TY - JOUR
T1 - The acute ischemic penumbra
T2 - Topography, life span, and therapeutic response
AU - Ginsberg, Myron D.
AU - Belayev, L.
AU - Zhao, W.
AU - Huh, P. W.
AU - Busto, R.
PY - 1999
Y1 - 1999
N2 - Recent advances in computerized image-averaging, used in conjunction with refined techniques for engendering highly reproducible rodent models of focal ischemia, now make it possible to derive topographically precise, quantitative descriptors of the ischemic penumbra its localization, lifespan, metabolic and hemodynamic features, and responses to therapy. Physiologically monitored normothermic rats received 2-h middle cerebral artery occlusion (MCAo) by means of a poly-L-lysine-coated intraluminal suture. In matched groups, local cerebral blood flow (LCBF) or glucose utilization (LCMRglc) were measured autoradiographically at either 2-h MCAo or at 1-h recirculation and were correlated on a pixel-by-pixel basis with histopathological infarction after 3-day survival. A large, consistent ischemic penumbra (defined as LCBF 20 40% of control) surrounded the core (0.20% of control). Penumbral LCMRglc at 2-h MCAo was near-normal, and its metabolism/flow ratio was elevated 4-fold above normal. By 1-h recirculation, however, LCMRglc throughout the prior zone of ischemia was depressed. Infarctive histopathology was precisely determined by the antecedent LCBF decrement during ischemia: 70% and 89% of infarcted pixels had antecedent LCBF values below the upper-core and upper-penumbral ranges, respectively, at 2-h MCAo. High-dose albumin therapy at the onset of recirculation dramatically attenuated cortical infarction and brain edema and appeared, by LCBF analysis at 1-h recirculation, to increase postischemic LCBF primarily in the former penumbra.
AB - Recent advances in computerized image-averaging, used in conjunction with refined techniques for engendering highly reproducible rodent models of focal ischemia, now make it possible to derive topographically precise, quantitative descriptors of the ischemic penumbra its localization, lifespan, metabolic and hemodynamic features, and responses to therapy. Physiologically monitored normothermic rats received 2-h middle cerebral artery occlusion (MCAo) by means of a poly-L-lysine-coated intraluminal suture. In matched groups, local cerebral blood flow (LCBF) or glucose utilization (LCMRglc) were measured autoradiographically at either 2-h MCAo or at 1-h recirculation and were correlated on a pixel-by-pixel basis with histopathological infarction after 3-day survival. A large, consistent ischemic penumbra (defined as LCBF 20 40% of control) surrounded the core (0.20% of control). Penumbral LCMRglc at 2-h MCAo was near-normal, and its metabolism/flow ratio was elevated 4-fold above normal. By 1-h recirculation, however, LCMRglc throughout the prior zone of ischemia was depressed. Infarctive histopathology was precisely determined by the antecedent LCBF decrement during ischemia: 70% and 89% of infarcted pixels had antecedent LCBF values below the upper-core and upper-penumbral ranges, respectively, at 2-h MCAo. High-dose albumin therapy at the onset of recirculation dramatically attenuated cortical infarction and brain edema and appeared, by LCBF analysis at 1-h recirculation, to increase postischemic LCBF primarily in the former penumbra.
KW - Cerebral blood flow
KW - Focal ischemia
KW - Image-processing
KW - Metabolism
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U2 - 10.1007/978-3-7091-6391-7_7
DO - 10.1007/978-3-7091-6391-7_7
M3 - Review article
C2 - 10494340
AN - SCOPUS:0032605521
VL - 1999
SP - 45
EP - 50
JO - Acta Neurochirurgica, Supplement
JF - Acta Neurochirurgica, Supplement
SN - 0065-1419
IS - SUPPL. 73
ER -