Volume expansion associated with brain infarction occurs in perfusion-diffusion mismatch of magnetic resonance imaging. We aimed at elucidating the metabolic impairment of this phenomenon with (15)O positron emission tomography and perfusion and diffusion magnetic resonance imaging. Eleven patients with acute unilateral embolic occlusion of the internal carotid or middle cerebral artery were studied within 6 hours of onset. Regional cerebral blood flow and cerebral metabolic rate of oxygen (CMRO(2)) were compared with those in the contralateral cerebral hemisphere. The relative apparent diffusion coefficient of water was estimated as a marker of cytotoxic edema. Relative cerebral blood flow and relative CMRO(2) in an evolving infarct (normal diffusion initially, but abnormal on day 3) were significantly (p < 0.05) less than those in the periinfarct area (normal diffusion initially and on day 3). The relative apparent diffusion coefficient between the evolving infarct and periinfarct showed no significant difference. These findings indicated that the initial 3-day volume expansion of an embolic brain infarction was associated with disturbed CMRD(2) but not with cytotoxic edema as early as 6 hours after onset. The "metabolic penumbra" defined as normal water diffusion with depressed CMRO(2) is a target to reduce the volume expansion of brain infarction.
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http://dx.doi.org/10.1002/ana.20427 | DOI Listing |
Cells
January 2025
Department of Chemistry, Biology and Biotechnologies, University of Perugia, Via dell'Elce di Sotto 8, 06123 Perugia, Italy.
J Am Heart Assoc
January 2025
Center for Stroke Research Berlin Charité-Universitätsmedizin Berlin Berlin Germany.
Background: Excessive supraventricular ectopic activity (ESVEA) is regarded as a risk marker for later atrial fibrillation (AF) detection.
Methods And Results: The investigator-initiated, prospective, open, multicenter MonDAFIS (Impact of Standardized Monitoring for Detection of Atrial Fibrillation in Ischemic Stroke) study randomized 3465 patients with acute ischemic stroke without known AF 1:1 to usual diagnostic procedures for AF detection or additive Holter monitoring in hospital for up to 7 days, analyzed in a core laboratory. Secondary study objectives include the comparison of recurrent stroke, myocardial infarction, major bleeding, and all-cause death within 24 months in patients with ESVEA (defined as ectopic supraventricular beats ≥480/day or atrial runs of 10-29 seconds or both) versus patients with newly diagnosed AF versus patients without ESVEA or AF (non-ESVEA/AF), randomized to the intervention group.
Eur Heart J Acute Cardiovasc Care
January 2025
Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Background: Acute myocardial infarction complicated by cardiogenic shock (AMICS) is frequently preceded by out-of-hospital cardiac arrest (OHCA), with risk of anoxic brain injury. Neuron-specific enolase (NSE) is central to neuroprognostication; however, concomitant hemolysis can increase NSE independent of neuronal injury due to the presence of NSE in erythrocytes. This consideration is critical in AMICS patients treated with a microaxial flow pump (Impella, Abiomed), where hemolysis is frequent.
View Article and Find Full Text PDFBrain Res Bull
January 2025
Department of Joint, Honghui Hospital, Xi'an Jiaotong University, No.555 Youyi East Road, Xi'an City, Shaanxi Province, 710054, PR China. Electronic address:
Background: Electroacupuncture (EA) and trigonelline (TG) have been reported to be beneficial in alleviating cerebral ischemia/reperfusion injury (CIRI). However, the synergistic effects of EA and TG in CIRI and the underlying mechanism have not been demonstrated.
Methods: Rats were subjected to middle cerebral artery occlusion (MCAO) surgery and reperfusion (MCAO/R) to establish a CIRI model.
Interdiscip Cardiovasc Thorac Surg
December 2024
Department of Cardiovascular Surgery, Kitasato University Hospital, Japan.
Objectives: The objective of this study was to evaluate the impact of minimally invasive extracorporeal circulation on blood transfusion and asymptomatic brain injury in comparison to conventional extracorporeal circulation, in the context of minimally invasive aortic valve replacement through right lateral mini-thoracotomy surgery.
Methods: This was a retrospective observational study. Patients who underwent isolated aortic valve replacement through right lateral mini-thoracotomy surgery were divided into two groups: the minimally invasive extracorporeal circulation group and the conventional extracorporeal circulation group.
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