Acidosis: A Marker for Penumbra or a Target for Treatment?

  • A. J. Strong
  • E. Monteiro
Conference paper


The recognition that lactate and proton accumulation in the ischaemic brain develop at relatively superficial levels of ischaemia has prompted several lines of investigation in recent years. Two examples are discussed in this chapter, one in the area of basic pathophysiology of focal ischaemia and the second in that of therapy.


Middle Cerebral Artery Occlusion Spreading Depression Cereb Blood Flow Extracellular Potassium Potassium Depletion 
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  1. Astrup J, Symon L, Branston NM, Lassen NA (1977) Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischaemia. Stroke 8: 51–57PubMedCrossRefGoogle Scholar
  2. Baskin DG, Wilcox BJ, Figlewicz DP, Dorsa DM (1988) Insulin and insulin-like growth factors in the CNS. Trends Neurosci 11: 107–111PubMedCrossRefGoogle Scholar
  3. Branston NM, Strong AJ, Symon L (1977) Extracellular potassium activity, evoked potential and tissue blood flow: relationships during progressive ischaemia in baboon cerebral cortex. J Neurol Sci 32: 305–321PubMedCrossRefGoogle Scholar
  4. Csiba L, Paschen W, Hossmann KA (1983) A topographic quantitative method for measuring brain tissue pH under physiological and pathophysiological conditions. Brain Res 289: 34–337CrossRefGoogle Scholar
  5. Duffy KR, Pardridge WM (1987) Blood-brain barrier transcytosis of insulin in developing rabbits. Brain Res 420: 32–38PubMedCrossRefGoogle Scholar
  6. Fukuoka S, Yeh H, Mandybur TI, Tew JM Jr (1989) Effect of insulin on acute experimental cerebral ischemia in gerbils. Stroke 20: 396–399PubMedCrossRefGoogle Scholar
  7. Gibson G, Miller SA, Venables GS, Strong AJ (1983) Evidence of acidosis in the ischaemic penumbra. J Cereb Blood Flow Metab 3 Suppl I:s401–s402Google Scholar
  8. Harris RJ, Richards PG, Symon L, Habib AH, Rosenstein J (1987) pH, K+, and P02 of the extracellular space during ischaemia of primate cerebral cortex. J Cereb Blood Flow Metab 7:599–604Google Scholar
  9. Hossmann KA, Mies G, Paschen W, Csiba L, Bodsch W, Rapin JR, Le Poncin-Lafitte M, Takahashi K (1985) Multiparametric imaging of blood flow and metabolism after middle cerebral artery occlusion in cats. J Cereb Blood Flow Metab 5: 97–107PubMedCrossRefGoogle Scholar
  10. Klip A, Ramlal T, Cragoe EJ Jr (1986) Insulin–induced cytoplasmic alkalinization and glucose transport in muscle cells. Am J Physiol 250: C720–C728PubMedGoogle Scholar
  11. LeMay DR, Gehua L, Zelenock GB, D’Alecy LG (1988) Insulin administration protects neurologic function in cerebral ischemia in rats. Stroke 19: 1411–1419PubMedCrossRefGoogle Scholar
  12. Mies G, Kloiber O, Drewes LR, Hossmann KA (1984) Cerebral blood flow and regional potassium distribution during focal ischemia of gerbil brain. Ann Neurol 16: 232–237PubMedCrossRefGoogle Scholar
  13. Rehncrona S, Rosen I, Siesjo BK (1981) Brain lactic acidosis and ischemic cell damage. I. Biochemistry and neurophysiology. J Cereb Blood Flow Metab 1: 297–311Google Scholar
  14. Robertson CS, Grossman RG (1987) Protection against spinal cord ischemia with insulininduced hypoglycemia. J Neurosurg 67: 739–744PubMedCrossRefGoogle Scholar
  15. Strong AJ, Miller SA, West IC (1985) Protection of respiration of a crude mitochondrial preparation in cerebral ischaemia by control of blood glucose. J Neurol Neurosurg Psychiatry 48: 450–454PubMedCrossRefGoogle Scholar
  16. Strong AJ, Wild AR, Obrenovitch TP (1987) Visual demonstration of the penumbra by differential imaging of acidosis and K+ depletion. J Cereb Blood Flow Metab 7 Suppl 1: S98Google Scholar
  17. Strong AJ, Fairfield JE, Monteiro E, Kirby M, Hogg AR, Snape M, Rossfield L (1990) Insulin protects cognitive function in experimental stroke. J Neurol Neurosurg Psychiatry 53:, 847–853Google Scholar
  18. Van Harreveld A, Fifkova E (1970) Glutamate release from the retina during spreading depression. J Neurobiol 2: 13–29PubMedCrossRefGoogle Scholar
  19. Voll CL, Auer RN (1991) Insulin attenuates ischemic brain damage independent of its hypoglycemic effect. J Cereb Blood Flow Metab 11: 1006–1014PubMedCrossRefGoogle Scholar
  20. Voll CL, Whishaw IQ, Auer RN (1989) Postischemic insulin reduces spatial learning deficit following transient forebrain ischemia in rats. Stroke 20: 646–651PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • A. J. Strong
    • 1
  • E. Monteiro
    • 1
  1. 1.Institute of PsychiatryLondonUK

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