Systemic and cerebral acidosis accompanies generalized tonic-clonic seizures and status epilepticus. Acidosis during status may be modified by neuromuscular paralysis, intubation and ventilation, or administration of a base, but the effect of acidosis on neuronal injury from status is uncertain. We studied the effect of acidosis, induced by hypercarbic ventilation, on heat-shock protein (HSP72) induction in rat brain as a measure of neuronal injury in experimental status epilepticus. Acidosis was found to attenuate neuronal injury, independent of its anticonvulsant effect.
Recent advances in magnetic resonance spectroscopy permit noninvasive study of brain metabolism in vivo, 31P spectroscopic imaging being the method for evaluation of localized phosphorous metabolism. Experimentally, an ischemic-hypoxic brain insult is characterized by depletion of high energy metabolites. These changes are seen immediately after an ischemic insult. We had the opportunity of carrying out 31P spectroscopic imaging of hyperacute cerebral infarction, while MRI and CT were negative. Cerebral infarction of the middle cerebral artery territory was suggested by 31P spectroscopic imaging, which was closely consistent with a later-developing region of low density on CT. In cerebral infarction, early detection of the lesion is a useful pointer to the patient's prognosis, making 31P spectroscopic imaging a potential tool.
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