Cerebral occlusion

Table 5.1 Effects of compound 231617 on infarct volume in the middle cerebral occlusion model of focal stroke...

Bitzer M, Topka H (1995). Progressive cerebral occlusive disease after radiation therapy. Stroke 26 131-136... 

Boers GHJ, Smals AGH, Trijbels FJM, Fowler B, Bakkeren JAJM, Schoonderwaldt HC, KleijerWJ, KloppenborgPWC. Heterozygosity for homocystinuria in premature peripheral and cerebral occlusive arterial disease. N Engl J Med 1985 313 709-715. 

Aspirin has been remarkably successful in the treatment of the pain and swelling of inflammatory disease and in fact, an estimated 45,000 tons of aspirin are still consumed each year. This success resulted in the syntheses of many other aspirin-like drugs , now referred to as NSAIDs. Aspirin, however, continues to have a unique use in the prevention of thrombosis. Since it produces irreversible inhibition of COX-1 by acetylation of serine at position 530 in the active site, a daily low dose of aspirin will cause a cumulative inhibition of COX-1 in platelets, in the portal circulation. A gradual inhibition of platelet aggregation occurs, reducing the possibility of occlusion of coronary or cerebral vessels by platelet thrombi. However, there are no systemic... 

Occasionally, the diagnosis of acute ischemia can be established by NCCT because embohc material can be visualized directly, usually in the MCA or its branches. Emboli are often more radiodense than normal brain tissue, and therefore an affected proximal MCA may appear as a linear hyperdensity ( hyperdense middle cerebral artery sign or HMCA sign, Fig. 2.1c). One study found that the HMCA sign was 100% specific for MCA occlusion, but only 27% sensitive, probably because the density of embohc material is often indistinguishable from that of the normal MCA. ... 

Slivka A, Murphy E, Horrocks L. Cerebral edema after temporary and permanent middle cerebral artery occlusion in the rat. Stroke 1995 26 1061-1065. 

Lin W, Celik A, Derdeyn C, An H, Lee Y, Videen T, Qstergaard L, Powers WJ. Quantitative measurements of cerebral blood flow in patients with unilateral carotid artery occlusion a PET and MR study. J Magn Reson Imaging 2001 14 659-667. 

Endo H, Inoue T, Ogasawara K, Fukuda T, Kanbara Y, Qgawa A. Quantitative assessment of cerebral hemodynamics using perfusion-weighted MRI in patients with major cerebral artery occlusive disease comparison with positron emission tomography. Stroke 2006 37 388-392. 

Ischemic stroke has numerous causes. Cerebral infarction may result from large artery atherosclerosis, cardiac embolism, small artery lipohyalinosis, cryptogenic embolism, or, more rarely, from other diverse conditions such as arterial dissection, infective endocarditis, and sickle cell disease. Arterial occlusion is the cause of at least 80% of acute cerebral infarctions. " ... 

Decreased cerebral blood flow, resulting from acute arterial occlusion, reduces oxygen and glucose delivery to brain tissue with subsequent lactic acid production, blood-brain barrier breakdown, inflammation, sodium and calcium pump dysfunction, glutamate release, intracellular calcium influx, free-radical generation, and finally membrane and nucleic acid breakdown and cell death. The degree of cerebral blood flow reduction following arterial occlusion is not uniform. Tissue at the... 

Middle Cerebral Artery Occlusion and the PROACT Trial The safety and efficacy of lAT in the anterior circulation have been evaluated in two randomized, multicenter, placebo-controlled trials. In the Prolyse in Acute Cerebral Thromboembolism (PROACT) 1 and 11 trials, patients with proximal MCA (Ml or M2 segment) occlusions within 6 hours of symptom onset were treated with recombinant prourokinase (r-pro-UK) or placebo. ... 

A significant neurologic deficit expected to result in long-term disability, and attributable to large vessel occlusion (basilar, vertebral, internal carotid, or middle cerebral artery M1 or M2 branches). 

Ueda T, Hatakeyama T, Kohno K, Kumon Y, Sakaki S. Endovascular treatment for acute thrombotic occlusion of the middle cerebral artery local intra-arterial thrombolysis combined with percutaneous transluminal angioplasty. Neuroradiology 1997 39 99-104. 

Sussman BJ, Fitch TS. Thrombolysis with lihrinolysin in cerebral arterial occlusion. J Am Med Assoc 1958 167 1705-1709. 

Nakano S, Iseda T, Yoneyama T, Kawano H, Wakisaka S. Direct percutaneous transluminal angioplasty for acute middle cerebral artery trunk occlusion an alternative option to intra-arterial thrombolysis. Stroke 2002 33 2872-2876. 

In one study, patients with significant diffusion-perfusion mismatch on MRI, large vessel occlusive disease, and fluctuating neurological deficits were found to be more likely to respond. Induced hypertension correlated with improved cortical cerebral... 

Izumi Y Roussel S, Pinard E, Seylaz J. Reduction of infarct volume by magnesium after middle cerebral artery occlusion in rats. J Cereb Blood Flow Metab 1991 11 1025-1030. 

Corbett D, Hamilton M, Colboume F. Persistent neuroprotection with prolonged postischemic h3fpothermia in adult rats subjected to transient middle cerebral artery occlusion. Exp Neurol 2000 163 200-206. 

Weinstein PR, Anderson GG, Telles DA. Results of h3fperbaric oxygen therapy during temporary middle cerebral artery occlusion in unanesthetized cats. Neurosurgery 1987 20 518-524. 

In the emergency situation, we beheve this technique can be successfully employed in selected patients with symptomatic ischemia due to dissection or atherosclerotic disease despite being on maximal medical therapy. We have also seen patients with carotid occlusion and an isolated cerebral hemisphere (poor collateral flow) benefit from EC-IC bypass. Any potential benefit, however, must... 

Meyer FB, Piepgras DG, Sundt TM, Yanagihara T. Emergency embolectomy for acute embolic occlusion of the middle cerebral artery. Clin Neurosurg 1985 32 155-173. 

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