Document Detail


Cerebral damage caused by interrupted, repeated arterial occlusion versus uninterrupted occlusion in a focal ischemic model.
MedLine Citation:
PMID:  7931589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Temporary intracranial arterial occlusion is often utilized during the surgical treatment of intracranial aneurysms. Although numerous experimental studies have suggested that repetitive, brief periods of global ischemia cause more severe cerebral injury than a similar single period of global ischemia, this issue has not been extensively studied in relation to focal ischemia. It remains controversial whether it is safer to use brief periods of interrupted, temporary occlusion separated by reperfusion periods, or a more prolonged, single temporary occlusion. This question is addressed in studies on a rabbit model of transient, focal cerebral ischemia. Sixteen anesthetized rabbits underwent transorbital occlusion of the left internal carotid, middle cerebral, and anterior cerebral arteries, with one of two paradigms:uninterrupted occlusion (1 hour of temporary occlusion followed by 5 hours of reperfusion in eight rabbits), or interrupted occlusion (three separate 20-minute periods of occlusion, with 10 minutes of reperfusion between occlusions, followed by 4 hours, 40 minutes of reperfusion in eight rabbits). Histopathological evaluation for ischemic neuronal damage and magnetic resonance imaging studies for ischemic edema were conducted 6 hours after the initial arterial occlusion. The animals in the interrupted, repeated occlusion group showed a 59% decrease in the area of cortical ischemic neuronal damage (mean +/- standard error of the mean 10.0% +/- 1.7%) compared with the uninterrupted occlusion group (24.4% +/- 5%, p = 0.016). There was no difference between the groups in the extent of striatal ischemic damage or area of ischemic edema. These results suggest that interrupted, repeated focal ischemia causes less cortical ischemic injury than uninterrupted transient ischemia of a similar total duration. Although caution should be exercised in extrapolating from these results to the clinical situation, they may have important implications for temporary arterial occlusion during intracranial surgery.
Authors:
G K Steinberg; N Panahian; G H Sun; C M Maier; D Kunis
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  81     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-10-27     Completed Date:  1994-10-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  554-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Stanford University School of Medicine, California.
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain Edema / etiology,  physiopathology
Brain Ischemia / complications,  pathology*,  physiopathology
Cerebral Cortex / pathology*
Constriction
Intracranial Aneurysm / complications,  surgery*
Magnetic Resonance Imaging
Male
Rabbits
Surgical Procedures, Operative / methods
Grant Support
ID/Acronym/Agency:
R01 NS27292-01A2/NS/NINDS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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