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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hemicraniectomy is increasingly used as treatment option in stroke and in head trauma, but little is known on the (patho)physiological regional effects of hemicraniectomy in the normal brain. A standard left-sided craniectomy was performed in three cats. Regional cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO(2)) and cerebral metabolic rate of glucose (CMR(glc)) were measured from the brain tissue underneath the craniectomy at 2, 20 and 28 h after hemicraniectomy. CBF significantly decreased (P<0.01) and oxygen extraction fraction (OEF) (P<0.05) significantly increased. CMRO(2) and CMR(glc) decreased only in regions with most severe CBF reduction. These effects remained for at least a day irrespective of corrective sustaining cranioplasty. The authors demonstrated for the first time that decompressive hemicraniectomy in the cat decreases CBF, and to a lesser extent CMR02 and CMR(glc) 2 h after hemicraniectomy in normal brain tissue that last for at least 1 day. Even though the underlying basis of these phenomena are not fully understood, this finding implies that persisting pathophysiological processes are induced by hemicraniectomy and should be taken into consideration for surgical indications.
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PMID:Hemodynamic and metabolic effects of decompressive hemicraniectomy in normal brain. An experimental PET-study in cats. 1291 37

Flavonoids, naturally occurring polyphenolic compounds, are known to inhibit both lipopolysaccharide (LPS) stimulated tumor necrosis factor alpha and interleukin 6 release which modulate the proinflammatory molecules that have been reported in many progressive neurodegenerative disorders, including Alzheimer's disease (AD), viral and bacterial meningitis, AIDS dementia complex, and stroke. The present experiments were performed to study the possible effects of exogenously administered flavonoids (apigenin-7-glucoside and quercetin) on the cognitive performance in aged and LPS-treated mice (an animal model for AD) using passive avoidance and elevated plus-maze tasks. Aged and LPS-treated mice showed poor retention of memory in step-through passive avoidance and in plus-maze tasks. Chronic administration of the flavonoids apigenin-7-glucoside (5-20 mg/kg i.p.) and quercetin (25-100 mg/kg i.p.) dose dependently reversed the age-induced and LPS-induced retention deficits in both test paradigms. However, flavonoids after chronic administration in young mice did not show any improvement of memory retention in both paradigms. Apigenin-7-glucoside showed more efficacy as compared with quercetin in both models that may be probably due to its greater efficacy to inhibit cyclooxygenase-2 and inducible nitric oxide synthase. Chronic treatment with flavonoids did not alter the locomotor activity in both young and aged mice; however, aged mice showed improvement of performance on Rota-Rod test. The results showed that chronic treatment with flavonoids reverses cognitive deficits in aged and LPS-intoxicated mice which suggests that modulation of cyclooxygenase-2 and inducible nitric synthase by flavonoids may be important in the prevention of memory deficits, one of the symptoms related to AD.
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PMID:Protective effect of flavonoids against aging- and lipopolysaccharide-induced cognitive impairment in mice. 1292 78

Positron emission tomography (PET) imaging in clinical neurology serves several purposes: differential diagnosis, especially in the early stage of neurologic disorders, description of pathophysiologic changes that are responsible for manifestation and course of a disease, and evaluation and follow-up of treatment effects. Many of these applications are possible with the most widely available PET tracer, 2-deoxy-2-[18F]fluoro-D-glucose (FDG). Additional tracers are used clinically to detect the disturbance of specific neurotransmitter and receptor systems, blood flow, oxygen metabolism, and amino acid uptake. Main diagnostic issues addressed in this review are early diagnosis of Alzheimer's disease and other dementias, differential diagnosis of movement disorders, diagnosis of recurrent brain tumors, identification of viable tissue in ischemic stroke, and localization of epileptogenic foci. Techniques for presurgical localization of eloquent cortex and monitoring of therapy are presented.
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PMID:Positron emission tomography in clinical neurology. 1526 39

Individual parameter settings of the duplex machine and limited insonation angles may influence the visualization of small intracranial vessels in 2-D transcranial color-coded sonography. The aim of our study was the morphologic assessment of intracranial collateral pathways (first auditory area celiac artery, A(1)CA; anterior communicating artery, AComA; first parental generation celiac artery P(1)CA; posterior communicating artery, PComA) using 3-D transcranial color-coded duplex sonography (3-D TCCS) and digital subtraction angiography (DSA). A total of 41 patients with large vessel disease and 30 patients who had suffered subarachnoidal hemorrhage (mean age 52 +/- 15 years) were involved. In all patients, angiography was performed within 10 days following 3-D sonography. The patients were investigated with a color-coded duplex system using the power mode. Contrast enhancement was achieved by continuous infusion of a galactose-based echo-enhancer using a perfusor pump. The 3-D system consists of an electromagnet that induces a low-intensity magnetic field near the head of the patient. A magnetic position sensor is attached to the ultrasound (US) probe and transmits the spatial orientation to a personal computer, which also receives the corresponding 2-D images from the video port of the duplex machine. Angiography revealed a "complete" circle of Willis in one third of the patients and, in the remaining patients at least one vessel was hypoplastic or absent. Sufficient temporal bone windows allowed the sonographic investigation of 466 (94%) of 497 expected arterial segments. The comparison of both techniques resulted in a weighted kappa value of 0.56 for the A(1)CA and 0.63 for the AComA. In the posterior circulation kappa values of 0.56 for the P(1)CA and 0.43 for the PComA were calculated. In 50 vessels (10%), 3-D sonography misdiagnosed the diameter of a collateral vessel as normal and angiography revealed hypoplasia or aplasia of this vessel. The main advantage of 3-D TCCS is that it enables the investigator to reconstruct virtually any arbitrary view angle. Compared with angiography or magnetic resonance (MR) angiography, 3-D sonography can be performed easily in critically ill patients on stroke units or intensive care units. The noninvasive assessment of the circle of Willis may be useful in patients who undergo carotid surgery without angiography. Combined with hemodynamic information, contrast-enhanced 3-D TCCS might increase the diagnostic impact of transcranial US.
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PMID:Intracranial collateral pathways assessed by contrast-enhanced three-dimensional transcranial color-coded sonography. 1558 53

The literature considers hyperthermic intraoperative intraperitoneal chemotherapy a safe and effective procedure for peritoneal carcinomatosis, but a technical improvement is necessary. Regional chemotherapy anticipates the "downfall" of tumoral cells in the peritoneum. The Authors considered 5 patients--female, age 27-45 years, ASA 2--operated of peritonectomy in ovaric neoplasia with peritoneal metastasis. The hyperthermic intraoperative intraperitoneal chemotherapy has been made at the end of the surgery with a hot solution (43 degrees C): 3000 ml of dextrose 1.5% with mytomicina C 25 mg e cysplatino 75 mg/m2. We considered variation of emodinamic parametres (blood pressure, central venous pressure, stroke volume, etc.) and biochemical parametres (Na, K, CI-, CO2, etc.). These parametres have been correlated with some complications: fistula, anastomotic leakage, pancreatitis and postoperative bleeding.
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PMID:[Anaesthesiologic problems about hyperthermic intraoperative intraperitoneal chemotherapy]. 1575 60

Brain edema that forms during the early stages of stroke involves increased transport of Na+ and Cl- across an intact blood-brain barrier (BBB). Our previous studies have shown that a luminal BBB Na+-K+-Cl- cotransporter is stimulated by conditions present during ischemia and that inhibition of the cotransporter by intravenous bumetanide greatly reduces edema formation in the rat middle cerebral artery occlusion model of stroke. The present study focused on investigating the effects of hypoxia, which develops rapidly in the brain during ischemia, on the activity and expression of the BBB Na+-K+-Cl- cotransporter, as well as on Na+-K+-ATPase activity, cell ATP content, and intracellular volume. Cerebral microvascular endothelial cells (CMECs) were assessed for Na+-K+-Cl- cotransporter and Na+-K+-ATPase activities as bumetanide-sensitive and ouabain-sensitive 86Rb influxes, respectively. ATP content was assessed by luciferase assay and intracellular volume by [3H]-3-O-methyl-D-glucose and [14C]-sucrose equilibration. We found that 30-min exposure of CMECs to hypoxia ranging from 7.5% to 0.5% O2 (vs. 19% normoxic O2) significantly increased cotransporter activity as did 7.5% or 2% O2 for up to 2 h. This was not associated with reduction in Na+-K+-ATPase activity or ATP content. CMEC intracellular volume increased only after 4 to 5 h of hypoxia. Furthermore, glucose and pyruvate deprivation increased cotransporter activity under both normoxic and hypoxic conditions. Finally, we found that hypoxia increased phosphorylation but not abundance of the cotransporter protein. These findings support the hypothesis that hypoxia stimulation of the BBB Na+-K+-Cl- cotransporter contributes to ischemia-induced brain edema formation.
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PMID:Moderate-to-severe ischemic conditions increase activity and phosphorylation of the cerebral microvascular endothelial cell Na+-K+-Cl- cotransporter. 1607 89

In the present study, the effects of paeoniflorin (PF), a characteristic monoterpene glucoside isolated from Paeoniae Radix, on cerebral infarction, neurological symptoms, tongue protrusion (TP) and performance in the water maze were examined at the chronic stage (4 weeks) of transient cerebral ischemia using a rat middle cerebral artery occlusion (MCAO) model. One-day (10 mg/kg, twice, s.c.) or seven-day (2.5-10 mg/kg, twice a day, s.c.) injection of PF significantly reduced the infarct volume as well as ameliorated the deficits in neurological symptoms caused by transient MCAO at chronic stage. Transient MCAO also induced impairments in TP and performance in the water maze. Treatment with PF was able to reverse or alleviate these impairments. These results indicate that PF may be effective for treatment of stroke.
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PMID:Effects of paeoniflorin on the cerebral infarction, behavioral and cognitive impairments at the chronic stage of transient middle cerebral artery occlusion in rats. 1613 17

The present study was completed to establish an epidemiologic database defining prehospital management of suspected cerebrovascular accidents (CVAs) with attention to blood glucose measurement, in the hope of developing recommendations for further treatment protocols. On review of 9495 paramedic run reports for the 24-month period from January 2001 through December 2002, from a low-volume urban emergency medical services system, 185 persons presented with CVA signs and/or symptoms. Data collected included patient chief complaint, neurologic examination, patient age, vital signs, ambulance field times, patient past medical history, and blood glucose measurement with resulting prehospital interventions, efficacy of interventions, and iatrogenic complications. Five persons (2.70%), all medication-controlled diabetics, were found to be hypoglycemic. After administration of intravenous dextrose 50% by rescue personnel, improvement in neurologic condition was noted in 100% of these cases. No sequelae as a result of such care occurred. No inappropriate use, point estimate ([0]/[5][0.00%-52.20%]), or unmet need, point estimate ([0]/[9495][0.00%-0.04%]), of care was noted. The data presented in this study suggest that given similar emergency medical service system characteristics, hypoglycemic patients presenting with neurologic deficits suggestive of CVAs constitute a rare event, associated with medical histories predictive of problems involving glucose homeostasis. Blood glucose measurement in persons presenting with CVA signs and/or symptoms is only necessary given the presence of history suspicious for hypoglycemia, or rescuer inability to obtain adequate patient information. Routine prehospital blood glucose measurement in patients with suspected CVA appears unnecessary.
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PMID:Is prehospital blood glucose measurement necessary in suspected cerebrovascular accident patients? 1698 58

The phenolic glucoside gastrodin (Gas) is a main component extracted from the rhizome of Gastrodia elata, a Chinese herbal medicine, which has long been used for treating dizziness, epilepsy, stroke and dementia. In this study, we investigated the neuroprotective effects of Gas on cerebral ischemic injury in rats caused by transient middle cerebral arterial occlusion (MCAO), oxygen/glucose deprivation (OGD) and glutamate-induced injury in cultured rat hippocampal neurons. Additionally, the effects of Gas on the extracellular glutamate level and changes in intracellular Ca (2+) and the generation of nitric oxide (NO) were examined in cultured hippocampal neurons subjected to OGD in vitro. The results showed that the high dose of Gas (100 mg/kg) markedly decreased the infarct volume and edema volume, and improved the neurological functions after MCAO. Gas treatment (15 microg/mL, 30 microg/mL) also significantly inhibited OGD- and glutamate-induced neuronal cell death and reduced the extracellular glutamate level following OGD. Moreover, Gas treatment significantly inhibited the OGD-induced Ca (2+) and NO increases. In conclusion, the present study indicates that Gas has a neuroprotective action.
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PMID:A study of the neuroprotective effect of the phenolic glucoside gastrodin during cerebral ischemia in vivo and in vitro. 1708 23

One of the major causes of neuronal death in neurodegenerative disease is excitotoxicity from the neurotransmitter glutamate. This form of cell death could arise from either excess levels of glutamate due to decreased astrocyte clearance or due to increased susceptibility. We have identified galectin-1, a galactose-binding lectin, as a potential neuroprotective factor secreted by astrocytes. Our results show that both native and recombinant galectin-1 protects mouse and rat cerebellar neurons from the toxic effects of glutamate. Galectin-1 applied to neurons increased their expression of the NMDA receptor NR1 and increased the proportion of the NR1a subunit subtype while antisense knockdown of the NR1a receptor blocked the neuroprotective effect of galectin-1. This effect of the protein was dependent upon it carbohydrate recognition domain, suggesting that the protein acts in a reduced dimerized form. In addition, galectin-1 caused a decreased expression of PKC associated with increased resistance to glutamate toxicity. These results suggest that the astrocytic lectin galectin-1 could protect neurons against the effects of excitotoxicity as seen in stroke and ischemic injury.
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PMID:Mouse galectin-1 inhibits the toxicity of glutamate by modifying NR1 NMDA receptor expression. 1715 63


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