We investigated vasoconstrictive responses of pial collaterals in vivo at baseline and during transient middle cerebral artery occlusion during chronic hypertension. A cranial window was used to measure diameter of leptomeningeal anastomoses (pial collaterals) in male Wistar (n=8) and spontaneously hypertensive rats (SHRs; n=8) using video dimensional analysis. Middle cerebral artery occlusion was induced by remote filament for 2 hours with 2 hours reperfusion. Phenylephrine was infused during ischemia as a pressor therapy. Active diameters of pial collaterals were significantly smaller in SHRs versus Wistar (14.1±1.5 versus 21.6±2.8 µm; <0.01); however, passive diameters were similar (25.0±2.9 versus 25.0±2.6 µm; >0.05). Basal tone of pial collaterals before occlusion was 42±5% in SHRs versus 15±4% in Wistar (<0.01). Tone decreased in both Wistar and SHRs during occlusion but remained higher in SHRs (9±2% versus 29±4%; <0.05). Phenylephrine increased blood pressure in both groups but had little effect on leptomeningeal anastomoses diameters. Reperfusion caused vasoconstriction of pial collaterals, increasing tone from 8±1% to 20±5% in Wistar and 29±5% to 44±5% in SHRs (<0.01). Higher tone in pial collaterals from SHRs basally and during occlusion/reperfusion could limit flow to the penumbra and promote evolution of infarction. Sustained elevated tone of pial collaterals from SHRs with phenylephrine suggests pressor therapy may not be appropriate during chronic hypertension.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.15356 | DOI Listing |
Stroke
January 2025
Institute of Pharmacology and Toxicology, Faculty of Medicine, University of Zurich, Switzerland (Z.C., Q.Z., Y.-H.L., C.G., I.G., M.W., H.A.I.Y., D.R.K., B.W., D.R.).
Background: Ischemic stroke is a common cause of death worldwide and a main cause of morbidity. Presently, laser speckle contrast imaging, x-ray computed tomography, and magnetic resonance imaging are the mainstay for stroke diagnosis and therapeutic monitoring in preclinical studies. These modalities are often limited in terms of their ability to map brain perfusion with sufficient spatial and temporal resolution, thus calling for development of new brain perfusion techniques featuring rapid imaging speed, cost-effectiveness, and ease of use.
View Article and Find Full Text PDFCureus
December 2024
Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Narita, JPN.
Background In treating acute ischemic stroke (AIS), asymmetrical vein signs (AVS) on blood-oxygen-level-dependent imaging reflect increased deoxyhemoglobin levels due to increased oxygen extraction fraction. Meanwhile, although veins connecting pial and deep venous systems, such as transcerebral veins, are well studied, dynamic observation of these veins remains challenging. This study aimed to elucidate the venous flow of the deep white matter (DWM), focusing on medullary AVS in patients with hyperacute cardioembolic M1 occlusion.
View Article and Find Full Text PDFStroke
January 2025
Department of Diagnostic Imaging (J.M.O., M.G., B.K.M., M.A.A., A.M.D., M.J., M.D.H.), University of Calgary, Alberta, Canada.
Background: In the ESCAPE-NA1 trial (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischemic Stroke), treatment with nerinetide was associated with a smaller infarct volume among patients who did not receive intravenous alteplase. We assessed the effect of nerinetide on the surrogate imaging outcome of final infarct volume in patients who did not receive intravenous alteplase and explored predictors of outcome and modifiers of nerinetide's effect on infarct volume.
Methods: ESCAPE-NA1 was a multicenter, randomized trial in which patients with acute stroke with a baseline Alberta Stroke Program Early CT Score >4, undergoing endovascular thrombectomy, were randomized to receive intravenous nerinetide or placebo.
J Neuroradiol
December 2024
Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China. Electronic address:
Neurol Res Pract
November 2024
Department of Neurology, University Hospital Wurzburg, Josef-Schneider-Str. 11, 97080, Wurzburg, Germany.
Background: Despite high recanalization rates of > 90% after endovascular thrombectomy (EVT) clinical outcome in around 50% of treated acute ischemic stroke (AIS) patients is still poor. Novel treatments augmenting the beneficial effects of recanalization are eagerly awaited, but this requires mechanistic insights to explain and overcome futile recanalization.
Main Body: At least two mechanisms contribute to futile recanalization after cerebral large vessel occlusions (LVO): (i) the no reflow phenomenon as evidenced by randomly distributed areas without return of blood flow despite reperfusion of large cerebral arteries, and (ii) ischemia/reperfusion (I/R) injury, the paradoxically harmful aspect of blood flow return in transiently ischemic organs.
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