Impaired cerebral autoregulation 24 h after induction of transient unilateral focal ischaemia in the rat

Cerebral blood flow (CBF) and cerebral autoregulation have been investigated 24 h after transient focal ischaemia in the rat. Cerebral blood flow was measured autoradiographically before and during a moderate hypotensive challenge, to test autoregulatory responses, using two CBF tracers, (99m)Tc-d,l-hexamethylproyleneamine oxide and 14C-iodoantipyrine. Prior to induced hypotension, CBF was significantly reduced within areas of infarction; cortex (28 +/- 20 compared with 109 +/- 23 mL/100 g/min contralateral to ischaemic focus, P = 0.001) and caudate (57 +/- 31 compared with 141 +/- 32 mL/100 g/min contralaterally, P = 0.005). The hypotensive challenge (mean arterial pressure reduced to 60 mmHg by increasing halothane concentration) did not compromise grey matter autoregulation in the contralateral hemisphere; CBF data were not significantly different at normotension and during hypotension. However, in the ipsilateral hemisphere, a significant volume of cortex adjacent to the infarct, which exhibited normal flow at normotension, became oligaemic during the hypotensive challenge (e.g. frontal parietal cortex 109 +/- 15% to 65 +/- 15% of cerebellar flow, P < 0.01). This resulted in a 2.5-fold increase in the volume of cortex which fell below 50% cerebellar flow (39 +/- 34 to 97 +/- 46 mm3, P = 0.003). Moderate hypotension induced a significant reduction in CBF in both ipsilateral and contralateral subcortical white matter (P < 0.01). In peri-infarct caudate tissue, CBF was not significantly affected by hypotension. In conclusion, a significant volume of histologically normal cortex within the middle cerebral artery territory was found to have essentially normal levels of CBF but impaired autoregulatory function at 24 h post-ischaemia.     

Analysis of cerebellar functions in spinocerebellar degeneration using positron emission tomography (PET)

We quantitatively evaluated the cerebellar functions of 23 patients with spinocerebellar degeneration (SCD) and 10 normal controls using positron emission tomography (PET). Statistical analysis was performed using the Student's test. Regional cerebral blood flow (CBF) and regional cerebral metabolic rate (CMR) of the cerebellar hemisphere and cerebellar vermis were significantly lower in patients with SCD than in normal subjects (p less than 0.001). However, no significant difference between the both groups was seen in the CBFs and the CMRs of the occipital cortex and frontal cortex. Even in the patients with SCD who had not apparent cerebellar atrophy on CT, their CBFs and CMRs of the cerebellum were significantly low, and with advance of cerebellar atrophy, they tended to fall. In the patients with SCD, the fall of CMR was more prominent than that of CBF. Neither CBF, nor CMR of the cerebellum showed correlation to the duration of the illness. The present investigation suggested that PETs were valuable for the early diagnosis and the research on the pathogenesis of SCD.     

Effect of thyrotropin-releasing hormone on cerebral blood flow in conscious rat

The effect of thyrotropin-releasing hormone (TRH) was studied on local CBF (LCBF) in normal conscious rats. LCBF was measured by the autoradiographic [14C]iodoantipyrine method 5 min after TRH (5 mg/kg, i.v.) administration. TRH significantly increased LCBF in 22 of 33 brain regions. This increase of LCBF exceeded 100% of the control values in the cerebral cortices, whereas there was no significant increase in white matter or in some gray matter structures. The increase of CBF following TRH administration was abolished by pretreatment with indomethacin (5 mg/kg, i.v.). The mechanisms underlying the increase of CBF following TRH administration are discussed in relation to prostaglandin metabolism.     

Regional cerebral blood flow, diaschisis, and steal after stroke

Regional CBF was measured by 133Xe inhalation in unilateral cerebral infarction, carotid TIAs, and normal volunteers. Regional CBF values were bilaterally and symmetrically reduced in patients measured within 3 weeks after stroke. Later, rCBF values returned toward normal in the contralateral hemisphere of patients with infarction and in both hemispheres with carotid TIAs. In cases with carotid occlusive disease, flow reduction was seen in the contralateral posterior cerebral artery distribution, with hyperemia in ipsilateral occipital lobe caused by interhemispheric steal. Brainstem-cerebellar flow values were increased following acute cerebral infarction if patients were alert but reduced if consciousness was impaired.     

Effect of the NMDA antagonist MK-801 on local cerebral blood flow in focal cerebral ischaemia in the rat

The effects of MK-801 upon local CBF after permanent middle cerebral artery (MCA) occlusion have been examined using [14C]iodoantipyrine autoradiography in halothane-anaesthetised rats. MK-801 (0.5 mg kg-1 i.v.) or saline was administered 30 min before MCA occlusion and CBF measured approximately 40 min after occlusion. In the hemisphere contralateral to the occluded MCA, MK-801 significantly reduced local CBF in 19 of the 22 regions examined from the levels in saline-treated rats. In the contralateral hemisphere, after treatment with MK-801, blood flow was reduced by an average of 37% with little variation in the magnitude of the reductions in different regions. In the hemisphere ipsilateral to MCA occlusion, MK-801 reduced CBF in almost every region located outside the territory of the occluded MCA. Within the territory of the occluded MCA, blood flow in the MK-801-treated rat did not significantly differ from values in vehicle-treated rats in any of the five cortical areas examined, although in the caudate nucleus there was a tendency for CBF to be lower in rats pretreated with MK-801. MK-801 had no effect on the amount of hypoperfused cerebral tissue (CBF less than 30 ml 100 g-1 min-1) in the ipsilateral hemisphere at any coronal plane examined; e.g., at coronal plane anterior 7.2 mm, 51 +/- 5% of the hemisphere displayed CBF of less than 30 ml 100 g-1 min-1 in saline-treated rats with MCA occlusion compared with 52 +/- 8% of the hemisphere in rats treated with MK-801 prior to MCA occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)     

Regional Cerebral Blood Flow,Diaschisis, and Steal After Stroke

Regional CBF was measured by ¹³³Xe inhalation in unilateral cerebral infarction, carotid TIAs, and normal volunteers. Regional CBF values were bilaterally and symmetrically reduced in patients measured within 3 weeks after stroke. Later, rCBF values returned toward normal in the contralateral hemisphere of patients with infarction and in both hemispheres with carotid TIAs. In cases with carotid occlusive disease, flow reduction was seen in the contralateral posterior cerebral artery distribution, with hyperemia in ipsilateral occipital lobe caused by interhemispheric steal. Brainstem-cerebellar flow values were increased following acute cerebral infarction if patients were alert but reduced if consciousness was impaired.     

Nimodipine pretreatment improves cerebral blood flow and reduces brain edema in conscious rats subjected to focal cerebral ischemia

The effect of nimodipine pretreatment on CBF and brain edema was studied in conscious rats subjected to 2.5 h of focal cortical ischemia. An infusion of nimodipine (2 micrograms/kg/min i.v.) or its vehicle, polyethylene glycol 400, was begun 2 h before the ischemic interval and was continued throughout the survival period. Under brief halothane anesthesia, the animals' right middle cerebral and common carotid arteries were permanently occluded, and 2.5 h later, they underwent a quantitative CBF study ([14C]iodoantipyrine autoradiography followed by Quantimet 970 image analysis). Nimodipine treatment improved blood flow to the middle cerebral artery territory without evidence of a "vascular steal" and reduced the volume of the ischemic core (cortex with CBF of less than 25 ml/100 g/min) and accompanying edema by approximately 50% when compared with controls (p = 0.006 and 0.0004, respectively). Mild hypotension induced by nimodipine did not aggravate the ischemic insult. The ischemic core volumes, however, were 50-75% smaller than the 24-h infarct volumes generated in a similar paradigm that demonstrated 20-30% infarct reduction with continuous nimodipine treatment. These results suggest that nimodipine pretreatment attenuates the severity of early focal cerebral ischemia, but that with persistent ischemia, cortex surrounding the ischemic core undergoes progressive infarction and the early benefit of nimodipine treatment is only partly preserved.     

Cerebral microembolization in the rat: Changes in blood-brain barrier permeability and cerebral blood flow as related to the degree of ischemia

Unilateral cerebral microembolism was performed in the rat by injecting calibrated, 50 micrometers in diameter, carbonized microspheres into the internal carotid artery. The events that follow brain ischemia due to cerebral embolization were studied by the analysis of the blood-brain barrier (BBB) function, the degree of regional cerebral blood flow (CBF) and the development of brain edema. Two hours after embolization there was no change in the brain water content. The local CBF (14C-ethanol technique) was only reduced in the ipsilateral hemisphere. Twenty-four hours after embolization the brain water content was increased significantly in the ipsilateral, but not in the contralateral hemisphere. Local CBF further decreased in the ipsilateral hemisphere and a reduction in flow was also observed in the contralateral hemisphere. Embolization led to an increase in the BBB permeability, analysed as regional penetrability of 3H-dextran and of Evans blue-albumin complexes, which was restricted to the side of the injection of the microspheres.     

Failure of the somatosensory evoked potential following middle cerebral artery occlusion and high-grade ischemia in the cat--effects of hemodilution

Acute focal ischemia was created in 10 cats by unilateral retro-orbital middle cerebral artery (MCA) occlusion. Regional cerebral blood flow (CBF) was determined utilizing the hydrogen clearance technique from electrode recordings within the gray matter and white matter of the ectosylvian gyrus of both hemispheres. The somatosensory evoked potential (SSEP) was obtained during contralateral median nerve stimulation. When the MCA was clipped the white and gray matter blood flows in the ipsilateral ectosylvian gyrus were reduced to 14.8 +/- 19.6% and 19.3 +/- 23.7% of control, and the cortical component of the SSEP was abolished. In the contralateral hemisphere an average increase of 3.5% above the control latency and a 10% mean depression in the amplitude of the cortical component of the SSEP were observed following occlusion. CBF in the contralateral hemisphere was unaffected by the MCA clip. Infusion of saline or dextran to lower the hematocrit by approximately 45% did not significantly improve blood flow or restore the SSEP in the hemisphere ipsilateral to the MCA clip. However, significant increases in the contralateral hemisphere gray matter CBF occurred following hemodilution while the latency of the cortical component of the SSEP in this same hemisphere was significantly extended. Elevations in gray and white matter blood flows were achieved in the experimental hemisphere of 3 of 10 cats suggesting a wide range of variation in the collateral circulation.     

Cortical deafferentation in cat focal ischemia: disturbance and recovery of sensory functions in cortical areas with different degrees of cerebral blood flow reduction

During and after 15-min occlusion of the middle cerebral artery (MCA) in cats, local CBF and neuronal activity were measured in cortical areas varying in the degree of CBF reduction. In an area within the ischemic center (primary auditory cortex, middle ectosylvian gyrus), CBF was severely suppressed. Click-induced auditory evoked potentials and evoked as well as spontaneous single-unit activity ceased within 1 min after occlusion. Recirculation resulted in a recovery of the different neurophysiological parameters with a time delay ranging from several minutes to 2 h. In two areas surrounding the ischemic focus (a visual area in the marginal gyrus and the forelimb representation area in the primary somatosensory cortex), CBF was reduced but remained above 30 ml/100 g/min during MCA occlusion. Visual flash-induced evoked potentials and somatosensory evoked potentials induced by median nerve electrical stimulation ceased in the corresponding areas with a somewhat slower time course as compared to the auditory responses and they recovered faster after recirculation. In another somatosensory area (hindlimb projection area in the primary somatosensory cortex), CBF stayed nearly at control levels during occlusion. Evoked potentials and single-unit activity induced by tibial nerve electrical stimulation decreased approximately 5 min after occlusion and were abolished approximately 5 min later. At that time, single-unit activity had changed to a nonresponsive pattern but persisted. However, potentials evoked transcallosally by electrical stimulation of the contralateral hemisphere were still recorded. After reopening the MCA, the recovery of neuronal functions was usually complete and occurred within approximately 5 min.(ABSTRACT TRUNCATED AT 250 WORDS)     

Alterations in behavior, brain electrical activity, cerebral blood flow, and intracranial pressure produced by triethyl tin sulfate induced cerebral edema.

The interrelationships between cerebral edema, intracranial pressure (ICP), and cerebral blood flow (CBF) were studied in acute and chronic triethyl tin sulfate treated rats. Prior to pentobarbital anesthesia behavioral observations were made. ICP and regional CBF were measured under steady state conditions and brain water content was determined by vacuum drying of the right cerebral hemisphere. Control and chronic animals were neurologically normal. There were two distinct acute groups: (1) acute low pressure (ALP) animals - alert but tetraperetic, and (2) acute high pressure (AHP) animals - deeply stuporous, with minimal pain response and gross EEG slowing. ICP was significantly elevated only in AHP animals. Hemispheric CBF was significantly reduced in AHP and chronic animals. The interaction of increased pressure and edema (AHP) produced the greatest decrease in CBF, although deep white flows were significantly affected in all experimental groups. Chronic animals had significantly lower flow in four of seven regions compared to ALP animals despite no significant difference in ICP. Water content was significantly increased in all experimental groups with the greatest increase in the chronic animals. In the absence of any significant increase in ICP, cerebral edema appears to cause a significant reduction in cerebral blood flow and this reduction corresponds with the magnitude and location of the edema.     

Cortical infarct volume is dependent on the ischemic reduction of perifocal cerebral blood flow in a three-vessel intraluminal MCA occlusion/reperfusion model in the rat

Occlusion of the middle cerebral artery (MCA) causes a reduction of cerebral blood flow (CBF), which shows a progressive decrease from the periphery to the core of the MCA territory. The severity of ischemia is dependent on the duration of the ischemic episode and degree of CBF reduction. Fixing the ischemic episode to 1 h, we have examined whether or not cortical infarct size was related to the degree of CBF reduction in a perifocal cortical area in rats. One-hour intraluminal MCA occlusion accompanied with bilateral common carotid artery (CCA) occlusion (three-vessel occlusion/reperfusion model) was carried out in Sprague-Dawley rats and CBF was monitored with laser-Doppler flowmetry in the fronto-parietal cortex, an area which is perifocal to the core of the MCA territory. Finally, infarct size was measured 7 days later and was related to the corresponding CBF decrease. Sequential ipsilateral CCA, MCA and contralateral CCA occlusions produced reductions of CBF to 96%, 52% and 33% of baseline, respectively. Cortical infarct volume was found to be dependent on the corresponding reduction of perifocal cortical CBF during the ischemic episode. These results show that the reduction of CBF in the periphery of the MCA territory during 1-h focal ischemia determines infarct size in a three-vessel occlusion/reperfusion model.     

大鼠实验性脑出血后脑组织中c-fos基因的表达与局部脑血流的改变

目的 探讨大鼠实验性脑出血后脑组织中即刻早期基因c-fos的表达和局部脑血流的变化。方法 采用Nath改良法建立大鼠脑出血模型；免疫组化法及RT－PCR法测定其脑组织中fos蛋白和c-fos mRNA的表达；氢清除法测定其局部脑血流。结果 大鼠血肿周围区（基底节）在脑出血后1小时即出现fos蛋白的表达，至3小时达高峰；c-fos mRNA于出血后1小时达表达高峰,至3小时后仍有较高水平的表达；出血后1小时全脑的的血流量均下降，4小时恢复至对照组水平，并维持至出血后24小时，随着的24小时内再次出现脑血流下降。结论 大鼠脑出血后，血肿周围区和双侧皮质区的脑组织中存在着c-fos基因的快速而长久的诱导表达。局部脑血流的下降相对短暂，且脑血流的下降在时程上与c-fos基因的表达不相一致。     

Specificities of arterial spin labeling (ASL) abnormalities in acute seizure

PurposeArterial spin labeling (ASL) is a non-invasive tool measuring cerebral blood flow (CBF) and is useful to assess acute neurological deficit. While acute stroke presents as hypoperfused vascular territory, epileptic activity causes cortical hyperperfusion. Other neurological conditions exhibit hyperperfusion, like migraine or secondary “luxury perfusion” in strokes. Our objectives were to evaluate the usefulness and potential specificities of ASL in acute seizure and correlate it with electroencephalogram.Materials and methodsAmongst a cohort of patients with neurological deficit, addressed for suspicion of stroke, we retrospectively reviewed 25 consecutive patients with seizures who underwent magnetic resonance imaging (MRI) with ASL and electroencephalography (EEG). We compared them with a control group of patients with migraine and stroke secondary re-perfusion, exhibiting ASL hyperperfusion.ResultsLateralized cortical hyperperfusion (high relative CBF) was observed in all patients. Good topographic correlation with EEG was found in 18 patients (72%). Eight (32%) had hyperperfusion of ipsilateral pulvinar, 5 (20%) had hyperperfused contralateral cerebellar hemisphere, 16 (64%) presented diffusion abnormalities and 20 (80%) had underlying epileptogenic lesions. Pulvinar hyperperfusion was not observed in the control group, nor were diffusion abnormalities in migrainous patients. Contralateral cerebellar hyperperfusion was observed in two migrainous patient, without associated pulvinar activation, whereas all patients with cerebellar hyperperfusion in the study group had associated pulvinar activation.ConclusionsElevated CBF can be observed in the epileptogenic zone, ipsilateral pulvinar and contralateral cerebellum (diaschisis) in seizure. These abnormalities seem specific when compared with other causes of hyperperfusion. Arterial spin labeling can be highly effective in the differential diagnosis of strokes.     

Cerebral hyperemia, stroke, and transfusion in sickle cell disease

To investigate cerebral hemodynamics in sickle cell disease (SCD), we used the 133Xenon inhalation technique of quantifying cerebral blood flow (CBF) in 67 patients. Clinical examinations and cerebral magnetic resonance imaging also were performed in all patients. Compared with age-matched healthy controls, CBF was elevated by 68% in patients, and inversely related to hematocrit. An experimental index of cerebral blood volume, pr4, was also elevated in the patients in a similar manner. Cerebral blood volume was positively correlated to CBF in SCD patients but not in controls. History of stroke and current neurologic symptoms were associated with lower flow and higher cerebral blood volume. Transfusion therapy reduced the hyperemia, the reduction being greater than expected by hematocrit elevation alone. These findings document a vasodilatory hyperemia in SCD. This dilatation may be a risk factor for ischemic distal-field infarctions, as visualized by MRI, due to a limitation of cerebrovascular reserve capacity.     

颅骨修补前后脑血流变化的CT灌注评价

目的探讨颅骨修补手术前后患者脑血流的变化。方法对24例早期行颅骨修补手术患者,在颅骨修补前1～2d和术后10～14d,应用16排螺旋CT做脑灌注扫描,记录大脑皮层、基底节和丘脑区域灌注图像上rCBV、rCBF、MTT及TTP等参数值。分析颅骨修补前后双侧大脑皮质,基底节和丘脑相关区域血流灌注数据的变化。结果颅骨修补术前患侧皮质区CBF明显低于对侧,和健侧相比差异具有统计学意义(P<0.01);术后患侧在皮质区CBF显著上升,和术前相比,差异具有统计学意义(P<0.01)。两侧基底节和丘脑区在术前术后脑血流相关数值虽有所上升,但前后相比差异无统计学意义(P>0.05)。结论头颅CT灌注可以及时检测颅脑外伤后不同阶段脑组织血流量的变化,而颅骨修补术可以明显提高患侧大脑皮质区的脑血流量,进而可能促进神经功能恢复。     

Effects of urotensin-II on cerebral blood flow and ischemia in anesthetized rats

Urotensin-II (U-II) is a cyclic peptide identified recently in many mammalian species including man. U-II and its receptor are expressed in the central nervous system, in the cardiovascular system and in other peripheral tissues. Although this peptide has been reported initially to be a potent vasoconstrictor, increasing evidence shows that its vascular actions strongly depend on species and vascular beds. Here we analyzed the effects of U-II administration on cerebral blood flow (CBF) under physiological conditions and following cerebral ischemia in rats. Although intravenous injection of U-II had minimal effects on CBF as measured by the technique of laser Doppler flowmetry, its administration (10 nmol) into the lateral cerebral ventricle induced gradual and long lasting increase in CBF (+61% at 1 h post-injection, p<0.05). These U-II-mediated CBF increases were not related to the transient systemic pressor actions of the peptide and were reduced by nitric oxide synthase inhibition (61 vs 17%, p<0.05). Intracerebroventricular administration of U-II following the induction of cerebral ischemia, failed to alter residual CBF in the affected cerebral hemisphere. Nonetheless, following reperfusion (90 min after ischemia), U-II-treated animals displayed a remarkable hyperperfusion compared to vehicle-treated rats (+168%, p<0.05). The volume of infarction was significantly increased in U-II-treated rats (+40%, p<0.05). These results provide the first evidence that U-II increases cerebral blood flow when administered into the cerebral ventricle and exacerbates brain damage following an ischemic insult.     

Effect of indomethacin on cerebral blood flow, carbon dioxide reactivity and the response to epoprostenol (prostacyclin) infusion in man.

Cerebral blood flow (CBF) has been measured using a non-invasive Xenon133 clearance technique in six normal subjects after 2 days pretreatment with oral indomethacin at a dose of 100 mg/day. The results were compared with placebo given in a double blind balanced cross-over design. Indomethacin was found to result in a reduction in resting CBF of about 25% but the reactivity of the cerebrovascular circulation to carbon dioxide was preserved at normal levels. Infusions of epoprostenol (prostacyclin, PGI2) at a dose of 5 ng/kg/min resulted in a reduction of CBF of about 10% after placebo but no significant change in CBF after indomethacin. The results suggest that prostaglandins are involved in the maintenance of cerebrovascular tone but not in the mechanism of cerebral vasodilation accompanying hypercapnia. The combination of indomethacin and PGI2 has been proposed as a treatment of cerebral artery spasm and the findings suggest that the combination therapy would not be accompanied by undesirable intracerebral steal.     

Positron emission tomography in minor ischemic stroke using oxygen-15 steady-state technique

A study with positron emission tomography (PET) was performed on 10 patients with ischemic stroke and mild disability. The patients underwent cerebral angiography, x-ray computed tomography (CT) scan and regional cerebral measurements of CBF, CMRO2, oxygen extraction ratio (OER), and cerebral blood volume (CBV). Only minor arterial involvement was detected by angiography. In all patients, PET images of functional defects were more extensive than the corresponding CT hypodensity, and there were statistically significant reductions in CBF, CMRO2, and CBF/CBV ratio as compared with control subjects. Half of the regions analyzed in the affected hemisphere demonstrated a disruption of the normal coupling between CBF and CMRO2 as reflected by OER values significantly higher or lower than those of the corresponding region of the contralateral hemisphere. The pathophysiological pattern of high OER combined with a reduction in CBF proportionally greater than the reduction in CMRO2 was particularly indicative of regional chronic hemodynamic compromise in these patients.     

The effect of pentobarbital and isoflurane on glucose metabolism in thermally injured rat brain

The effect of pentobarbital and isoflurane on cerebral glucose metabolism (CMRglc) was studied in thermally injured rat brain using quantitative autoradiography. In awake lesioned animals, CMRglc in cortical regions ipsilateral to the injury was reduced to 50% of normal while little if any decrease was observed in contralateral cortical regions and subcortical regions bilaterally. Treatment of lesioned animals with pentobarbital or isoflurane further reduced CMRglc, but more in the hemisphere contralateral to the injury than on the injured side. Thus, the side-to-side difference in cortical CMRglc present in the awake lesioned animals was abolished by the anesthetics. The results support the hypothesis that CMRglc depression associated with a focal cold injury is functional in nature. Reduction of metabolism by anesthetics in functionally depressed brain is limited by the decrease in CMRglc associated with the injury.