Acute cerebral ischemia mechanisms

Benveniste H, Hedlund LW, Johnson GA (1992) Mechanism of detection of acute cerebral ischemia in rats by diffusion-weighted magnetic resonance microscopy. Stroke 23 746-754... 

The ongoing IMS III trial is a randomized, multicenter, phase III trial continuing the investigation into the efficacy of the combined IV and lA approach to treat acute stroke. Patients are being randomized to IV/IA therapy and IV rt-PA alone in a 2 1 ratio. In the group allocated to combination IV/IA therapy, the physician will select either the EKOS microcatheter or a standard microcatheter to infuse rt-PA, or select the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) clot retrieval device. The primary outcome is the percentage of patients with an mRS score of 0-2 at 90 days. ... 

Smith WS. Safety of mechanical thrombectomy and intravenous tissue plasminogen activator in acute ischemic stroke. Results of the multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I. Am J Neuroradiol 2006 27 1177-1182. 

Using DWI and PI in acute stroke patients with the detection of the acute lesion and the delineation of the area of hemodynamic compromise, the understanding of pathophysiological mechanisms leading to cerebral ischemia in patients with ICA disease has been improved. DWI offers a better chance of detecting not only gross abnormalities but also very subtle acute ischemic lesions. In a systematic study using DWI in 102 consecutive patients with ICA stenosis > 50% or ICA occlusion and acute stroke, we... 

Many events occuring during and after cerebral ischemia are well known, but they are not known enough to fully elucidate the mechanisms of brain damage. Factors responsible for the extension of infarction into the penumbral zone include acidosis, edema formation, acute local inflammation, dissipative ion fluxes, calcium overload, glutamate excitotoxicity, free radical formation, nitric oxide overproduction and programmed cell death [2,13-16]. 

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