The significance of basal ganglia infarction (original) (raw)
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Stroke, 2008
Background and Purpose-Symptomatic progression is frequently observed in lacunar infarcts. The exact mechanisms of this phenomenon have not yet been clarified. Summary of Cases-We report 2 patients with lenticulostriate artery infarcts that presented with skip lesions that were restricted to gray matter. One of the patients subsequently developed symptomatic deterioration; the other experienced no further neurological events. Conclusions-A possible mechanism of differential vulnerability to ischemia of gray and white matter is considered. White matter may have a longer therapeutic time window for neuroprotective treatment than gray matter. (Stroke. 2008;39: 494-496.)
Stroke, 2012
Background and Purpose-Experimental models are essential for research on ischemic stroke, the second most common cause of death worldwide. The failure of clinical trials on neuroprotective treatment may be due in part to poor animal models. To push the translation of new therapies, we describe a new rat model that captures key elements of human brain ischemia. The model includes imaging and neurointerventional tools that represent the near future of clinical diagnosis and treatment of stroke. Methods-Using Sprague-Dawley rats (nϭ26), we navigated a microwire with fluoroscopy and MRI guidance from the ventral tail artery to 2 different positions in the middle cerebral artery to establish local occlusion. Animals were scanned with 9.4-T MRI before occlusion, during ischemia, and after reperfusion. Results-We detected stroke lesions, corresponding to the level of occlusion, in all animals by diffusion-weighted and T2
Research Journal of Pharmaceutical, Biological and Chemical Sciences
The present study was undertaken to compare the clinical features and severity of ischemic stroke affecting various areas of brain using neuro-imaging techniques. Based on our results, we conclude that there is no association between aphasia and area of brain affected and no significant association between brain area and facial palsy however the association between type of hemiplegia and brain area involved and association between severities of stroke with hemisphere affected is significant. However small sample size constrains the significance of the results. Hence we recommend further study with higher sample size and long term follow up.
1990
We investigated 32 patients with completed ischemic stroke ^6 hours after the onset of symptoms by means of computed tomography, cerebral angiography, and technetium-99m-labeled hexamethylpropyleneamtne oxime single-photon emission computed tomography to study cerebral blood flow. Follow-up computed tomography and cerebral blood flow studies were performed 1 week and 1 month after admission. Poor outcome at 1 month was evident in 18 (78%) of the 23 patients with severe neurologic deficit on admission and in 11 (92%) of the 12 patients with severe hypoperfusion in the affected hemisphere on admission. All 10 patients with severe impairment of both neurologic status and cerebral blood flow had a poor outcome at 1 month. We detected severe hypoperfusion in patients with large lesions on computed tomograms or cerebral artery occlusions on angiograms. Cerebral blood flow had increased at the 1-week follow-up despite different clinical outcomes. Our data provide evidence that early evaluation of cerebral blood flow with single-photon emission computed tomography is useful to detect subgroups of patients with different clinical outcomes during the acute phase of ischemic stroke. (Stroke 1990^1:895-900) R eliable and accurate predictions of final clinical outcome in patients with acute stroke are likely to be of value for both planning the care of individual patients and organizing therapeutic trials. The final amount of neuronal damage and degree of functional impairment depend on several factors, of which the duration of occlusion 1-2 and the absolute decrease in regional cerebral blood flow (CBF) 3 " 6 during ischemia are of greatest importance. Data are available on early CBF changes in experimental cerebral ischemia, but similar observations are lacking in humans. Changes during the first 24-48 hours after a stroke have been described using both positron emission tomography (PET) and single-photon emission computed tomography (SPECT). 4-57-13 However, no data are available on CBF impairment in humans during the first 3-6 hours of an ischemic stroke or the correlation between CBF impairment and the presentation or clinical outcome of patients.
Cortical Ischemic Lesion Burden Measured by DIR Is Related to Carotid Artery Disease Severity
Cerebrovascular Diseases, 2014
Background: Over time, exposure to cerebrovascular risk factors and carotid artery disease may cause multiple asymptomatic brain cortical and subcortical microinfarcts, which are commonly found at brain autopsy. So far, lack of convenient neuroimaging tools limited the investigation of grey matter ischemic damage in vivo. We applied the Double Inversion Recovery (DIR) sequence to explore the impact of carotid artery disease on intracortical ischemic lesion load in vivo, taking into account the impact of demographic characteristics and vascular risk factors. Methods: DIR was acquired in 62 patients with common cerebrovascular risk factors stratified in three groups according to carotid artery disease severity. Intracortical lesions scored on DIR (DIRlns) were classified by vascular territory, lobe and hemisphere. White matter hyperintensities (WMHs) volume was also quantified on Fluid Attenuated Inversion Recovery sequence (FLAIR). Results: Among demographic characteristics and cereb...
Striatal Infarction Elicits Secondary Extrafocal MRI Changes in Ipsilateral Substantia Nigra
PLOS ONE, 2015
Focal ischemia may induce pathological alterations in brain areas distant from the primary lesion. In animal models, exofocal neuron death in the ipsilateral midbrain has been described after occlusion of the middle cerebral artery (MCA). Using sequential magnetic resonance imaging (T2-and diffusion-weighted) at 3 Tesla, we investigated acute ischemic stroke patients on days 1, 2, 6, 8, and 10 after stroke onset. Sixteen consecutive patients who had suffered a stroke involving the caudate nucleus and/or putamen of either hemisphere were recruited into the study. Four additional patients with strokes sparing the caudate nucleus and putamen but encompassing at least one-third of the MCA territory served as controls. Ischemic lesions involving striatal structures resulted in hyperintense lesions in ipsilateral midbrain that emerged between days 6 and 10 after stroke and were not present on the initial scans. In contrast, none of the control stroke patients developed secondary midbrain lesions. Hyperintense lesions in the pyramidal tract or the brain stem caused by degeneration of the corticospinal tract could be clearly distinguished from these secondary midbrain gray matter lesions and were detectable from day 2 after ischemia. Co-registration of high-resolution images with a digitized anatomic atlas revealed localization of secondary lesions primarily in the substantia nigra pars compacta. Apparent diffusion coefficient (ADC) values in the secondary lesions showed a delayed sharp decline through day 10. Normalization of ADC values was observed at late measurements. Taken together, our study demonstrates that striatal infarction elicits delayed degenerative changes in ipsilateral substantia nigra pars compacta.
Validation of a simple and inexpensive method for the quantitation of infarct in the rat brain
Brazilian Journal of Medical and Biological Research, 2004
A gravimetric method was evaluated as a simple, sensitive, reproducible, low-cost alternative to quantify the extent of brain infarct after occlusion of the medial cerebral artery in rats. In ether-anesthetized rats, the left medial cerebral artery was occluded for 1, 1.5 or 2 h by inserting a 4-0 nylon monofilament suture into the internal carotid artery. Twenty-four hours later, the brains were processed for histochemical triphenyltetrazolium chloride (TTC) staining and quantitation of the schemic infarct. In each TTC-stained brain section, the ischemic tissue was dissected with a scalpel and fixed in 10% formalin at 0ºC until its total mass could be estimated. The mass (mg) of the ischemic tissue was weighed on an analytical balance and compared to its volume (mm 3), estimated either by plethysmometry using platinum electrodes or by computer-assisted image analysis. Infarct size as measured by the weighing method (mg), and reported as a percent (%) of the affected (left) hemisphere, correlated closely with volume (mm 3 , also reported as %) estimated by computerized image analysis (r = 0.88; P < 0.001; N = 10) or by plethysmography (r = 0.97-0.98; P < 0.0001; N = 41). This degree of correlation was maintained between different experimenters. The method was also sensitive for detecting the effect of different ischemia durations on infarct size (P < 0.005; N = 23), and the effect of drug treatments in reducing the extent of brain damage (P < 0.005; N = 24). The data suggest that, in addition to being simple and low cost, the weighing method is a reliable alternative for quantifying brain infarct in animal models of stroke.
Signal Change of the Substantia Nigra on Diffusion-Weighted Imaging Following Striatal Infarction
Internal Medicine, 2010
Diffusion-weighted imaging can depict secondary signal changes of the substantia nigra in patients with ipsilateral striatal infarction. We report four patients who demonstrated obvious signal changes of the substantia nigra in the subacute phase of stroke. Embolic stroke was diagnosed in all of the cases, and none of the patients presented clinical deterioration in their course. Embolic mechanism might be more closely related to the secondary change of the substantia nigra than thrombosis. The relationship between secondary nigral degeneration and stroke etiology or between the nigral lesions and recanalization of the middle cerebral artery remains unclear.
Identification of Ischemic Regions in a Rat Model of Stroke
PLoS ONE, 2009
Background: Investigations following stroke first of all require information about the spatio-temporal dimension of the ischemic core as well as of perilesional and remote affected tissue. Here we systematically evaluated regions differently impaired by focal ischemia.