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Delayed cerebral ischemia

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https://www.readbyqxmd.com/read/28548598/associations-between-endothelin-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage-clinical-vasospasm-delayed-cerebral-ischemia-and-functional-outcome
#1
Christoph J Griessenauer, Robert M Starke, Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Beverly C Walters, Jean-Francois Pittet, Mali Mathru
OBJECTIVE Endothelin-1, a potent vasoconstrictor, and its receptors may be involved in the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH), clinical vasospasm, delayed cerebral ischemia (DCI), and functional outcome following aSAH. In the present study, common endothelin single nucleotide polymorphisms (SNPs) and their relation to aSAH were evaluated. METHODS Blood samples from all patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study were used for genetic evaluation. The CARAS study prospectively enrolled patients with aSAH at 2 academic institutions in the US from 2012 to 2015...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28526764/subarachnoid-hemorrhage-severely-impairs-brain-parenchymal-cerebrospinal-fluid-circulation-in-nonhuman-primate
#2
Romain Goulay, Julien Flament, Maxime Gauberti, Michael Naveau, Nolwenn Pasquet, Clement Gakuba, Evelyne Emery, Philippe Hantraye, Denis Vivien, Romina Aron-Badin, Thomas Gaberel
BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) is a devastating form of stroke with neurological outcomes dependent on the occurrence of delayed cerebral ischemia. It has been shown in rodents that some of the mechanisms leading to delayed cerebral ischemia are related to a decreased circulation of the cerebrospinal fluid (CSF) within the brain parenchyma. Here, we evaluated the cerebral circulation of the CSF in a nonhuman primate in physiological condition and after SAH. METHODS: We first evaluated in physiological condition the circulation of the brain CSF in Macaca facicularis, using magnetic resonance imaging of the temporal DOTA-Gd distribution after its injection into the CSF...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28512045/early-diagnosis-of-delayed-cerebral-ischemia-possible-relevance-for-inflammatory-biomarkers-in-routine-clinical-practice
#3
Bishwas Chamling, Stefan Gross, Birgit Stoffel-Wagner, Gerrit A Schubert, Hans Clusmann, Mark Coburn, Anke Höllig
BACKGROUND: Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is one of the main causes of neurological deterioration. However, it frequently evades timely detection. Early identification and effective reversal may improve the clinical outcome. In this prospective study, we evaluate several serum inflammatory markers after aSAH with regard to the occurrence of DCI. METHODS: On days 1, 4, 7, 10 and 14 after SAH leucocyte count, C-reactive protein, interleukin-6, E-selectin, matrix metallopeptidase 9, intercellular adhesion molecule 1 and leukemia inhibitory factor were assessed in patients´ serum samples...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28504050/how-long-is-sufficient-for-optimal-neuroprotection-with-cerebral-cooling-after-ischemia-in-fetal-sheep
#4
Joanne O Davidson, Vittoria Draghi, Sean Whitham, Simerdeep K Dhillon, Guido Wassink, Laura Bennet, Alistair J Gunn
The optimal duration of mild "therapeutic" hypothermia for neonates with hypoxic-ischemic encephalopathy is surprisingly unclear. This study assessed the relative efficacy of cooling for 48 h versus 72 h. Fetal sheep (0.85 gestation) received sham ischemia (n = 9) or 30 min global cerebral ischemia followed by normothermia (n = 8) or delayed hypothermia from 3 h to 48 h (n = 8) or 72 h (n = 8). Ischemia was associated with profound loss of electroencephalogram (EEG) power, neurons in the cortex and hippocampus, and oligodendrocytes and myelin basic protein expression in the white matter, with increased Iba-1-positive microglia and proliferation...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28487988/delayed-administration-of-guanosine-improves-long%C3%A2-term-functional-recovery-and-enhances-neurogenesis-and-angiogenesis-in-a-mouse-model-of-photothrombotic-stroke
#5
Gang Deng, Zhandong Qiu, Dayong Li, Yu Fang, Suming Zhang
Guanosine (GUO) is neuroprotective when administered acutely for the treatment of cerebral ischemia. The aim of the present study was to investigate whether delayed administration of GUO improved long‑term functional recovery following stroke, as well as to explore the potential underlying mechanisms. GUO (8 mg/kg) or a vehicle was administered intraperitoneally for 7 consecutive days beginning 24 h prior to photothrombosis‑induced stroke in male C57/B6J mice. Behaviour tests were performed at days 1, 3, 7, 14 and 28 post‑stroke...
June 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28484291/follow-up-of-vasospasm-by-transcranial-doppler-sonography-tcd-in-subarachnoid-hemorrhage-sah
#6
Jasminka Djelilovic-Vranic, Vanja Basic-Kes, Merita Tiric-Campara, Edina Djozic, Jasmin Kulenovic
INTRODUCTION: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics...
March 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28483029/value-of-3d-pseudo-continuous-arterial-spin-labeling-magnetic-resonance-perfusion-imaging-in-evaluating-posterior-circulation-ischemia-in-the-elderly
#7
Rui Jia, Xian Xu, Xinqiu Liu, Bing Wu, Weiwei Men, Ningyu An
Objective To investigate the value of 3D pseudo-continuous arterial spin labeling (3D-pCASL) magnetic resonance perfusion technique in evaluating posterior circulation ischemia (PCI) of the elderly beyond 80 years old and to offer the evidence of PCI of the elderly for clinical diagnosis. Methods Totally 53 male subjects older than 80 years were recruited in this study,including 20 subjects with clinically diagnosed PCI and 33 normal subjects. All the subjects underwent routine brain magnetic resonance imaging and 3D-pCASL sequence on a 3...
April 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28468328/heparin-and-heparin-derivatives-in-post-subarachnoid-hemorrhage-brain-injury-a-multimodal-therapy-for-a-multimodal-disease
#8
REVIEW
Erik G Hayman, Akil P Patel, Robert F James, J Marc Simard
Pharmacologic efforts to improve outcomes following aneurysmal subarachnoid hemorrhage (aSAH) remain disappointing, likely owing to the complex nature of post-hemorrhage brain injury. Previous work suggests that heparin, due to the multimodal nature of its actions, reduces the incidence of clinical vasospasm and delayed cerebral ischemia that accompany the disease. This narrative review examines how heparin may mitigate the non-vasospastic pathological aspects of aSAH, particularly those related to neuroinflammation...
May 2, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28464523/low-level-light-emitting-diode-therapy-promotes-long-term-functional-recovery-after-experimental-stroke-in-mice
#9
Hae In Lee, Sae-Won Lee, Nam Gyun Kim, Kyoung-Jun Park, Byung Tae Choi, Yong-Il Shin, Hwa Kyoung Shin
We aimed to investigate the effects of low-level light emitting diode therapy (LED-T) on the long-term functional outcomes after cerebral ischemia, and the optimal timing of LED-T initiation for achieving suitable functional recovery. Focal cerebral ischemia was induced in mice via photothrombosis. These mice were assigned to a sham-operated (control), ischemic (vehicle), or LED-T group [initiation immediately (acute), 4 days (subacute) or 10 days (delayed) after ischemia, followed by once-daily treatment for 7 days]...
May 2, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/28448965/neuroprotective-treatments-after-perinatal-hypoxic-ischemic-brain-injury-evaluated-with-magnetic-resonance-spectroscopy
#10
Hester Rijkje Berger, Eva Brekke, Marius Widerøe, Tora Sund Morken
Perinatal hypoxic-ischemic brain injury is a major health problem. Adjuvant treatments that improve the neuroprotective effect of the current treatment, therapeutic hypothermia, are urgently needed. The growing knowledge about the complex pathophysiology of hypoxia-ischemia (HI) has led to the discovery of several important targets for neuroprotection. Early interventions should focus on the preservation of energy metabolism, the reduction of glutamate excitotoxicity and oxidative stress, the maintenance of calcium homeostasis, and the prevention of apoptosis...
April 28, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28445478/delayed-histochemical-alterations-within-the-neurovascular-unit-due-to-transient-focal-cerebral-ischemia-and-experimental-treatment-with-neurotrophic-factors
#11
Dominik Michalski, Roman Pitsch, Deepu R Pillai, Bianca Mages, Susanne Aleithe, Jens Grosche, Henrik Martens, Felix Schlachetzki, Wolfgang Härtig
Current stroke therapy is focused on recanalizing strategies, but neuroprotective co-treatments are still lacking. Modern concepts of the ischemia-affected neurovascular unit (NVU) and surrounding penumbra emphasize the complexity during the transition from initial damaging to regenerative processes. While early treatment with neurotrophic factors was shown to result in lesion size reduction and blood-brain barrier (BBB) stabilization, cellular consequences from these treatments are poorly understood. This study explored delayed cellular responses not only to ischemic stroke, but also to an early treatment with neurotrophic factors...
2017: PloS One
https://www.readbyqxmd.com/read/28442781/spreading-depolarization-remarkably-exacerbates-ischemia-induced-tissue-acidosis-in-the-young-and-aged-rat-brain
#12
Ákos Menyhárt, Dániel Zölei-Szénási, Tamás Puskás, Péter Makra, M Tóth Orsolya, Borbála É Szepes, Réka Tóth, Orsolya Ivánkovits-Kiss, Tihomir P Obrenovitch, Ferenc Bari, Eszter Farkas
Spreading depolarizations (SDs) occur spontaneously in the cerebral cortex of subarachnoid hemorrhage, stroke or traumatic brain injury patients. Accumulating evidence prove that SDs exacerbate focal ischemic injury by converting zones of the viable but non-functional ischemic penumbra to the core region beyond rescue. Yet the SD-related mechanisms to mediate neurodegeneration remain poorly understood. Here we show in the cerebral cortex of isoflurane-anesthetized, young and old laboratory rats, that SDs propagating under ischemic penumbra-like conditions decrease intra and- extracellular tissue pH transiently to levels, which have been recognized to cause tissue damage...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28428349/toll-like-receptor-4-mediates-hemorrhagic-transformation-after-delayed-tissue-plasminogen-activator-administration-in-in-situ-thromboembolic-stroke
#13
Alicia García-Culebras, Sara Palma-Tortosa, Ana Moraga, Isaac García-Yébenes, Violeta Durán-Laforet, Maria I Cuartero, Juan de la Parra, Ana L Barrios-Muñoz, Jaime Díaz-Guzmán, Jesús M Pradillo, María A Moro, Ignacio Lizasoain
BACKGROUND AND PURPOSE: Hemorrhagic transformation is the main complication of revascularization therapies after stroke. Toll-like receptor 4 (TLR4) is implicated in cerebral damage and inflammation in stroke. This study was designed to determine the role of TLR4 in hemorrhagic transformation development after tissue plasminogen activator (tPA) administration. METHODS: Mice expressing (TLR4(+/+)) or lacking functional TLR4 (TLR4(-)(/-)) were subjected to middle cerebral artery occlusion using an in situ thromboembolic model by thrombin injection into the middle cerebral artery, and tPA (10 mg/kg) was administered 20 minutes or 3 hours after ischemia...
April 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28419304/incorporating-a-modified-graeb-score-to-the-modified-fisher-scale-for-improved-risk-prediction-of-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage
#14
Matt E Eagles, Blessing N R Jaja, R Loch Macdonald
BACKGROUND: Delayed cerebral ischemia (DCI) is a cause of poor outcome after aneurysmal subarachnoid hemorrhage. Risk scales to predict DCI have scarcely been evaluated for predictive accuracy. Accounting for volume of intraventricular hemorrhage (IVH) in the modified Fischer scale (mFS) may improve its predictive accuracy. OBJECTIVE: To compare the modified Graeb score (mGS) to the mFS for risk prediction of DCI, and to investigate whether incorporating an mGS cut-point into the mFS could improve predictive accuracy...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28401316/the-orally-active-noncompetitive-ampar-antagonist-perampanel-attenuates-focal-cerebral-ischemia-injury-in-rats
#15
Hong-Xia Niu, Jun-Zhe Wang, Dong-Liang Wang, Jun-Jie Miao, Hua Li, Zhi-Gang Liu, Xing Yuan, Wei Liu, Jing-Ru Zhou
Inhibition of ionotropic glutamate receptors (iGluRs) is a potential target of therapy for ischemic stroke. Perampanel is a potent noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptor (AMPAR) antagonist with good oral bioavailability and favorable pharmacokinetic properties. Here, we investigated the potential protective effects of perampanel against focal cerebral ischemia in a middle cerebral artery occlusion (MCAO) model in rats. Oral administration with perampanel significantly reduced MCAO-induced brain edema, brain infarct volume, and neuronal apoptosis...
April 11, 2017: Cellular and Molecular Neurobiology
https://www.readbyqxmd.com/read/28400792/toll-like-receptor-4-as-a-possible-therapeutic-target-for-delayed-brain-injuries-after-aneurysmal-subarachnoid-hemorrhage
#16
REVIEW
Takeshi Okada, Hidenori Suzuki
Neuroinflammation is a well-recognized consequence of subarachnoid hemorrhage (SAH), and Toll-like receptor (TLR) 4 may be an important therapeutic target for post-SAH neuroinflammation. Of the TLR family members, TLR4 is expressed in various cell types in the central nervous system, and is unique in that it can signal through both the myeloid differentiation primary-response protein 88-dependent and the toll receptor associated activator of interferon-dependent cascades to coordinate the maximal inflammatory response...
February 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28396199/hypoxia-response-element-regulated-mmp-9-promotes-neurological-recovery-via-glial-scar-degradation-and-angiogenesis-in-delayed-stroke
#17
Hongxia Cai, Yuanyuan Ma, Lu Jiang, Zhihao Mu, Zhen Jiang, Xiaoyan Chen, Yongting Wang, Guo-Yuan Yang, Zhijun Zhang
Matrix metalloproteinase 9 (MMP-9) plays a beneficial role in the delayed phase of middle cerebral artery occlusion (MCAO). However, the mechanism is obscure. Here, we constructed hypoxia response element (HRE)-regulated MMP-9 to explore its effect on glial scars and neurogenesis in delayed ischemic stroke. Adult male Institute of Cancer Research (ICR) mice underwent MCAO and received a stereotactic injection of lentivirus carrying HRE-MMP-9 or normal saline (NS)/lentivirus-GFP 7 days after ischemia. We found that HRE-MMP-9 improved neurological outcomes, reduced ischemia-induced brain atrophy, and degraded glial scars (p < 0...
April 7, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28392287/blocked-delayed-or-obstructed-what-causes-poor-white-matter-development-in-intrauterine-growth-restricted-infants
#18
REVIEW
Mary Tolcos, Steven Petratos, Jonathan J Hirst, Flora Wong, Sarah J Spencer, Aminath Azhan, Ben Emery, David W Walker
Poor white matter development in intrauterine growth restricted (IUGR) babies remains a major, untreated problem in neonatology. New therapies, guided by an understanding of the mechanisms that underlie normal and abnormal oligodendrocyte development and myelin formation, are required. Much of our knowledge of the mechanisms that underlie impaired myelination come from studies in adult demyelinating disease, preterm brain injury, or experimental models of hypoxia-ischemia. However relatively less is known for IUGR which is surprising because IUGR is a leading cause of perinatal mortality and morbidity, second only to premature birth...
April 6, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/28387139/intracortical-electrophysiological-correlates-of-blood-flow-after-severe-sah-a-multimodality-monitoring-study
#19
Brandon Foreman, David Albers, J Michael Schmidt, Cristina Maria Falo, Angela Velasquez, E Sander Connolly, Jan Claassen
Subarachnoid hemorrhage (SAH) is a devastating form of stroke. Approximately one in four patients develop progressive neurological deterioration and silent infarction referred to as delayed cerebral ischemia (DCI). DCI is a complex, multifactorial secondary brain injury pattern and its pathogenesis is not fully understood. We aimed to study the relationship between cerebral blood flow (CBF) and neuronal activity at both the cortex and in scalp using electroencephalography (EEG) in poor-grade SAH patients undergoing multimodality intracranial neuromonitoring...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28365434/ultra-early-angiographic-vasospasm-after-aneurysmal-subarachnoid-hemorrhage-a%C3%A2-systematic-review-and-meta-analysis
#20
REVIEW
Kevin Phan, Justin M Moore, Christoph J Griessenauer, Joshua Xu, Ian Teng, Adam A Dmytriw, Albert H Chiu, Christopher S Ogilvy, Ajith Thomas
OBJECTIVE: After aneurysmal subarachnoid hemorrhage (aSAH), prognosis is affected heavily by the presence of delayed cerebral ischemia (DCI). There is growing recognition of ultra-early angiographic vasospasm (UEAV) occurring within 48 hours of aSAH; however, its relationship with DCI and ultimately prognosis remains unclear. METHODS: Various databases limited to the English language through September 2016 were searched systematically. Eligible studies were those comparing UEAV with control non-UEAV outcomes and follow-up...
March 29, 2017: World Neurosurgery
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