Document Detail

Excitotoxicity and Metabolic Changes in Association With Infarct Progression.
MedLine Citation:
PMID:  24643407     Owner:  NLM     Status:  Publisher    
BACKGROUND AND PURPOSE: We investigated to what extent excitotoxicity and metabolic changes in the peri-infarct region of patients with malignant hemispheric stroke are associated with delayed infarct progression.
METHODS: In 18 patients with malignant hemispheric stroke, 2 microdialysis probes were implanted within the peri-infarct tissue at a distance of 5 and 15 mm to the infarct. Precise probe placement was achieved by intraoperative laser speckle imaging. Glutamate, glucose, pyruvate, and lactate levels were monitored for 5 days after surgery. Delayed infarct progression was determined from serial MRI on the day after surgery and after the monitoring period.
RESULTS: Initial stroke volume ranged from 122 to 479 cm(3) with a median of 295 cm(3). Nine of 18 patients (50%) had delayed infarct progression (median, 44 cm(3); range, 19-93 cm(3)). In these patients, glucose and individual pyruvate levels were significantly lower when compared with patients without infarct progression, whereas glutamate and the lactate-pyruvate ratio were significantly elevated in patients with infarct progression early after surgery (12-36 hours) at the 15-mm microdialysis probe location. Lactate was elevated but without difference between groups.
CONCLUSIONS: Excitotoxic or metabolic impairment was associated with delayed infarct progression and could serve as a treatment target.
Johannes Woitzik; Alexandra Pinczolits; Nils Hecht; Nora Sandow; Michael Scheel; Christoph Drenckhahn; Jens P Dreier; Peter Vajkoczy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-18
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  -     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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