Characteristics of microcirculation in patients with acute ischemic stroke and chronic cerebral ischemia

BackgroundTotal body hypothermia is an established neuroprotectant in global cerebral ischemia. The role of hypothermia in acute ischemic stroke remains uncertain. Selective application of hypothermia to a region of focal ischemia may provide similar protection with more rapid cooling and elimination of systemic side effects. We studied the effect of selective endovascular cooling in a focal stroke model in adult domestic swine.MethodsAfter craniotomy under general anesthesia, a proximal middle cerebral artery branch was occluded for 3 h, followed by 3 h of reperfusion. In half of the animals, selective hypothermia was induced during reperfusion using a dual lumen balloon occlusion catheter placed in the ipsilateral common carotid artery. Following reperfusion, the animals were sacrificed. Brain MRI and histology were evaluated by experts who were blinded to the intervention.Results25 animals were available for analysis. Using selective hypothermia, hemicranial temperature was successfully cooled to a mean of 26.5°C. Average time from start of perfusion to attainment of moderate hypothermia (<30°C) was 25 min. Mean MRI stroke volumes were significantly reduced by selective cooling (0.050±0.059 control, 0.005±0.011 hypothermia (ratio stroke:hemisphere volume) (p=0.046). Stroke pathology volumes were reduced by 42% compared with controls (p=0.256).ConclusionsSelective moderate hypothermia was rapidly induced using endovascular techniques in a clinically realistic swine stroke model. A significant reduction in stroke volume on MRI was observed. Endovascular selective hypothermia can provide neuroprotection within time frames relevant to acute ischemic stroke treatment.

Download Full-text

Update on therapies for acute ischemic stroke

Neurosurgical FOCUS ◽

10.3171/foc.2000.8.5.2 ◽

2000 ◽

Vol 8 (5) ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Dean D. Kindler ◽

George A. Lopez ◽

Bradford B. Worrall ◽

Karen C. Johnston

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Type ◽

Tissue Type Plasminogen Activator ◽

Emerging Therapies ◽

Type Plasminogen Activator ◽

Acute Cerebral Ischemia ◽

Promising Treatment

Acute ischemic stroke is now considered a neurological emergency for which there are new therapies. Neurosurgeons and neurologists need to remain apprised of advances in this field. The authors discuss approved and emerging therapies for patients suffering from acute ischemic stroke, based on a review of recent publications. Currently, intravenous tissue-type plasminogen activator is the only Food and Drug Administration–approved therapy for acute ischemic stroke. Intraarterial delivery of thrombolytics is a promising treatment and may be effective in selected patients. Other therapies for acute cerebral ischemia are intriguing but still in the investigational stages.

Download Full-text

ATTITUDES TOWARDS DISEASE IN PATIENTS WITH CHRONIC PHASE OF ISCHEMIC STROKE BY THE RESULTS OF THE PERSONAL QUESTIONNAIRE OF THE BEKHTEREV INSTITUTE

East European Journal of Parkinson`s Disease and Movement Disorders ◽

10.33444/2414-0007.6.3-4.19-26 ◽

2020 ◽

Vol 6 (3-4) ◽

pp. 19-26

Author(s):

A.M. Babirad

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Chronic Phase ◽

Complete Recovery ◽

Chronic Cerebral Ischemia ◽

Personal Questionnaire ◽

Patient Department

Every year, strokes are diagnosed in about 16 million people, of whom 5.7 million die and about the same number become disabled (Feigin V.L., Forouzanfar M.H., Krishnamurthi R., et al., 2014; Virani S.S., Alonso A., Benjamin E.J., et al., 2020; Kim J., Thayabaranathan T., Donnan G.A., et al. 2020). The objective of our research was to study the attitudes towards disease in patients with chronic phase of ischemic stroke. Material and methods. 100 consecutive patients with chronic phase of ischemic stroke and 17 patients with chronic cerebral ischemia were questioned in neurology in-patient department. The types of attitude towards disease were identified with the help of the Personal Questionnaire of the Bekhterev Institute. Results. We found that pathological types of attitude towards disease begin to form before the development of a stroke as a result of chronic cerebral ischemia. Among patients with chronic phase of ischemic stroke, pathological types of attitude towards disease prevailed significantly, and the harmonious type was rare (84.0% vs 16.0%, p < 0.001). The most frequently observed were neurasthenic (36.0%), harmonious (16.0%), anxious (16.0%), ergopathic (10.0%) and sensitive (8.0%) types of attitude towards disease. Our study has shown that any ischemic stroke, even in the case of complete recovery of the lost functions, can be associated with pathological types of attitude towards disease. Keywords: ischemic stroke, the Personal Questionnaire of the Bekhterev Institute, attitudes towards disease.

Download Full-text

Neuroprotective therapy for chronic cerebral ischemia and ischemic stroke in the rehabilitation period; use of cavinton

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2011-173 ◽

2011 ◽

Vol 0 (3) ◽

pp. 80 ◽

Cited By ~ 1

Author(s):

S A Rumyantsev ◽

O Sokhov ◽

E V Silina

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Chronic Cerebral Ischemia ◽

Neuroprotective Therapy ◽

Rehabilitation Period

Download Full-text

A tetracycline derivative, minocycline, reduces inflammation and protects against focal cerebral ischemia

Neurology Bulletin ◽

10.17816/nb79500 ◽

2000 ◽

Vol XXXII (3-4) ◽

pp. 76-76

Author(s):

J. Yrjanheikki ◽

T. Tikka ◽

R. Keinanen ◽

G. Goldsteins ◽

P. H. Chan ◽

...

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Acute Ischemic Stroke ◽

Brain Tissue ◽

Focal Cerebral Ischemia ◽

The Brain ◽

Tetracycline Derivative

One of the reasons for the insufficient effectiveness of treatment of acute ischemic stroke may be secondary inflammation of the brain tissue, which, according to the results of modern studies, significantly worsens the consequences and outcome of the disease.

Download Full-text

Abstract 2981: Neuroprotective Effect Of Acute Ethanol Administration In Rat With Transient Cerebral Ischemia

Stroke ◽

10.1161/str.43.suppl_1.a2981 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Xiaokun Geng ◽

Xunming Ji ◽

Fei Wang ◽

Yu Wang ◽

Karam ASMARO ◽

...

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Acute Ischemic Stroke ◽

Infarct Volume ◽

Neuroprotective Effect ◽

Elevated Serum ◽

Transient Cerebral Ischemia ◽

Alcoholic Beverages ◽

Ethanol Administration ◽

Lesion Volume

Background and Purpose _ Despite a focus on the pathological effects of alcohol abuse, numerous studies published over the past several decades also demonstrate beneficial effects of light-to-moderate consumption of alcoholic beverages. Recent studies have demonstrated that elevated serum ethanol levels are associated with increased survival in patients with traumatic brain injury (TBI), suggesting that an acute exposure to alcohol exerts a neuroprotective effect. In a rat model of transient cerebral ischemia, we identified administration of ethanol as a possible treatment for acute ischemic stroke. Methods _Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for two hours. Five sets of experiments were conducted: 1) to determine the dose-response effect of ethanol (0.5, 1.0 and 1.5g/kg) on brain infarction and functional outcome; 2) to determine whether combining ethanol (1.5g/kg) and hypothermia produces synergistic neuroprotection; 3) to determine the therapeutic windows of opportunity for ethanol in stroke; to test whether ethanol promotes intracerebral hemorrhage (ICH) in hemorrhagic or ischemic stroke, or after administration of thrombolytics in ischemic stroke; and 5) to test the affect of ethanol on HIF-1α protein expression. Results —Ethanol at 1.5 g/kg, which produce blood levels (89mg/dL) within the legally intoxicated range for driving (80-100 g/dL), most effectively reduced infarct volume and behavioral dysfunction when administered at 2, 3 or 4 hours after MCAO. We find that ethanol and moderate hypothermia (32-34 °C) exert neuroprotective effects of similar magnitude at both the lesion volume and functional levels, but do not exert a synergistic effect in this model. Ethanol did not promote cerebral hemorrhage in hemorrhagic or ischemic stroke in combination with recombinant tissue plasminogen activator (rt-PA) or urokinase (UK). Up-regulation of HIF-1α protein levels was enhanced by ethanol, in association with reduced brain infarct volume and improved functional recovery in rats subjected to stroke using the same dose (1.5 g/kg). Conclusions —Ethanol exerts a strong neuroprotective effect when administered up to 4 hours after ischemia, and does not promote ICH when used with thrombolytics. Ethanol is a potential neuroprotectant for acute ischemic stroke.

Download Full-text

Mucosal‐Associated Invariant T Cells Are Involved in Acute Ischemic Stroke by Regulating Neuroinflammation

Journal of the American Heart Association ◽

10.1161/jaha.120.018803 ◽

2021 ◽

Author(s):

Sho Nakajima ◽

Ryota Tanaka ◽

Kazuo Yamashiro ◽

Asako Chiba ◽

Daisuke Noto ◽

...

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Acute Ischemic Stroke ◽

Focal Cerebral Ischemia ◽

Infarct Volume ◽

Flow Cytometric Analysis ◽

Interleukin 17 ◽

Ischemic Brain ◽

Mait Cells ◽

Acute Cerebral Ischemia

Background Mucosal‐associated invariant T (MAIT) cells have been associated with inflammation in several autoimmune diseases. However, their relation to ischemic stroke remains unclear. This study attempted to elucidate the role of MAIT cells in acute ischemic stroke in mice. Methods and Results We used MR1 knockout C57BL/6 (MR1 −/− ) mice and wild‐type littermates (MR1 +/+ ). After performing a transient middle cerebral artery occlusion (tMCAO), we evaluated the association with inflammation and prognosis in the acute cerebral ischemia. Furthermore, we analyzed the tMCAO C57BL/6 mice administered with the suppressive MR1 ligand and the vehicle control. We also evaluated the infiltration of MAIT cells into the ischemic brain by flow cytometry. Results showed a reduction of infarct volume and an improvement of neurological impairment in MR1 −/− mice (n=8). There was a reduction in the number of infiltrating microglia/macrophages (n=3–5) and in their activation (n=5) in the peri‐infarct area of MR1 −/− mice. The cytokine levels of interleukin‐6 and interleukin‐17 at 24 hours after tMCAO (n=3–5), and for interleukin‐17 at 72 hours after tMCAO (n=5), were lower in the MR1 −/− mice. The administration of the suppressive MR1 ligand reduced the infarct volume and improved functional impairment (n=5). Flow cytometric analysis demonstrated there was a reduction of MAIT cells infiltrating into the ischemic brain at 24 hours after tMCAO (n=17). Conclusions Our results showed that MAIT cells play an important role in neuroinflammation after focal cerebral ischemia and the use of MAIT cell regulation has a potential role as a novel neuroprotectant for the treatment of acute ischemic stroke.

Download Full-text

DISTRIBUTION OF TYPES OF PSYCHOLOGICAL RESPONSE TO THE DISEASE IN DIFFERENT GROUPS OF PATIENTS WITH CHRONIC PHASE OF ISCHEMIC STROKE

East European Journal of Parkinson`s Disease and Movement Disorders ◽

10.33444/2414-0007.7.1-2.7-14 ◽

2021 ◽

Vol 7 (1-2) ◽

pp. 7-14

Author(s):

A.M. Babirad

Keyword(s):

Ischemic Stroke ◽

Cerebral Ischemia ◽

Cholesterol Level ◽

Chronic Phase ◽

Chronic Cerebral Ischemia ◽

Ischemic Lesion ◽

Psychological Response ◽

Gender And Education ◽

Personal Questionnaire ◽

Lesion Severity

The objective of our research was to study the types of psychological response to the disease in different groups of patients with chronic phase of ischemic stroke. Material and methods. 100 consecutive patients with chronic phase of ischemic stroke and 17 patients with chronic cerebral ischemia were questioned in neurology in-patient department. The types of attitude towards disease were identified with the help of the Personal Questionnaire of the Bekhterev Institute. Results. Our data indicate that clinical (location of the ischemic lesion, severity of paresis), laboratory (cholesterol level) and individual (gender and education) factors are involved in the formation of the internal picture of the disease in patients with chronic phase of ischemic stroke. Keywords: ischemic stroke, the Personal Questionnaire of the Bekhterev Institute, attitudes towards disease.

Download Full-text