Comparative neuroprotective efficacy of prolonged moderate intraischemic and postischemic hypothermia in focal cerebral ischemia

2000 ◽  
Vol 92 (1) ◽  
pp. 91-99 ◽  
Author(s):  
Pil W. Huh ◽  
Ludmila Belayev ◽  
Weizhao Zhao ◽  
Sebastian Koch ◽  
Raul Busto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Focal Cerebral Ischemia ◽  
Infarct Volume ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sprague Dawley ◽  
Content Type ◽  
Mca Occlusion ◽  
Neurological Score ◽  
Fine Print

Object. The purpose of this study was to compare the effects of prolonged hypothermia on ischemic injury in a highly reproducible model of middle cerebral artery (MCA) occlusion in rats.Methods. Male Sprague—Dawley rats were anesthetized with halothane and subjected to 120 minutes of temporary MCA occlusion by retrograde insertion of an intraluminal nylon suture coated with poly-l-lysine through the external carotid artery into the internal carotid artery and the MCA. Two levels of prolonged postischemic cranial hypothermia (32°C and 27°C) and one level of intraischemic cranial hypothermia (32°C) were compared with the ischemic normothermia (37°C) condition. Target cranial temperatures were maintained for 3 hours and then gradually restored to 35°C over an additional 2-hour period. The animals were evaluated using a quantitative neurobehavioral battery of tests before inducing MCA occlusion, during occlusion (at 60 minutes postonset in all rats except those in the intraischemic hypothermia group), and at 24, 48, and 72 hours after reperfusion. The rat brains were perfusion fixed at 72 hours after ischemia, and infarct volumes and brain edema were determined. Both intraischemic and postischemic cooling to 32°C led to similar significant reductions in cortical infarct volume (by 89% and 88%, respectively) and total infarct volume (by 54% and 69%, respectively), whereas postischemic cooling to 27°C produced lesser reductions (64% and 49%, respectively), which were not statistically significant. All three hypothermic regimens significantly lessened hemispheric swelling and improved the neurological score at 24 hours. The authors' data confirm that a high degree of histological neuroprotection is conferred by postischemic cooling to 32°C, which is virtually equivalent to that observed with intraischemic cooling to the same level.Conclusions. These results may be relevant to the design of future clinical trials of therapeutic hypothermia for acute ischemic stroke.

Comparative neuroprotective efficacy of prolonged moderate intraischemic and postischemic hypothermia in focal cerebral ischemia

1999 ◽  
Vol 7 (5) ◽  
pp. E2 ◽  
Author(s):  
Pil W. Huh ◽  
Ludmila Belayev ◽  
Weizhao Zhao ◽  
Sebastian Koch ◽  
Raul Busto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Focal Cerebral Ischemia ◽  
Infarct Volume ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sprague Dawley ◽  
Mca Occlusion ◽  
Sprague Dawley Rats ◽  
Neurological Score ◽  
High Degree

Object The purpose of this study was to compare the effects of prolonged hypothermia on ischemic injury in a highly reproducible model of middle cerebral artery (MCA) occlusion in rats. Methods Male Sprague-Dawley rats were anesthetized with halothane and subjected to 120 minutes of temporary MCA occlusion by retrograde insertion of an intraluminal nylon suture coated with poly-L-lysine through the external carotid artery into the internal carotid artery and the MCA. Two levels of prolonged postischemic cranial hypothermia (32°C and 27°C), and one level of intraischemic cranial hypothermia (32°C) were compared with the ischemic normothermia (37°C) condition. Target cranial temperatures were maintained for 3 hours and then gradually restored to 35°C over an additional 2-hour period. The animals were evaluated using a quantitative neurobehavioral battery of tests before inducing MCA occlusion, during occlusion (at 60 minutes postonset in all rats except those in the intraischemic hypothermia group), and at 24, 48, and 72 hours after reperfusion. The rat brains were perfusion fixed at 72 hours after ischemia and infarct volumes and brain edema were determined. Both intraischemic and postischemic cooling to 32°C led to similar significant reductions in cortical infarct volume (by 89 and 88%, respectively) and total infarct volume (by 54 and 69%, respectively), whereas postischemic cooling to 27°C produced lesser reductions (64 and 49%, respectively), which were not statistically significant. All three hypothermic regimens significantly lessened hemispheric swelling and improved the neurological score at 24 hours. Our data confirm that a high degree of histological neuroprotection is conferred by postischemic cooling to 32°C, which is virtually equivalent to that observed with intraischemic cooling to the same level. Conclusions These results may be relevant to the design of future clinical trials of therapeutic hypothermia for acute ischemic stroke.

Effect of delayed albumin hemodilution on infarction volume and brain edema after transient middle cerebral artery occlusion in rats

1997 ◽  
Vol 87 (4) ◽  
pp. 595-601 ◽  
Author(s):  
Ludmila Belayev ◽  
Raul Busto ◽  
Weizhao Zhao ◽  
James A. Clemens ◽  
Myron D. Ginsberg
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Brain Edema ◽  
Cerebral Artery ◽  
Infarct Volume ◽  
Content Type ◽  
Mca Occlusion ◽  
Neurological Score ◽  
Albumin Therapy ◽  
Fine Print

✓ The authors examined the effect of delayed high-concentration albumin therapy on ischemic injury in a highly reproducible model of middle cerebral artery (MCA) occlusion in rats. Male Sprague—Dawley rats weighing 270 to 320 g were anesthetized with halothane and subjected to 120 minutes of temporary MCA occlusion induced by means of a poly-l-lysine—coated intraluminal nylon suture inserted retrograde via the external carotid artery into the internal carotid artery and MCA. The agent (20% human serum albumin [HSA]) or control solution (sodium chloride 0.9%) was administered intravenously at a dosage of 1% of body weight immediately after suture removal following a 2-hour period of MCA occlusion. The animals' neurological status was evaluated during MCA occlusion (at 60 minutes) and daily for 3 days thereafter. The brains were perfusion-fixed, and infarct volumes and brain edema were determined. The HSA significantly improved the neurological score compared with saline at 24 hours after MCA occlusion. The rats treated with HSA also had significantly reduced total infarct volume (by 34%) and brain edema (by 81%) compared with saline-treated rats. There was a strong correlation between hematocrit level and brain edema (p < 0.01), and between total infarct volume or brain edema and neurological score at 24, 48, and 72 hours postinjury (p < 0.0002). These results strongly support the beneficial effect of delayed albumin therapy in transient focal ischemia and indicate its possible usefulness in treating patients with acute ischemic stroke.

External carotid-cavernous fistula treated by arterial embolization

1974 ◽  
Vol 40 (1) ◽  
pp. 110-114 ◽  
Author(s):  
M. Stephen Mahalley ◽  
Stephan C. Boone
Keyword(s):  
Carotid Artery ◽  
Successful Treatment ◽  
Arterial Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Unusual Occurrence ◽  
Fine Print

✓ The unusual occurrence of a carotid-cavernous fistula supplied entirely by branches of the external carotid artery is presented, and its successful treatment by arterial embolization described.

Arteriovenous malformation in the posterior fossa supplied by the external carotid circulation

1974 ◽  
Vol 41 (4) ◽  
pp. 502-507 ◽  
Author(s):  
Carl J. Graf ◽  
Arnold H. Menezes
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Malformation ◽  
Posterior Fossa ◽  
Blood Supply ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Carotid Circulation ◽  
Fine Print

✓ The authors report a case in which the blood supply of a posterior fossa arteriovenous malformation was derived entirely from the external carotid artery.

Intraparenchymal arteriovenous malformations with predominant external carotid artery contribution

1974 ◽  
Vol 41 (6) ◽  
pp. 681-687 ◽  
Author(s):  
Raymond E. Dahl ◽  
David G. Kline
Keyword(s):  
Carotid Artery ◽  
Blood Supply ◽  
Arteriovenous Malformations ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Cerebral Parenchyma ◽  
Fine Print

✓ Arteriovenous malformations located within cerebral parenchyma are usually supplied by intracranial vessels. An extracranial blood supply to these lesions is rare. The authors report their experience with two such cases and discuss the 21 comparable reports.

Lateral sinus pericranii

1983 ◽  
Vol 58 (1) ◽  
pp. 139-140 ◽  
Author(s):  
Jesús Vaquero ◽  
Rafael G. de Sola ◽  
Roberto Martínez
Keyword(s):  
Differential Diagnosis ◽  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Lateral Sinus ◽  
Content Type ◽  
Sinus Pericranii ◽  
Fine Print

✓ A case of lateral sinus pericranii in a 49-year-old woman is presented. These extraordinarily rare lesions should be considered in the differential diagnosis of epicranial tumors. The lack of filling on external carotid artery angiograms may lead to the error of dismissing the possibility of a vascularized lesion.

Internal carotid artery stump angioplasty for the treatment of cerebrovascular occlusive disease

1986 ◽  
Vol 65 (4) ◽  
pp. 461-464 ◽  
Author(s):  
Edward C. Benzel ◽  
Kevin M. Sittig ◽  
Mansour Mirfakhraee
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
Occlusive Disease ◽  
External Carotid ◽  
Content Type ◽  
Cerebrovascular Occlusive Disease ◽  
Intracranial Vasculature ◽  
Fine Print

✓ Nineteen patients underwent a total of 21 stump angioplasty procedures for an occluded internal carotid artery. Indications for surgery included the preparation of the donor vessel for a subsequent extracranial-intracranial bypass procedure, the occurrence of emboli to the intracranial vasculature from the external carotid artery circulation, and the association with symptomatic occlusive disease of the external carotid artery accompanying occlusion of the ipsilateral internal carotid artery. The technique utilized and the results obtained in these 19 patients are presented. In select patients, the removal of an occluded internal carotid artery stump via a stump angioplasty is beneficial in preventing the catastrophic sequela of embolic cerebrovascular disease.

Subselective preoperative embolization for meningiomas

1984 ◽  
Vol 60 (3) ◽  
pp. 506-511 ◽  
Author(s):  
Evelyn Teasdale ◽  
James Patterson ◽  
Douglas McLellan ◽  
Peter Macpherson
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Computerized Tomography ◽  
Tumor Necrosis ◽  
External Carotid Artery ◽  
External Carotid ◽  
Preoperative Embolization ◽  
Content Type ◽  
Tumor Specimen ◽  
Fine Print

✓ Over a 2-year period the authors have studied the effects of preoperative subselective embolization of meningiomas. Thirty-six consecutive patients shown by computerized tomography (CT) to have a meningioma underwent selective internal and external carotid artery angiography, and any significant external carotid artery feeders were embolized (27 cases). It was found that CT and dynamic radioisotope scan findings were unable to predict the degree of vascularity of the tumor or its suitability for embolization. Furthermore, these tests, repeated after embolization, were unreliable in detecting either the extent of necrosis or reduction in blood flow. The effects of embolization upon surgery were recorded, and the excised tumor specimen examined for evidence of thrombosis and infarction. Subselective embolization was determined to be a simple, safe, and effective method of producing tumor necrosis and intraoperative hemostasis in selected patients.

Recurrent retinal ischemia beyond cervical carotid occlusions

1981 ◽  
Vol 55 (4) ◽  
pp. 532-542 ◽  
Author(s):  
Roger W. Countee ◽  
Thurairasah Vijayanathan ◽  
Pamela Chavis
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Clinical History ◽  
Retinal Ischemia ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Anticoagulant Drug ◽  
Nonsurgical Patients ◽  
Fine Print

✓ Seventeen patients with persistent amaurosis fugax ipsilateral to angiographically documented internal carotid artery (ICA) occlusions in the neck have been treated by the authors over the past 5 years. Complete cerebral arteriography in each case demonstrated that the symptomatic ophthalmic artery was perfused exclusively by the ipsilateral external carotid artery (ECA), which invariably had an obstructive and/or ulcerative lesion at its origin, and/or an adjacent residual “stump” of the occluded ICA. In nine patients, retinal artery branch emboli were visible on funduscopy. One patient had angiographic evidence of intracranial embolization via the ophthalmic artery from the ECA. Although ipsilateral superficial temporal-middle cerebral artery anastomosis in one patient, and endarterectomy of a contralateral carotid stenosis in another patient, failed to relieve symptoms, endarterectomy of the ECA with resection of the “stump” of the occluded ICA effectively terminated symptoms in 10 of 11 patients. Anticoagulant drug therapy promptly abolished symptoms in four nonsurgical patients as well as in two patients with failed operations. It is concluded that recurrent retinal ischemia beyond cervical carotid occlusions frequently results from microembolism via the ipsilateral ECA. Patients with this mechanism of postocclusion recurrent ischemia can be identified on the basis of clinical history, ophthalmological examinations, and complete cerebral arteriography. Termination of embolic phenomena should be the major treatment goal in these individuals, and ECA endarterectomy is recommended. Anticoagulant drugs are an effective alternative treatment in patients who are poor surgical risks.

Persistent proatlantal artery with carotid-vertebral anastomosis

1975 ◽  
Vol 43 (4) ◽  
pp. 499-501 ◽  
Author(s):  
T. Surya Rao ◽  
Prahlad K. Sethi
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Foramen Magnum ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Proatlantal Artery ◽  
Fine Print

✓ The authors describe the occurrence of proatlantal artery as an incidental angiographic observation in a young Indian soldier. This primitive anastomotic channel is seen extending from near the origin of the external carotid artery to the suboccipital region, traversing the foramen magnum and coursing beyond like a vertebral artery. The developmental and roentgenological aspects of carotid-basilar and carotid-vertebral anastomosis are discussed, along with a review of four similar cases reported previously.

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