaloacetate transaminase in ischemic stroke: An experimental study

2011 ◽  
Vol 31 (6) ◽  
pp. 1378-1386 ◽  
Author(s):  
Francisco Campos ◽  
Tomás Sobrino ◽  
Pedro Ramos-Cabrer ◽  
Bárbara Argibay ◽  
Jesús Agulla ◽  
...  
Keyword(s):  
Animal Model ◽  
Ischemic Stroke ◽  
Arterial Occlusion ◽  
Brain Parenchyma ◽  
Resonance Spectroscopy ◽  
Glutamate Oxaloacetate Transaminase ◽  
Neuroprotective Effects ◽  
Sensorimotor Deficits ◽  
Cerebral Arterial Occlusion ◽  
The Brain

As ischemic stroke is associated with an excessive release of glutamate into the neuronal extracellular space, a decrease in blood glutamate levels could provide a mechanism to remove it from the brain tissue, by increasing the brain-blood gradient. In this regard, the ability of glutamate oxaloacetate transaminase (GOT) to metabolize glutamate in blood could represent a potential neuroprotective tool for ischemic stroke. This study aimed to determine the neuroprotective effects of GOT in an animal model of cerebral ischemia by means of a middle cerebral arterial occlusion (MCAO) following the Stroke Therapy Academic Industry Roundtable (STAIR) group guidelines. In this animal model, oxaloacetate-mediated GOT activation inhibited the increase of blood and cerebral glutamate after MCAO. This effect is reflected in a reduction of infarct size, smaller edema volume, and lower sensorimotor deficits with respect to controls. Magnetic resonance spectroscopy confirmed that the increase of glutamate levels in the brain parenchyma after MCAO is inhibited after oxaloacetate-mediated GOT activation. These findings show the capacity of the GOT to remove glutamate from the brain by means of blood glutamate degradation, and suggest the applicability of this enzyme as an efficient and novel neuroprotective tool against ischemic stroke.

Vorläufige Ergebnisse von 99mTc-HMPAO-SPECT-Untersuchungen bei endogenen Psychosen

1989 ◽  
Vol 28 (03) ◽  
pp. 88-91
Author(s):  
J. Schröder ◽  
H. Henningsen ◽  
H. Sauer ◽  
P. Georgi ◽  
K.-R. Wilhelm
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Regions Of Interest ◽  
Post Mortem ◽  
Regional Cerebral Blood ◽  
Hmpao Spect ◽  
Endogenous Psychoses ◽  
The Brain ◽  
99Mtc Hmpao

18 psychopharmacologically treated patients (7 schizophrenics, 5 schizoaffectives, 6 depressives) were studied using 99mTc-HMPAO-SPECT of the brain. The regional cerebral blood flow was measured in three transversal sections (infra-/supraventricular, ventricular) within 6 regions of interest (ROI) respectively (one frontal, one parietal and one occipital in each hemisphere). Corresponding ROIs of the same section in each hemisphere were compared. In the schizophrenics there was a significantly reduced perfusion in the left frontal region of the infraventricular and ventricular section (p < 0.02) compared with the data of the depressives. The schizoaffectives took an intermediate place. Since the patients were treated with psychopharmaca, the result must be interpreted cautiously. However, our findings seem to be in accordance with post-mortem-, CT- and PET-studies presented in the literature. Our results suggest that 99mTc-HMPAO-SPECT may be helpful in finding cerebral abnormalities in endogenous psychoses.

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