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Improvement of Cerebral Blood Flow in Acute Ischemia of the Brain

  • A. Hartmann
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 15)

Abstract

The most appropriate therapy for acute cerebral ischemia is still a matter of debate. Attempts at vasodilation by hypercapnia (14a), pharmacological vasodilatation (16), and barbiturate protection (17) have not gained general acceptance:
  • Hypercapnia and administration of cerebral vasodilators may cause steal effects, so decreasing flow in the tissue of concern. Hyperventilation with consecutive vasoconstriction may cause an increase of flow in the ischemic tissue if vasoparalysis has taken place. However, in the neighborhood with reacting vessels, blood flow may be at a critical level which during hypocapnia leads to further flow depression and provocation of true ischemia.

Keywords

Cerebral Blood Flow Middle Cerebral Artery Flow Depression Acute Cerebral Ischemia Epidural Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Agnoli A, Palesse N, Ruggieri S, Leonardis G, Benzi G (1979) Barbiturate treatment of acute stroke. Adv Neurol 25:269–274PubMedGoogle Scholar
  2. 2.
    Allen GS, Presziosi TJ, Battye R et al. (1983) Cerebral arterial spasm — a controlled trial of nimodipine in patients with subarachnoidal hemorrhage. N Engl J Med 308:619–624PubMedCrossRefGoogle Scholar
  3. 3.
    Böker DK, Solymosi L, Wassmann H (1985) Immediate postangiographic intraarterial treatment of cerebral vasospasm after subarachnoid hemorrhage with nimodipine. Neurochirurgia 28:118–120PubMedGoogle Scholar
  4. 4.
    Brown NM, Marshall J (1982) Effect of plasma exchange on blood viscosity and cerebral blood flow. Br Med J 284:1733–1736CrossRefGoogle Scholar
  5. 5.
    Chan R, Leninger-Follert (1983) Effect of isovolemic hemodilution on oxygen supply and electrocorticogram in cat brain during focal ischemia and in normal tissue. Int J Microcirc Clin Exp 2:297–313PubMedGoogle Scholar
  6. 6.
    Christensen MS (1972) A controlled study of the effect of prolonged hypocapnia in stroke. In: Meyer JS, Lechner H, Eichborn O (eds) Research on the cerebral circulation. Thomas, Springfield, IllGoogle Scholar
  7. 7.
    Gaab MR, Rode CP, Schakel EH, Haubitz I, Bockhorn J, Brawanski A (1985) Zum Einfluß des Ca-Antagonisten Nimodipin auf die globale und regionale Hirndurchblutung. Klin Wochenschr 63:8–15PubMedCrossRefGoogle Scholar
  8. 8.
    Gelmers HK (1984) Cerebrovascular effect of nimodipine in patients with acute ischemic stroke. 5th South European Conference for Neurology and Psychiatry, Sept. 21–24, 1983Google Scholar
  9. 9.
    Gilroy J, Barnhart MH, Meyer JS (1969) Treatment of acute stroke with dextran 40. Am Med Ass 210(2):293–298CrossRefGoogle Scholar
  10. 10.
    Gottstein U, Held K, Sedlmeyer I (1972) Cerebral and peripheral blood flow as affected by induced hemodilution. In: Messmer K, Schmid-Schönbein H (eds) Hemodilution: theoretical basis and clinical application. Karger, Basel, pp 247–263Google Scholar
  11. 11.
    Heiss WD, Prosenz P, Tschabitscher H, Lasek C, Herles HJ (1972) Effect of low molecular dextran on total cerebral blood flow and on regional flow within ischemic brain lesion. Eur Neurol 8:129–133PubMedCrossRefGoogle Scholar
  12. 12.
    Henriksen L, Paulson OB, Smith RJ (1981) Cerebral blood flow following normovolemic hemodilution in patients with high hematocrit. Ann Neurol 9:454–457PubMedCrossRefGoogle Scholar
  13. 13.
    Matthews WB, Oxbury JM, Grainger KMR, Greenball RCD (1976) A blind controlled trial of dextran in the treatment of ischemic stroke. Brain 99:193–206PubMedCrossRefGoogle Scholar
  14. 14.
    Michenfelder JD, Milde JH, Sundt TM (1976) Cerebral protection by barbiturate anesthesia. Arch Neurol 33:345–350PubMedGoogle Scholar
  15. 14a..
    Millikan CH (1955) Evaluation of CO2 inhalation for acute focal cerebral infarction. Arch Neurol Psychiat 73:324–318Google Scholar
  16. 15.
    Olesen J (1976) Role of calcium entry blockers in the prophylaxis of migraine. Eur Neurol 25(Suppl 1):72–79CrossRefGoogle Scholar
  17. 16.
    Olesen J, Paulson OB (1971) The effect of intra-arterial papaverine on the regional cerebral blood flow in patients with stroke or intracranial tumors. Stroke 2:148–153PubMedCrossRefGoogle Scholar
  18. 17.
    Safar P (1981) Barbiturate anesthesia in cerebral ischemia: a review. In: Mossey J, Reinmuth OM (eds) Cerebrovascular disease. Raven Press, pp 205–220Google Scholar
  19. 18.
    Siesjö B (1981) Cell damage in the brain: a speculative synthesis. J Cereb Blood Flow Metabolism 1:155–185CrossRefGoogle Scholar
  20. 19.
    Simeone FA, Frazer G, Lawner P (1979) Ischemic brain edema: comparative effects of barbiturates and hypothermia. Stroke 10:8–12PubMedCrossRefGoogle Scholar
  21. 20.
    Schneider U, Wendt M (1984) Hämodilution bei reduzierter O2-Trans-portkapazität. In: Lawin P, Paravicini D (Hrsg) Hämodilution und Autotransfusion in der perioperativen Phase. Thieme, Stuttgart, pp 23–29Google Scholar
  22. 21.
    Strand T, Asplund K, Eriksson S, Hagg E, Lithner F, Wester PO (1984) A randomized controlled trial of hemodilution therapy in acute ischemic stroke. Stroke 15:980–989PubMedCrossRefGoogle Scholar
  23. 22.
    White BC, Winegar CD, Wilson RF, Krause GS (1983) Calcium blockers in cerebral resuscitation. J Trauma 23:788–793PubMedCrossRefGoogle Scholar
  24. 23.
    Zimmer HG (1983) Normalization of depressed heart function in rats by ribose. Science 220:81–82PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • A. Hartmann
    • 1
  1. 1.Neurologische UniversitätsklinikBonn 1Germany

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