Document Detail


Predictors of deteriorating cerebral infarct: role of inflammatory mechanisms. Would its early treatment be useful?
MedLine Citation:
PMID:  11244199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The development of neurological deterioration in the hours following the stroke onset occurs in somewhat more than 1 in 3 cerebral infarcts and is associated with an increase in morbidity and mortality. This early deterioration (0--48/72 h) entails the conversion of the ischemic penumbra area in an irreversible lesion, a process that is mediated as much by hemodynamic changes in the local cerebral circulation as by biochemical mechanisms. Late neurological deterioration (3--7 days) is more frequently associated with systemic causes. Knowledge of the various clinical, biochemical and imaging markers associated with neurological deterioration is consequently of fundamental importance. For their repercussion in clinical practice, we classify these predictors of deteriorating cerebral infarct into nonmodifiable, modifiable and possibly modifiable. The reduction in cerebral blood flow in a particular cerebral zone causes very early cerebral damage as a consequence of a significant liberation of neuroexcitatory amino acids, followed by an excessive entry of calcium into the interior of cells; this process causes lipid peroxidation, disintegration of the cellular membranes, nuclear destruction and neuronal death. Moreover, ischemia and posterior reperfusion induce an inflammatory response leading to further cellular destruction. It is therefore conceivable that therapeutic interventions aimed at decreasing proinflammatory cytokines and cell adhesion molecules might result in better outcome in this population.
Authors:
J Castillo; R Leira
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  11 Suppl 1     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2001  
Date Detail:
Created Date:  2001-03-13     Completed Date:  2001-06-14     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  40-8     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Affiliation:
Department of Neurology, Hospital Clínico Universitario, University of Santiago de Compostela, Spain. mecasti@usc.es
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MeSH Terms
Descriptor/Qualifier:
Cerebral Infarction / diagnosis*,  immunology*
Cytokines / blood,  cerebrospinal fluid
Disease Progression
Encephalitis / diagnosis*,  immunology*
Humans
Neuroimmunomodulation*
Predictive Value of Tests
Chemical
Reg. No./Substance:
0/Cytokines

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


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