Ischemic infarction

The neuromuscular complications of diabetes mellitus are most often neuropathic in origin, with distal sensorimotor polyneuropathies being the most common. In addition, ischemic infarction of skeletal muscle may occur due to occlusive vascular disease, with small and medium-sized arterioles particularly affected. This occurs in poorly-controlled diabetes and affects thigh, muscles in most cases. In acute stages, muscle biopsy findings are those of widespread muscle necrosis, edema, and phagocytic cell infiltration. Muscle regeneration may be incomplete and increased fibrous connective tissue may replace lost muscle tissue. 

Schaefer PW, Hunter GJ, He J, Hamberg LM, Sorensen AG, Schwamm LH, Koroshetz WJ, Gonzalez RG. Predicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging. Am J Neuroradiol 2002 23 1785-1794. 

Stanley HR, Weisman MI, Michanowicz AE and Bellizzi R (1978) Ischemic infarction of the pulp sequential degenerative changes of the pulp after traumatic injury. J Endodont 4, 325-335. 

Doetsch F, Alvarez-Buylla A (1996) Network of tangential pathways for neuronal migration in adult mammalian brain. Proc Natl Acad Sci USA 93 14895-14900 Du Bois M, Bowman PD, Goldstein GW (1985) Cell proliferation after ischemic infarction in gerbil brain. Brain Res 347 245-252... 

Beis JM, Keller C, Morin N et al (2004) Right spatial neglect after left hemisphere stroke qualitative and quantitative study. Neurology 63 1600-1605 Benninger DH, Georgiadis D, Kremer C et al (2004) Mechanism of ischemic infarct in spontaneous carotid dissection. Stroke 35 482-485... 

Simultaneous or sequential strokes in different arterial territories, multi-level posterior circulation infarcts, simultaneous infarcts in the three subterritories (superficial anterior, superficial posterior and deep) of the MCA, and hemorrhagic transformation of an ischemic infarct also point to a cardiac origin of the stroke (Arquizan et al. 1997 Ay et al. 1999 Ferro 2003a,b). Occlusion of the carotid artery by a mobile thrombus, early recanalization of an occluded vessel and the identification of microembolism in both MCAs are all highly indicative of a cardiac source of emboli. 

Studer A, Georgiadis D, Baumgartner RW (2003) Ischemic infarct involving all arterial territories of the thalamus. Acta Neurol Scand 107 423-425 Timsit SG, Sacco RL, Mohr JP et al (1992) Early clinical differentiation of cerebral infarction from severe atherosclerotic stenosis and cardioembolism. Stroke 23 486-491 Tong DC, Adami A, Moseley ME et al (2000) Relationship between apparent diffusion coefficient and subsequent hemorrhagic transformation following acute ischemic stroke. Stroke 31 2378-2384... 

Ischemic infarction of the spinal cord is difficult to establish in the early phase, only 50% of the patients show early demarcation within 24 h. The role of MRI in the acute phase is to exclude hematomyelia, spinal vascular malformation (which requires spinal angiography in special cases) or a compressive lesion. 

Aminorex fumarate Aspirin Intimai and medical thickening of pulmonary arteries Endothelial damage, gastric erosion obliteration of small vessels, ischemic infarcts Pulmonary hypertension... 

Further animal studies showed the agent to be also selectively retained in acutely ischemic brain, but not in the ischemic infarct. It is therefore a marker of ischemic tissue at risk of infarction and may contribute to the clinical management of acute stroke [221]. In addition, BMS-181321 was recently reported to be taken up in solid mice tumors with a tumor-to-musclc activity ratio of 3.5-4.0 at 4-8 h after injcc-... 

Russell E (1997) Diagnosis of hyperacute ischemic infarct with CT key to improved cUnical outcome after intravenous thrombolysis Radiology 205 315-318. 

Pressman BD, Touije EJ, Thompson JR (1987) An early CT sign of ischemic infarction increased density in a cerebral artery. Am J Neuroradiol 8 645-648. 

Fig. 5.10 CT images in a patient with left hemiparesis. Admission CTP images show cerebral blood flow (CBF, upper left), cerebral blood volume (CBV, upper middle), and mean transit time (MTT, upper right). The presence of a matched CBF/CBV perfusion deficit suggests irreversibly ischemic infarct core , likely to correlate with DWI findings, and not a target for reperfusion therapies The admission non-contrast CT...

Table 7.3 Reliability of DWl for the detection of acute ischemic infarction in hyperacute stroke...

Nagai, N., et al.. Role of plasminogen system components in focal cerebral ischemic infarction a gene targeting and gene transfer study in mice. Circulation, 1999. 99(18) p. 2440-4. 

R. J. Nudo, B. M. Wise, F. SiFuentes, and G. W. Milliken (1996), Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science 272 1791-1794. 

Although the majority of cerebral infarctions are located in the territories of the internal carotid arteries, 20% of cerebral ischemic infarctions involve tissue supplied by the vertebrobasilar circulation. Basilar artery occlusion is a life-threatening condition whose unfavourable spontaneous prognosis can only be improved by early detection and subsequent aggressive recanafization therapy (Pfefferkorn et al. 2006). 

---