Document Detail


Heterogeneity in the penumbra.
MedLine Citation:
PMID:  21731034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Original experimental studies in nonhuman primate models of focal ischemia showed flow-related changes in evoked potentials that suggested a circumferential zone of low regional cerebral blood flow with normal K(+) homeostasis, around a core of permanent injury in the striatum or the cortex. This became the basis for the definition of the ischemic penumbra. Imaging techniques of the time suggested a homogeneous core of injury, while positing a surrounding 'penumbral' region that could be salvaged. However, both molecular studies and observations of vascular integrity indicate a more complex and dynamic situation in the ischemic core that also changes with time. The microvascular, cellular, and molecular events in the acute setting are compatible with heterogeneity of the injury within the injury center, which at early time points can be described as multiple 'mini-cores' associated with multiple 'mini-penumbras'. These observations suggest the progression of injury from many small foci to a homogeneous defect over time after the onset of ischemia. Recent observations with updated imaging techniques and data processing support these dynamic changes within the core and the penumbra in humans following focal ischemia.
Authors:
Gregory J del Zoppo; Frank R Sharp; Wolf-Dieter Heiss; Gregory W Albers
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2011-07-06
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  31     ISSN:  1559-7016     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-02     Completed Date:  2011-10-27     Revised Date:  2011-11-02    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1836-51     Citation Subset:  IM    
Affiliation:
Department of Medicine (Division of Hematology), University of Washington School of Medicine, Seattle, Washington 98104, USA. grgdlzop@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain / blood supply*,  metabolism,  pathology*,  physiopathology
Brain Ischemia / metabolism*,  pathology*,  physiopathology
Cerebrovascular Circulation*
Humans
Grant Support
ID/Acronym/Agency:
NS 036945/NS/NINDS NIH HHS; NS 038710/NS/NINDS NIH HHS; NS 053716/NS/NINDS NIH HHS; NS044848/NS/NINDS NIH HHS; NS054652/NS/NINDS NIH HHS; NS066845/NS/NINDS NIH HHS; NS39325/NS/NINDS NIH HHS

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


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