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Revascularization in the Acute State of Cerebral Ischemia

  • Fernando G. Diaz
  • James I. Ausman
  • Manuel Dujovny
Conference paper

Abstract

Large numbers of people are affected throughout the world by the development of cerebral ischemic infarcts every year. Seventy percent of these events are caused by occlusive lesions, most of which are not directly accessible by surgical means. It has been suggested by Astrup [1] that a period of grace exists during which the presence of cerebral ischemia is not followed by the development of cell death, as long as the perfusion to the ischemic tissue is reestablished. The major concern voiced by most physicians regarding the possibility of reperfusing the acutely ischemic brain has been the potential for the development of a hemorrhagic infarction in the area of ischemia [4, 5, 20].

Keywords

Cerebral Ischemia Focal Cerebral Ischemia Perfusion Deficit Carotid Artery Occlusion Hemorrhagic Infarction 
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.
    Astrup J, Siesjo BK, Symon L (1981) Thresholds in cerebral ischemia: The ischemic penumbra. Stroke 12:723–725 (editorial)PubMedCrossRefGoogle Scholar
  2. 2.
    Ausman JI, Diaz FG (1986) Critique of the Extracranial-Intracranial Bypass Study. Surg Neurol 26:218–221PubMedCrossRefGoogle Scholar
  3. 3.
    Crowell RM, Olsson Y, Klatzo I, Ommaya A (1970) Temporary occlusion of the middle cerebral artery in the monkey: Clinical and pathological observations. Stroke 1:439–448PubMedCrossRefGoogle Scholar
  4. 4.
    Diaz FG, Ausman JI, Mehta B, Dujovny M, de los Reyes RA, Pearce J, Patel S (1985) Acute cerebral revascularization. J Neurosurg 63:200–209PubMedCrossRefGoogle Scholar
  5. 5.
    Diaz FG, Mastri AR, Ausman JI, Chou SN (1979) Acute cerebral revascularization after regional cerebral ischemia in the dog: II. Clinicopathological correlation. J Neurosurg 51:644–653PubMedCrossRefGoogle Scholar
  6. 6.
    Dujovny M, Osgood CP, Barrionuevo PJ, Hellstrom R, Laha RK (1976) Middle cerebral artery microneurosurgical embolectomy. Surgery 80:336–339PubMedGoogle Scholar
  7. 7.
    The EC/IC Bypass Study Group (1985) Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke: Results of an international randomized trial. N Engl J Med 313:1191–1200CrossRefGoogle Scholar
  8. 8.
    Handa H (1982) Effect of Fluosol-DA on cerebral circulation in humans. In: Frey R, Beisbarth H, Stosseck K (eds) Oxygen-carrying colloidal blood substitutes. Zuckschwendt, Munich, pp 204–207Google Scholar
  9. 9.
    Jones TH, Morawetz RB, Crowell RM, Marcoux FW, FitzGibbon SJ, DeGirolami U, Ojemann RG (1981) Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg 54:773–782PubMedCrossRefGoogle Scholar
  10. 10.
    Lawner PM, Laurent JP, Simeone FA, Fink EA (1982) Effect of extracranial-intracranial bypass and pentobarbital on acute stroke in dogs. J Neurosurg 56:92–96PubMedCrossRefGoogle Scholar
  11. 11.
    Little JR (1978) Modification of acute focal ischemia by treatment with mannitol. Stroke 9:4–9PubMedCrossRefGoogle Scholar
  12. 12.
    Michenfelder JD, Milde JH (1975) Influence of anesthetics on metabolic, functional and pathological responses to regional cerebral ischemia. Stroke 6:405–410PubMedCrossRefGoogle Scholar
  13. 13.
    Morawetz RB, Crowell RH, DeGirolami U, Marcoux FW, Jones TH, Halsey JH (1979) Regional cerebral blood flow thresholds during cerebral ischemia. Fed Proc 38:2493–2494PubMedGoogle Scholar
  14. 14.
    Moseley JI, Laurent JP, Molinari GF (1975) Barbiturate attenuation of the clinical course and pathologic lesions in a primate stroke model. Neurology (Minneap) 25:870–874CrossRefGoogle Scholar
  15. 15.
    Peerless SJ, Ishikawa R, Hunter IG, Peerless MJ (1981) Protective effect of Fluosol-DA in acute cerebral ischemia. Stroke 12:558–563PubMedCrossRefGoogle Scholar
  16. 16.
    Powers WJ, Raichle ME (1985) Positron emission tomography and its application to the study of cerebrovascular disease in man. Stroke 16:361PubMedCrossRefGoogle Scholar
  17. 17.
    Selman WR, Spetzler RF, Roski RA, Roessmann U, Crumrine R, Macko R (1982) Barbiturate coma in focal cerebral ischemia: Relationship of protection to timing of therapy. J Neurosurg 56:685–690PubMedCrossRefGoogle Scholar
  18. 18.
    Smith AL, Hoff JT, Nielsen SL, Larson CP (1974) Barbiturate protection in acute focal cerebral ischemia. Stroke 5:1–7PubMedCrossRefGoogle Scholar
  19. 19.
    Spetzler RF, Selman WR, Roski RA, Bonstelle C (1982) Cerebral revascularization during barbiturate coma in primates and humans. Surg Neurol 17:111–115PubMedCrossRefGoogle Scholar
  20. 20.
    Sundt TM Jr, Grant WC, Garcia JH (1969) Restoration of middle cerebral artery flow in experimental infarction. J Neurosurg 31:311–322PubMedCrossRefGoogle Scholar
  21. 21.
    Sundt TM Jr, Onofrio BM, Merideth J (1973) Treatment of cerebral vasospasm from subarachnoid hemorrhage with isoproterenol and lidocaine hydrochloride. J Neurosurg 38:557–560PubMedCrossRefGoogle Scholar
  22. 22.
    Sundt TM Jr, Whisnant JP, Fode NC, Piepgras DG, Houser OW (1985) Results, complications, and follow-up of 415 bypass operations for occlusive disease of the carotid system. Mayo Clin Proc 60:230–240PubMedCrossRefGoogle Scholar
  23. 23.
    Suzuki J, Fujimoto S, Mizoi K, Oba M (1984) The protective effect of combined administration of anti-oxidants and perfluorochemicals on cerebral ischemia. Stroke 15:672–679PubMedCrossRefGoogle Scholar
  24. 24.
    Symon L, Branston NM, Strong AJ, Hope TD (1977) The concept of thresholds of ischaemia in relation to brain structure and function. J Clin Pathol 30(Suppl 11): 149–154CrossRefGoogle Scholar
  25. 25.
    Wood JH, Fleischer AS (1982) Observations during hypervolemic hemodilution of patients with acute focal cerebral ischemia. JAMA 248:2999–3004PubMedCrossRefGoogle Scholar
  26. 26.
    Yanagihara T, Wahner HW (1984) Cerebral blood flow measurement in cerebrovascular occlusive diseases. Stroke 15:816–822PubMedCrossRefGoogle Scholar
  27. 27.
    Yoshimoto T, Sakamoto T, Watanabe T, Tanaka S, Suzuki J (1978) Experimental cerebral infarction. Part 3: Protective effect of mannitol in thalamic infarction in dogs. Stroke 9:217–218PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Fernando G. Diaz
    • 1
  • James I. Ausman
    • 1
  • Manuel Dujovny
    • 1
  1. 1.Department of NeurosurgeryHenry Ford HospitalDetroitUSA

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