J.Jpn. Surg. Soc.. 80(12): 1592-1597, 1979
Report on the annual meeting
PATHOPHYSIOLOGICAL ASPECTS OF EXPERIMENTAL CEREBRAL ISCHEMIA, WITH SPECIAL REGARDS TO CEREBRAL CHANGES FOLLOWING RESTORATION OF BLOOD FLOW
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Department of Neurosurgery, Tokyo Medical and Dental University Umeo Ito, Yutaka Inaba |
Main outcomes were : 1) By computer analysed EEG study, We found that EEG recovered rapidly, following 1 hr ischemia, during 1 hr, then gradually until 8 hr and worsened again 48 hr after restoration of blood flow. 2) Histopathological damage progressed gradually after restoration of blood flow following 1 hr ischemia, on the other hand progressed rapidly in permanent ischemia. 3) Following restoration of blood flow, "no-reflow phenomenon" disappeared after very transient appearance. Regional cerebral blood flow study by14C-antipyrine autoradiogram as well as 3H-nicotine scintillation method showed bi-phasic post-ischemic reactive hyperemia with oligemic phase inbetween, after restoration of blood flow following 1 hr ischemia. 4) Biochemical assay on carbohydrate and catecholamine revealed that post-ischemic lactate accumulation and increased endogenous norepinephrine content seemed to relate histopathological deterioration after restoration of blood flow. 5) Quantitative measurement of water, Na+, K+ content and RISA permeability from blood to brain tissue were carried out. Pure cytotoxic edema developed during ischemia and short duration after restoration of blood flow, and vasogenic edema developed later. 6) The ultrastructural morphogenesis of BBB change which cause vasogenic edema in the ischemic brain edema had been studied by use of horseradish peroxydase (HRP) as a tracer. Extravasation of HRP had not been induced by brake through at the inter-cellular tight junction, but by prominent pinocytotic transportation of the endothelial cells. Hypertension remarkably enhanced extravasation of HRP associated with increased number of pinocytotic vesicles.
Over all conclusions: Neuron can torrelate considerable amount of ischemic insults, however many detrimental factors effect further retrogressive changes of the brain tissue, after restoration of blood flow.
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