Characterizing infarction and selective neuronal loss following temporary focal cerebral ischemia in the rat: A multi-modality imaging study

Selective Neuronal Loss in Ischemic Stroke and Cerebrovascular Disease

“…Increased T2 signal from around 3 to 6 hours and persisting into the chronic stage is the hallmark of infarction in both the experimental and the clinical setting. 29 In contrast, numerous rodent studies have demonstrated that SNL, be it striatal or cortical, does not display chronically increased T2 signal 17,37,39,42,49 ( Figure 1E), although transiently present slight signal change may be present at day 1 post MCAo. 39 By definition, changes on follow-up standard MRI disqualify SNL in clinical studies.…”

“…This difference in histopathological outcome between these two studies suggests that the divide between cortical SNL and infarction can be a fine line 39 and that 45-minute distal MCAo in the SHR is not a reliable model for consistently isolated cortical SNL. On investigating shorter occlusions, Ejaz et al 17 found that both 30-and 22-minute occlusion times invariably resulted in infarction, whereas 15 minutes consistently resulted in pure SNL. 53 Overall, therefore, cortical SNL is consistently observed with shorter occlusion durations in distal as compared with proximal MCAo (B15 vs B25 to 30 minutes, respectively), probably because the former induces more severe ischemia (see below).…”

“…Similarly, the terms 'partial' or 'incomplete' infarction should not be used to describe SNL, as they refer to subtypes of/phases toward pannecrosis. 16,17 Another potential source of confusion is that different names have often been given to the same condition over the years, including incomplete ischemic injury, selective neuronal necrosis, selective neuronal death, and of course SNL. However, incomplete ischemic injury is vague and does not explicitly mention neurons, whereas selective neuronal necrosis assumes that ischemic necrosis is the underlying process, whereas as will be seen below both necrosis and apoptosis seem to contribute to the condition.…”

Progressive Cortical Neuronal Damage and Extracranial-Intracranial Bypass Surgery in Patients with Misery Perfusion

“…20 After a transmission scan by germanium-68/gallium-68, a series of 15 O-gas study was followed by a study of 11 C-flumazenil, 16,21 which was synthesized by 11 C-methylation of demethylated-flumazenil (FMZ) (Hoffmann-La Roche, Basel, Switzerland). After the slow intravenous injection of 11 C-FMZ, a 50-minute dynamic PET scan was initiated.…”

“…[12][13][14] Selective neuronal damage can be detected in humans by using PET and 11 C-labeled flumazenil, a neuronal tracer. 15,16 Bypass surgery can improve MP and may prevent neuronal damage. Conversely, surgery conveys a risk of selective neuronal damage.…”