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Penumbra stroke

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https://www.readbyqxmd.com/read/28217292/oxygen-or-cooling-to-make-a-decision-after-acute-ischemia-stroke
#1
REVIEW
Wen-Cao Liu, Xin-Chun Jin
The presence of a salvageable penumbra, a region of ischemic brain tissue with sufficient energy for short-term survival, has been widely agreed as the premise for thrombolytic therapy with tissue plasminogen activator (tPA), which remains the only United States Food and Drug Administration (FDA) approved treatment for acute ischemia stroke. However, the use of tPA has been profoundly constrained due to its narrow therapeutic time window and the increased risk of potentially deadly hemorrhagic transformation (HT)...
October 2016: Medical Gas Research
https://www.readbyqxmd.com/read/28207602/spreading-depolarization-monitoring-in-neurocritical-care-of-acute-brain-injury
#2
Jed A Hartings
PURPOSE OF REVIEW: Spreading depolarizations are unique in being discrete pathologic entities that are well characterized experimentally and also occur commonly in patients with substantial acute brain injury. Here, we review essential concepts in depolarization monitoring, highlighting its clinical significance, interpretation, and future potential. RECENT FINDINGS: Cortical lesion development in diverse animal models is mediated by tissue waves of mass spreading depolarization that cause the toxic loss of ion homeostasis and limit energy substrate supply through associated vasoconstriction...
February 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28202414/lncrna-tug1-sponges-microrna-9-to-promote-neurons-apoptosis-by-up-regulated-bcl2l11-under-ischemia
#3
Shengcai Chen, Mengdie Wang, Hang Yang, Ling Mao, Quanwei He, Huijuan Jin, Zi-Ming Ye, Xue-Ying Luo, Yuan-Peng Xia, Bo Hu
Emerging studies have illustrated that LncRNAs TUG1 play critical roles in multiple biologic processes. However, the LncRNA TUG1 expression and function in ischemic stroke have not been reported yet. In this study, we found that LncRNA TUG1 expression was significantly up-regulated in brain ischemic penumbra from rat middle carotid artery occlusion (MCAO) model, while similar results were also observed in cultured neurons under oxygen-glucose deprivation (OGD) insult. Knockdown of TUG1 decreased the ratio of apoptotic cells and promoted cells survival in vitro, which may be regulated by the elevated miRNA-9 expression and decreased Bcl2l11 protein...
February 12, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28192195/puerarin-provides-a-neuroprotection-against-transient-cerebral-ischemia-by-attenuating-autophagy-at-the-ischemic-penumbra-in-neurons-but-not-in-astrocytes
#4
He Hongyun, Guo Tao, Zhang Pengyue, Yang Liqiang, Deng Yihao
Puerarin is an isoflavone derived from the Chinese medical herb of Radix puerariae (kudzu root), and has been widely used in the treatment for ischemic stroke in China. However, its underlying pharmacological mechanisms are still not understood. This study was to investigate the efficacy of puerarin on autophagy in the ischemic penumbra after cerebral stroke. A model of cerebral stroke in Sprague-Dawley rats was prepared by middle cerebral artery occlusion (MCAO); rats were then randomly divided into 5 groups: MCAO+Pue group (rats were treated with puerarin), MCAO+Pue+Tat-Beclin-1 group (rats were administrated with both puerarin and autophagy inducer Tat-Beclin-1), MCAO+Tat-Beclin-1 group (rats were treated with Tat-Beclin-1), MCAO+saline group (rats were administrated with the same volume of physiological saline), and sham surgery group...
February 10, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28188261/role-of-genetic-variation-in-collateral-circulation-in-the-evolution-of-acute-stroke-a-multimodal-magnetic-resonance-imaging-study
#5
Yu-Chieh Jill Kao, Esteban A Oyarzabal, Hua Zhang, James E Faber, Yen-Yu Ian Shih
BACKGROUND AND PURPOSE: No studies have determined the effect of differences in pial collateral extent (number and diameter), independent of differences in environmental factors and unknown genetic factors, on severity of stroke. We examined ischemic tissue evolution during acute stroke, as measured by magnetic resonance imaging and histology, by comparing 2 congenic mouse strains with otherwise identical genetic backgrounds but with different alleles of the Determinant of collateral extent-1 (Dce1) genetic locus...
February 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28178170/use-of-susceptibility-weighted-imaging-in-assessing-ischemic-penumbra-a-case-report
#6
Xiujuan Wu, Song Luo, Ying Wang, Yang Chen, Jun Liu, Jing Bai, Jiachun Feng, Hongliang Zhang
RATIONALE: The ischemic penumbra assessment is essential for the subsequent therapy and prediction of evolution in patients with acute ischemic infraction. Although controversial as a perfect equivalence to penumbra, perfusion-weighted imaging (PWI)-diffusion-weighted imaging (DWI) mismatch may predict the response to thrombolysis. Due to the reliance of PWI on contrast agents, noninvasive alternatives remain an unmet need. PATIENT CONCERNS: We reported a 65-year-old man complained of paroxysmal hemiplegia of his right limbs and anepia for 2 days, whereas the symptoms lasted for about 12 hours when he admitted to the hospital...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28154103/acute-ischemic-stroke-therapy-overview
#7
Luciana Catanese, Joseph Tarsia, Marc Fisher
The treatment of acute ischemic stroke has undergone dramatic changes recently subsequent to the demonstrated efficacy of intra-arterial (IA) device-based therapy in multiple trials. The selection of patients for both intravenous and IA therapy is based on timely imaging with either computed tomography or magnetic resonance imaging, and if IA therapy is considered noninvasive, angiography with one of these modalities is necessary to document a large-vessel occlusion amenable for intervention. More advanced computed tomography and magnetic resonance imaging studies are available that can be used to identify a small ischemic core and ischemic penumbra, and this information will contribute increasingly in treatment decisions as the therapeutic time window is lengthened...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28114983/panaxatriol-saponins-promotes-angiogenesis-and-enhances-cerebral-perfusion-after-ischemic-stroke-in-rats
#8
Zhen Hui, Du-Juan Sha, Su-Lei Wang, Chao-Sheng Li, Jian Qian, Jing-Qing Wang, Yang Zhao, Jing-Hua Zhang, Hong-Yu Cheng, Hui Yang, Lin-Jie Yu, Yun Xu
BACKGROUND: Panaxatriol saponins (PTS), an extract from the traditional Chinese herb Panax notoginseng, which has been used to treat ischemic stroke for many years in China. However, the mechanism underlying the effects of PTS remains unclear. This study aimed to determine whether PTS can protect against ischemic brain injury by promoting angiogenesis and to explore the possible mechanism by which it promotes angiogenesis. METHODS: Middle cerebral artery occlusion (MCAO) was induced in rats, and neurological deficit scores and brain infarct volumes were assessed...
January 23, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28103599/evaluations-of-intravenous-administration-of-cd34-human-umbilical-cord-blood-cells-in-a-mouse-model-of-neonatal-hypoxic-ischemic-encephalopathy
#9
Makiko Ohshima, Akihiko Taguchi, Yoshiaki Sato, Yuko Ogawa, Satoshi Saito, Kenichi Yamahara, Masafumi Ihara, Mariko Harada-Shiba, Tomoaki Ikeda, Tomohiro Matsuyama, Masahiro Tsuji
Several cell therapies have been explored as novel therapeutic strategies for neonatal encephalopathy because the benefits of current treatments are limited. We previously reported that intravenous administration of human umbilical cord blood (hUCB) CD34+ cells (hematopoietic stem cells/endothelial progenitor cells) at 48 h after insult exerts therapeutic effects in neonatal mice with stroke, i.e., permanent middle cerebral artery occlusion. Although neonatal stroke and hypoxic-ischemic encephalopathy (HIE) are grouped under the term "neonatal encephalopathy," their pathogenesis differs...
January 20, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28079313/postischemic-inflammation-in-acute-stroke
#10
REVIEW
Simone Vidale, Arturo Consoli, Marco Arnaboldi, Domenico Consoli
Cerebral ischemia is caused by arterial occlusion due to a thrombus or an embolus. Such occlusion induces multiple and concomitant pathophysiological processes that involve bioenergetic failure, acidosis, loss of cell homeostasis, excitotoxicity, and disruption of the blood-brain barrier. All of these mechanisms contribute to neuronal death, mainly via apoptosis or necrosis. The immune system is involved in this process in the early phases after brain injury, which contributes to potential enlargement of the infarct size and involves the penumbra area...
January 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28078626/time-course-investigation-of-blood-brain-barrier-permeability-and-tight-junction-protein-changes-in-a-rat-model-of-permanent-focal-ischemia
#11
Peng Liu, Rui Zhang, Danyang Liu, Jinling Wang, Chunling Yuan, Xuemei Zhao, Yinjie Li, Xuefei Ji, Tianyan Chi, Libo Zou
Permanent middle cerebral artery occlusion (pMCAO) is an animal model that is widely used to simulate human ischemic stroke. However, the timing of the changes in the expression of tight junction (TJ) proteins and synaptic proteins associated with pMCAO remain incompletely understood. Therefore, to further explore the characteristics and mechanisms of blood-brain barrier (BBB) damage during cerebral ischemic stroke, we used a pMCAO rat model to define dynamic changes in BBB permeability within 120 h after ischemia in order to examine the expression levels of the TJ proteins claudin-5 and occludin and the synaptic proteins synaptophysin (SYP) and postsynaptic density protein 95 (PSD95)...
January 11, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28068417/preserved-collateral-blood-flow-in-the-endovascular-m2cao-model-allows-for-clinically-relevant-profiling-of-injury-progression-in-acute-ischemic-stroke
#12
Philip Little, Ola Kvist, Rikard Grankvist, Stefan Jonsson, Peter Damberg, Michael Söderman, Fabian Arnberg, Staffan Holmin
Interventional treatment regimens have increased the demand for accurate understanding of the progression of injury in acute ischemic stroke. However, conventional animal models severely inhibit collateral blood flow and mimic the malignant infarction profile not suitable for treatment. The aim of this study was to provide a clinically relevant profile of the emergence and course of ischemic injury in cases suitable for acute intervention, and was achieved by employing a M2 occlusion model (M2CAO) that more accurately simulates middle cerebral artery (MCA) occlusion in humans...
2017: PloS One
https://www.readbyqxmd.com/read/28064357/ischemic-stroke-experimental-models-and-reality
#13
REVIEW
Clemens J Sommer
The vast majority of cerebral stroke cases are caused by transient or permanent occlusion of a cerebral blood vessel ("ischemic stroke") eventually leading to brain infarction. The final infarct size and the neurological outcome depend on a multitude of factors such as the duration and severity of ischemia, the existence of collateral systems and an adequate systemic blood pressure, etiology and localization of the infarct, but also on age, sex, comorbidities with the respective multimedication and genetic background...
February 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28040669/perfusion-computed-tomography-in-patients-with-stroke-thrombolysis
#14
Hiroyuki Kawano, Andrew Bivard, Longting Lin, Henry Ma, Xin Cheng, Richard Aviv, Billy O'Brien, Kenneth Butcher, Min Lou, Jingfen Zhang, Jim Jannes, Qiang Dong, Christopher R Levi, Mark W Parsons
Stroke shortens an individual's disability-free life. We aimed to assess the relative prognostic influence of pre- and post-treatment perfusion computed tomography imaging variables (e.g. ischaemic core and penumbral volumes) compared to standard clinical predictors (such as onset-to-treatment time) on long-term stroke disability in patients undergoing thrombolysis. We used data from a prospectively collected international, multicentre, observational registry of acute ischaemic stroke patients who had perfusion computed tomography and computed tomography angiography before treatment with intravenous alteplase...
December 31, 2016: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28030891/impact-of-slow-blood-filling-via-collaterals-on-infarct-growth-comparison-of-mismatch-and-collateral-status
#15
Jeong Pyo Son, Mi Ji Lee, Suk Jae Kim, Jong-Won Chung, Jihoon Cha, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, Oh Young Bang
BACKGROUND AND PURPOSE: Perfusion-diffusion mismatch has been evaluated to determine whether the presence of a target mismatch helps to identify patients who respond favorably to recanalization therapies. We compared the impact on infarct growth of collateral status and the presence of a penumbra, using magnetic resonance perfusion (MRP) techniques. METHODS: Consecutive patients who were candidates for recanalization therapy and underwent serial diffusion-weighted imaging (DWI) and MRP were enrolled...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28017783/anti-apoptotic-and-angiogenic-effects-of-intelectin-1-in-rat-cerebral-ischemia
#16
Naibing Gu, Yaru Dong, Ye Tian, Zhengli Di, Zhiqin Liu, Mingze Chang, Xiaotao Jia, Yihua Qian, Weiping Zhang
Ischemic stroke is an acute life-threatening disease, which causes neurological dysfunction. The formation of new blood vessels around the infarct is vital to the restoration of perfusion and healing of brain tissue. Studies have shown that intelectin-1 (omentin) promotes endothelial cell function and angiogenesis in response to ischemia and inhibits apoptosis in rats with unilateral hind limb surgery. In the present study, we investigated the neuroprotective role of intelectin-1 following focal cerebral ischemia...
December 23, 2016: Brain Research Bulletin
https://www.readbyqxmd.com/read/27999623/personalized-approach-in-brain-protection-by-hypothermia-individual-changes-in-non-pathological-and-ischemia-related-glutamate-transport-in-brain-nerve-terminals
#17
Artem Pastukhov, Natalia Krisanova, Vitalii Maksymenko, Tatiana Borisova
BACKGROUND: Both deep and profound hypothermia are effectively applied in cardiac surgery of the aortic arch, when the reduction of cerebral circulation facilitates operations, and for the prevention of ischemic stroke consequences. Neurochemical discrimination of the effects of deep and profound hypothermia (27 and 17 °C, respectively) on non-pathological and pathological ischemia-related mechanisms of presynaptic glutamate transport with its potential contribution to predictive, preventive and personalized medicine (PPPM) was performed...
2016: EPMA Journal
https://www.readbyqxmd.com/read/27999507/the-penumbra-5max-ace-catheter-is-safe-efficient-and-cost-saving-as-a-primary-mechanical-thrombectomy-device-for-large-vessel-occlusions-in-acute-ischemic-stroke
#18
Gabriel A Vidal, James M Milburn
BACKGROUND: Reperfusion of large vessel occlusions in acute stroke can improve patient outcomes. The purposes of this study were to assess the safety and efficacy of the Penumbra 5MAX ACE catheter for revascularization of large vessels and to compare its cost to the cost of stent retrievers. METHODS: In this retrospective, single-center case review study, data were captured on consecutive patients treated with the Penumbra 5MAX ACE as first-line therapy during an 11-month period...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27987215/cortical-spreading-depression-preconditioning-mediates-neuroprotection-against-ischemic-stroke-by-inducing-amp-activated-protein-kinase-dependent-autophagy-in-a-rat-cerebral-ischemic-reperfusion-injury-model
#19
Pingping Shen, Shuai Hou, Mingqin Zhu, Mingming Zhao, Yibing Ouyang, Jiachun Feng
Cortical spreading depression (CSD), based on its similarities with peri-infarct depolarization, is an ideal model for investigating transformation from the ischemic penumbra to infarct core. However, the underlying mechanisms remain unclear. To our knowledge, this is the first study to use a middle cerebral artery occlusion ischemic-reperfusion (I/R) injury model to determine whether AMP-activated protein kinase (AMPK)-dependent autophagy contributes to the neuroprotection of CSD preconditioning in rat cortex...
December 17, 2016: Journal of Neurochemistry
https://www.readbyqxmd.com/read/27987133/tat-pep-enhanced-neurobehavioral-functional-recovery-by-facilitating-axonal-regeneration-and-corticospinal-tract-projection-after-stroke
#20
Bin Deng, Liya Li, Xingchun Gou, Hao Xu, Zhaohua Zhao, Qiang Wang, Lixian Xu
Paired immunoglobulin-like receptor B (PirB) has been identified as a new receptor for myelin-associated inhibitory (MAI) proteins, which may play important role in axonal regeneration and corticospinal tract (CST) projection associated with neurobehavioral function recovery after stroke. Here, we found that the expression of PirB was increased in the cortical penumbra from 1 to 28 days after transient focal cerebral ischemic reperfusion of rats. Then, transactivator of transcription-PirB extracellular peptide (TAT-PEP) was generated that might block the interactions between MAIs and PirB...
December 16, 2016: Molecular Neurobiology
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