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ischemic penumbra

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https://www.readbyqxmd.com/read/29337840/targeted-temperature-management-at-33%C3%A2-c-or-36%C3%A2-c-produces-equivalent-neuroprotective-effects-in-the-middle-cerebral-artery-occlusion-rat-model-of-ischemic-stroke
#1
Jung Ho Lee, Jisoo Lim, Yong Eun Chung, Sung Phil Chung, Incheol Park, Chul Hoon Kim, Je Sung You
Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke...
January 15, 2018: Shock
https://www.readbyqxmd.com/read/29315561/faim2-contributes-to-neuroprotection-by-erythropoietin-in-transient-brain-ischemia
#2
Daniel Komnig, Karen Gertz, Pardes Habib, Kay W Nolte, Tareq Meyer, Marc A Brockmann, Matthias Endres, Birgit Rathkolb, Martin Hrabě de Angelis, Jörg B Schulz, Björn H Falkenburger, Arno Reich
Delayed cell death in the penumbra region of acute ischemic stroke occurs through apoptotic mechanisms, making it amenable to therapeutic interventions. Fas/CD95 mediates apoptotic cell death in response to external stimuli. In mature neurons, Fas/CD95 signaling is modulated by Fas-apoptotic inhibitory molecule 2 (Faim2), which reduces cell death in animal models of stroke, meningitis, and Parkinson disease. Erythropoietin (EPO) has been studied as a therapeutic strategy in ischemic stroke. Erythropoietin stimulates the phosphatidylinositol-3 kinase/Akt (PI3K/Akt) pathway, which regulates Faim2 expression...
January 8, 2018: Journal of Neurochemistry
https://www.readbyqxmd.com/read/29299743/basic-fibroblast-growth-factor-protects-astrocytes-against-ischemia-reperfusion-injury-by-upregulating-the-caveolin-1-vegf-signaling-pathway
#3
Meixia Liu, Yudan Wu, Yidian Liu, Zhenzhen Chen, Shujuan He, Huimei Zhang, Liang Wu, Fengxia Tu, Yun Zhao, Chan Liu, Xiang Chen
A previous in vivo study demonstrated that intracerebroventricular injection of basic fibroblast growth factor (bFGF) in middle cerebral artery occlusion rats increased the expression of caveolin-1 (cav-1) and vascular endothelial growth factor (VEGF) in cerebral ischemia penumbra. Because astrocytes are the largest population in the brain, the aim of this in vitro study was to investigate the influence of bFGF on cav-1 and VEGF expression in rat astrocytes following oxygen glucose deprivation/reoxygenation (OGD/R)...
January 3, 2018: Journal of Molecular Neuroscience: MN
https://www.readbyqxmd.com/read/29298658/hemopexin-promotes-angiogenesis-via-up-regulating-ho-1-in-rats-after-cerebral-ischemia-reperfusion-injury
#4
Beibei Dong, Zhishen Zhang, Keliang Xie, Yongyan Yang, Yuan Shi, Chenxu Wang, Yonghao Yu
BACKGROUND: Ischemia-reperfusion (I/R) is a critical pathophysiological change of ischemic stroke. Heme-oxygenase-1 (HO-1) is a rate-limiting enzyme of eliminating excessive free heme by combining with hemopexin (HPX), a plasma protein contributing to alleviating infarct size due to ischemia stroke. This study was to investigate whether HPX could improve angiogenesis after cerebral ischemia-reperfusion via up-regulating HO-1. METHODS: Rats were randomly divided into five groups: sham, MCAO, MCAO + Vehicle, MCAO + HPX and MCAO + HPX + protoporphyrin IX (ZnPPIX, an HO-1 inhibitor)...
January 3, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29296999/safety-and-efficacy-of-a-3-dimensional-stent-retriever-with-aspiration-based-thrombectomy-vs-aspiration-based-thrombectomy-alone-in-acute-ischemic-stroke-intervention-a-randomized-clinical-trial
#5
Raul G Nogueira, Donald Frei, Jawad F Kirmani, Osama Zaidat, Demetrius Lopes, Aquilla S Turk, Donald Heck, Brian Mason, Diogo C Haussen, Elad I Levy, Siddhart Mehta, Marc Lazzaro, Michael Chen, Arnd Dörfler, Albert J Yoo, Colin P Derdeyn, Lee Schwamm, David Langer, Adnan Siddiqui
Importance: The treatment effects of individual mechanical thrombectomy devices in large-vessel acute ischemic stroke (AIS) remain unclear. Objective: To determine whether the novel 3-dimensional (3-D) stent retriever used in conjunction with an aspiration-based mechanical thrombectomy device (Penumbra System; Penumbra) is noninferior to aspiration-based thrombectomy alone in AIS. Design, Setting, and Participants: This randomized, noninferiority clinical trial enrolled patients at 25 North American centers from May 19, 2012, through November 19, 2015, with follow-up for 90 days...
January 2, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29289703/enhancing-interpretability-of-automatically-extracted-machine-learning-features-application-to-a-rbm-random-forest-system-on-brain-lesion-segmentation
#6
Sérgio Pereira, Raphael Meier, Richard McKinley, Roland Wiest, Victor Alves, Carlos A Silva, Mauricio Reyes
Machine learning systems are achieving better performances at the cost of becoming increasingly complex. However, because of that, they become less interpretable, which may cause some distrust by the end-user of the system. This is especially important as these systems are pervasively being introduced to critical domains, such as the medical field. Representation Learning techniques are general methods for automatic feature computation. Nevertheless, these techniques are regarded as uninterpretable "black boxes"...
December 20, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/29274273/nicotinic-acetylcholine-receptor-alpha7-subunit-mediates-vagus-nerve-stimulation-induced-neuroprotection-in-acute-permanent-cerebral-ischemia-by-a7nachr-jak2-pathway
#7
Xin-Xin Lu, Zhong-Qiu Hong, Zhi Tan, Ming-Hong Sui, Zhi-Qiang Zhuang, Hui-Hua Liu, Xiu-Yuan Zheng, Tie-Bin Yan, Deng-Feng Geng, Dong-Mei Jin
BACKGROUND The role of nicotinic acetylcholine receptor alpha7 subunit (a7nAchR) in the treatment of acute cerebral ischemia by VNS has not been thoroughly clarified to date. Therefore, this study aimed to investigate the specific role of a7nAchR and explore whether this process is involved in the mechanisms of VNS-induced neuroprotection in rats undergoing permanent middle cerebral artery occlusion (PMCAO) surgery. MATERIAL AND METHODS Rats received a7nAChR antagonist (A) or antagonist placebo injection for control (AC), followed by PMCAO and VNS treatment, whereas the a7nAChR agonist (P) was utilized singly without VNS treatment but only with PMCAO pretreatment...
December 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29262429/blood-pressure-management-for-acute-ischemic-and-hemorrhagic-stroke-the-evidence
#8
Sang-Bae Ko, Byung-Woo Yoon
Hypertension is the most common modifiable risk factor for stroke (both ischemic and hemorrhagic types). In the hyperacute phase, a majority of patients shows an elevated blood pressure (BP) at the time of presentation because of sympathetic hyperactivity or a physiological response to tissue ischemia. Therefore, BP may decrease spontaneously in a few hours and may drop further when complete recanalization is achieved. In stroke guidelines, an elevated BP is usually left untreated up to a systolic BP (SBP) of 220 mm Hg and a diastolic BP of 120 mm Hg...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29249590/neuroprotective-effects-of-oxytocin-hormone-after-an-experimental-stroke-model-and-the-possible-role-of-calpain-1
#9
Sepideh Etehadi Moghadam, Abolfazl Azami Tameh, Zeinab Vahidinia, Mohammad Ali Atlasi, Hassan Hassani Bafrani, Homayoun Naderian
BACKGROUND: Different mechanisms will be activated during ischemic stroke. Calpain proteases play a pivotal role in neuronal death after ischemia damage through apoptosis. Anti-apoptotic activities of the oxytocin (OT) in different ischemic tissues were reported in previous studies. Recently, a limited number of studies have noted the protective effects of OT in the brain. In the present study, the neuroprotective potential of OT in an animal model of transient middle cerebral artery occlusion (tMCAO) and the possible role of calpain-1 in the penumbra region were assessed...
December 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29238322/acute-ischemic-pediatric-stroke-management-an-extended-window-for-mechanical-thrombectomy
#10
Ashish Kulhari, Elizabeth Dorn, Jonathan Pace, Vilakshan Alambyan, Stephanie Chen, Osmond C Wu, Macym Rizvi, Anthony Hammond, Ciro Ramos-Estebanez
Ischemic stroke is a rare condition to afflict the pediatric population. Congenital cardiomyopathy represents one of several possible etiologies in children. We report a 9-year-old boy who developed right middle cerebral artery stroke secondary to primary restrictive cardiomyopathy. In the absence of pediatric guidelines, the child met adult criteria for mechanical thrombectomy given the small core infarct and large penumbra. The literature suggests children may benefit from mechanical thrombectomy in carefully selected cases...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29222823/dominant-role-of-microglial-and-macrophage-innate-immune-responses-in-human-ischemic-infarcts
#11
Tobias Zrzavy, Joana Machado-Santos, Sheren Christine, Christoph Baumgartner, Howard L Weiner, Oleg Butovsky, Hans Lassmann
Inflammatory mechanisms, involving granulocytes, T-cells, B-cells, macrophages and activated microglia, have been suggested to play a pathogenic role in experimental models of stroke and may be targets for therapeutic intervention. However, knowledge on the inflammatory response in human stroke lesions is limited. Here, we performed a quantitative study on the inflammatory reaction in human ischemic infarct lesions. We found increased numbers of T-lymphocytes, mainly CD8+ cells, but not of B-lymphocytes. Their number was very low in comparison to that seen in inflammatory diseases of the central nervous system and they did not show signs of activation...
December 8, 2017: Brain Pathology
https://www.readbyqxmd.com/read/29205357/hexokinase-2-dependent-hyperglycolysis-driving-microglial-activation-contributes-to-ischemic-brain-injury
#12
Yuan Li, Bingzheng Lu, Longxiang Sheng, Zhu Zhu, Hongjiaqi Sun, Yuwei Zhou, Yang Yang, Dongdong Xue, Wenli Chen, Xuyan Tian, Yun Du, Min Yan, Wenbo Zhu, Fan Xing, Kai Li, Suizhen Lin, Pengxin Qiu, Xingwen Su, Yijun Huang, Guangmei Yan, Wei Yin
Hyperglycolysis, observed within the penumbra zone during brain ischemia, was shown to be detrimental for tissue survival due to lactate accumulation and reactive oxygen species (ROS) overproduction in clinical and experimental settings. Recently, mounting evidence suggests that glycolytic reprogramming and induced metabolic enzymes can fuel the activation of peripheral immune cells. However, the possible roles and details regarding hyperglycolysis in neuroinflammation during ischemia are relatively poorly understood...
December 5, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/29188434/photothrombotic-stroke-as-a-model-of-ischemic-stroke
#13
REVIEW
Anatoly B Uzdensky
The search of effective anti-stroke neuroprotectors requires various stroke models adequate for different aspects of the ischemic processes. The photothrombotic stroke model is particularly suitable for the study of cellular and molecular mechanisms underlying neurodegeneration, neuroprotection, and neuroregeneration. It is a model of occlusion of small cerebral vessels, which provides detailed study of molecular mechanisms of ischemic cell death and useful for search of potential anti-stroke agents. Its advantages include well-defined location and size of ischemic lesion that are determined by the aiming of the laser beam at the predetermined brain region; easy impact dosing by changing light intensity and duration; low invasiveness and minimal surgical intervention without craniotomy and mechanical manipulations with blood vessel, which carry the risk of brain trauma; low animal mortality and prolonged sensorimotor impairment that provide long-term study of stroke consequences including behavior impairment and recovery; independence on genetic variations of blood pressure and vascular architecture; and high reproducibility...
November 29, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29183174/limit-of-intraoperative-near-infrared-spectroscopy-monitoring-during-endovascular-thrombectomy-in-acute-ischemic-stroke
#14
Ryo Hiramatsu, Motomasa Furuse, Ryokichi Yagi, Hiroyuki Ohnishi, Naokado Ikeda, Naosuke Nonoguchi, Shinji Kawabata, Shigeru Miyachi, Toshihiko Kuroiwa
Endovascular thrombectomy is recommended for a persistent ischemic penumbra if recanalization cannot be achieved by the intravenous (IV) administration of recombinant tissue-plasminogen activator (rt-PA) alone. Although endovascular thrombectomy is a powerful treatment for major cerebral artery occlusion, the monitoring of recanalization and reperfusion during acute ischemic stroke presents a therapeutic challenge, and a previous study reported the usefulness of near-infrared spectroscopy (NIRS) for intraoperative monitoring during emergency endovascular thrombectomy for acute large ischemic stroke...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29172990/thresholds-for-infarction-vary-between-gray-matter-and-white-matter-in-acute-ischemic-stroke-a-ct-perfusion-study
#15
Chushuang Chen, Andrew Bivard, Longting Lin, Christopher R Levi, Neil J Spratt, Mark W Parsons
We aimed to investigate optimal perfusion thresholds defining ischemic core and penumbra for hemispheric-cortical gray matter (GM) and subcortical white matter (WM). A total of 65 sub-6 h ischemic stroke patients were assessed, who underwent acute computed tomography perfusion (CTP) and acute magnetic resonance imaging. CTP maps were generated by both standard singular value deconvolution (sSVD) and SVD with delay and dispersion correction (ddSVD). Analyses were undertaken to calculate sensitivity, specificity, and area under the curve (AUC) for each CTP threshold for core and penumbra in GM and WM...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#16
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29140184/refining-the-ischemic-penumbra-with-topography
#17
Tharani Thirugnanachandran, Henry Ma, Shaloo Singhal, Lee-Anne Slater, Stephen M Davis, Geoffrey A Donnan, Thanh Phan
It has been 40 years since the ischemic penumbra was first conceptualized through work on animal models. The topography of penumbra has been portrayed as an infarcted core surrounded by penumbral tissue and an extreme rim of oligemic tissue. This picture has been used in many review articles and textbooks before the advent of modern imaging. In this paper, we review our understanding of the topography of the ischemic penumbra from the initial experimental animal models to current developments with neuroimaging which have helped to further define the temporal and spatial evolution of the penumbra and refine our knowledge...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29136153/reverse-ncx-attenuates-cellular-sodium-loading-in-metabolically-compromised-cortex
#18
Niklas J Gerkau, Cordula Rakers, Simone Durry, Gabor C Petzold, Christine R Rose
In core regions of ischemic stroke, disruption of blood flow causes breakdown of ionic gradients and, ultimately, calcium overload and cell death. In the surrounding penumbra, cells may recover upon reperfusion, but recovery is hampered by additional metabolic demands imposed by peri-infarct depolarizations (PIDs). There is evidence that sodium influx drives PIDs, but no data exist on PID-related sodium accumulations in vivo. Here, we found that PIDs in mouse neocortex are associated with propagating sodium elevations in neurons and astrocytes...
November 9, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/29123467/the-role-of-sdf-1-cxcr4-cxcr7-in-neuronal-regeneration-after-cerebral-ischemia
#19
REVIEW
Xi Cheng, Huibin Wang, Xiuchun Zhang, Shanshan Zhao, Zhike Zhou, Xiaopeng Mu, Chuansheng Zhao, Weiyu Teng
Stromal cell-derived factor-1 is a chemoattractant produced by bone marrow stromal cell lines. It is recognized as a critical factor in the immune and central nervous systems (CNSs) as well as exerting a role in cancer. SDF-1 activates two G protein-coupled receptors, CXCR4 and CXCR7; these are expressed in both developing and mature CNSs and participate in multiple physiological and pathological events, e.g., inflammatory response, neurogenesis, angiogenesis, hematopoiesis, cancer metastasis, and HIV infection...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29121798/angelica-sinensis-exerts-angiogenic-and-anti-apoptotic-effects-against-cerebral-ischemia-reperfusion-injury-by-activating-p38mapk-hif-1-formula-see-text-vegf-a-signaling-in-rats
#20
Chin-Yi Cheng, Tin-Yun Ho, Chien-Yun Hsiang, Nou-Ying Tang, Ching-Liang Hsieh, Shung-Te Kao, Yu-Chen Lee
This study evaluated the effects of Angelica sinensis extract [Dang Gui (DG)] administered before 60[Formula: see text]min of middle cerebral artery occlusion followed by 3[Formula: see text]d of reperfusion and investigated the involvement of mitogen-activated protein kinase (MAPK)/hypoxia-inducible factor (HIF)-1[Formula: see text] signaling in the cortical ischemic penumbra. DG was intraperitoneally administered at a dose of 0.25[Formula: see text]g/kg (DG-0.25g), 0.5[Formula: see text]g/kg (DG-0.5g), or 1[Formula: see text]g/kg (DG-1g) 30[Formula: see text]min before the onset of cerebral ischemia...
2017: American Journal of Chinese Medicine
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