Stroke-ischemia

Many derivatives of 4-hydroxy-3-nitro-l,X-naphthyridin-2(lH)-ones (X = 5,6,7, and 8) were claimed to have been used for treating or preventing neuronal loss associated with stroke, ischemia, CNS trauma, hypoglycemia, and surgery as well as for treating neurodegenerative diseases, chronic pain, convulsion, anxiety, and opiate tolerance (96MI2). 

IIM-HAOI Inlcrnalional (.170-740) perfusion, cerebral stroke, ischemia. 

DHA has been shown to induce endothelium-independent vasodilation. The meehanism(s) underlying DHA-induced vasodilation are 1) aetivation of ATP-sensitive channels in VSMCs by prostanoids (DHA metabolite) [30], 2) inhibition of L-type Ca channel and intracellular calcium release in VSMCs [30], Ingestion of -3 fatty acid supplements (e.g. fish oil and com oil) in rats reduced norepinephrine or vasopressin-mediated aortic vasoconstriction and enhanced endothelium-dependent vasodilation via acetylcholine. Furthermore, DHA-mediated vasodilation was prevalent in spontaneous hypertensive rat aorta suggesting that dietary intake of DHA is beneficial to counteract hypertension [30, 31], Similarly, ALA causes coronary arterial vasodilation via activation of VSMC Na /K -ATPase-mediated hyperpolarization [32]. Administration of ALA ean also increase CBF and vasodilation of rodent basilar artery (via activation of TREK-1 potassium chaimel) [33] indicating that ALA may also have therapeutic value used to eombat stroke/ischemia by increasing eerebral eirculation. 

Tumor, infarction (stroke/ischemia), haemorrhage (bleeding/ ischemia) and infection (abscess) are the example of brain lesions that are affected in the brain cerebrum. In 2006, it was reported that tumor and brain diseases such as brain infarction and haemorrhage were the third and fourth leading cause of death in Malaysia [1]. The incidence of brain tumor in 2006 was 3.9 among males and 3.2 among females per 100,000 populations with a total of 664 cases reported by the Minister of Health Malaysia. In the United States, the combined incidence of primary brain tumor was 6.6 per 100,000 persons per year with a total of 22,070 new cases in 2009 [2], while brain infarction affects approximately 750,000 new cases per year [3]. 

Infarction (Stroke/ Ischemia) Acute (30 minutes -72 hours after onset) Hyperintense Chronic (after 2 weeks) Hypointense Paralysis visual disturbances speech problems gait difficulties altered level of consciousness Cerebral vascular occlusion/ blockage... 

Ischemia-reperfusion damage Stroke (A,l), cardiac failure (A), transplantation (A)... 

Excitotoxicity is the over-activity of the glutamatergic system responsible for the large number of dead neurons observed after ischemia (stroke) or epileptic seizures. This neuronal death is due to an overexcitation of the neurons and the massive Ca2+ entry... 

Pignataro G, Gala R, Cuomo O et al (2004) Two sodium/ calcium exchanger gene products, NCX1 andNCX3, play a major role in the development of permanent focal cerebral ischemia. Stroke 35 2566-2570... 

Reduction of the risk of transient ischemic attacks or strokes in men who have had transient ischemia of the brain due to fibrin platelet emboli (aspirin only). This use has been found to be effective only in men (not women). 

They are useful against hypertension but also for cases of angina, heart failure, heart attack, arythmia, silent ischemia, stroke and senility. 

Barher PA, Demchuk AM, Hudon ME, Pexman JH, HiU MD, Buchan AM. H3fperdense Sylvian fissure MCA dot sign a CT marker of acute ischemia. Stroke 2001 32 84-88. 

Darby DG, Barber PA, Gerraty RP, Desmond PM, Yang Q, Parsons M, Li T, Tress BM, Davis SM. Pathophysiological topography of acute ischemia by combined diffusion-weighted and perfusion MRI. Stroke 1999 30 2043-2052. 

Warach S, Latour LL. Evidence of reperfusion injury, exacerbated by thrombolytic therapy, in human focal brain ischemia using a novel imaging marker of early blood-brain barrier disruption. Stroke 2004 35 2659-2661. 

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. ... 

Acute ischemic stroke s3miptoms with onset or last known well, clearly defined. Treatment within 6 h of established, nonfluctuating deficits due to Anterior Circulation (carotid/MCA) stroke, between 6 and 8 h mechanical treatment (e.g.. Concentric Retriever) should be considered. The window of opportunity for treatment is less well defined in posterior circulation (vertebral/basilar) ischemia, and patients may have fluctuating, reversible ischemic symptoms over many hours or even days and stiU be appropriate candidates for therapy. 

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. 

Belayev L, Pinard E, Nallet H, Seylaz J, Liu Y, Riyamongkol P, Zhao W, Busto R, Ginsberg MD. Albumin therapy of transient focal cerebral ischemia in vivo analysis of dynamic microvascular responses. Stroke 2002 33 1077-1084. 

Onal MZ, Li F, Tatbsumak T, Locke KW, Sandage Jr, BW, Fisher M. Synergistic effects of citicobne and mk-801 in temporary experimental focal ischemia in rats. Stroke 1997 28 1060-1065. 

Sumii T, Lo EH. Involvement of matrix metalloproteinase in thrombolysis-associated hemorrhagic transformation after embohc focal ischemia in rats. Stroke 2002 33 831-836. 

Astmp J, Siesjo BK, Symon L. Thresholds in cerebral ischemia-the ischemic penumbra. Stroke 1981 12 723-725. 

Lou M, Eschenfelder CC, Herdegen T, Brecht S, Deuschl G. Therapeutic window for use of hyperbaric oxygenation in focal transient ischemia in rats. Stroke 2004 35 578-583. 

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