Long-term survival in permanent middle cerebral artery occlusion: a model of malignant stroke in rats

Abstract

Occlusion of the middle cerebral artery (MCA) by an intraluminal filament is widely used to study focal brain ischemia in male Sprague-Dawley rats. However, permanent occlusion goes along with a high fatality. To overcome this drawback we designed a new filament carrying a bowling pin-shaped tip (BP-tip) and compared this with three conventionally tipped filaments. Follow-up periods were 24 h (all groups) and 72 and 120 h in BP-tip group. Ischemic damage and swelling were quantified using silver nitrate staining. Collateral flow via the posterior cerebral artery (PCA) was assessed using selective dye perfusion of the internal carotid artery. Despite a comparable decrease of brain perfusion in all groups, ischemic damage was significantly smaller in BP-tips (p < 0.05). Moreover, BP-tip significantly reduced mortality from 60% to 12.5% and widely spared the occipital region and hypothalamus from ischemic damage. Conventional but not BP-tip filaments induced vascular distortion, measured as gross displacement of the MCA origin, which correlated with occipital infarction size. Accordingly, BP-tip occluded rats showed a significantly better collateral filling of the PCA territory. Ischemic volume significantly increased in BP-tip occlusion at 72 h follow-up. BP-tip filaments offer superior survival in permanent MCA occlusion, while mimicking the course of a malignant stroke in patients.

Bone Marrow Stromal Cells Combined with Sodium Ferulate andn-Butylidenephthalide Promote the Effect of Therapeutic Angiogenesis via Advancing Astrocyte-Derived Trophic Factors after Ischemic Stroke

“…In the present study, we successfully established the pMCAo model. Our dropout rate was 9% because of exclusion of unstandardized experimental animals, and the mortality rate as reported by Shanbhag and colleagues was about 12.5% using a new filament 21 , while our animal survival rate was about 82%. Additionally, in order to more clearly illustrate animal experimental design, a scheme of animal experimental timeline is presented in Figure 2A.…”

Long-Term Functionality Prediction for First Time Ischemic Middle Cerebral Artery Stroke Patients Receiving Conventional Medical Treatment

“…In addition to brain stem infarct, middle cerebral artery (MCA) ischemic stroke stands out as the most precarious type, as its initial presentations often occur all of a sudden with the cerebral oedematous changing within a few days of the index episode, often requiring intensive care monitoring to prevent neurological deterioration, respiratory distress, and subsequent in-hospital infection. 18 As mentioned in the introduction section, the current gold standard treatment for MCA ischemic stroke (excluding other aetiologies, including cardiogenic emboli) is for an in-charge stroke neurologist to administer intravenous thrombolytic interventions (r-tPA) and/or thrombectomy. If a stroke patient is diagnosed within the therapeutic time window of ≤4.5 hours for r-tPA and ≤6 hours for IA, the 3-month of functional recovery from the index stroke event is satisfactory when compared to those without treatment.…”

Anesthesia Comlications After Neurosurgical Procedure in Post-Anesthesia Care Unit Running Title: Complications in Post-Anesthesia Care Unit

“…For neurological patients, hypertension in the perioperative and postoperative period may increase intracranial pressure and cause bleeding at the surgical site, intracranial hemorrhage, or cerebral ischemia, resulting in poor outcomes that include prolonged hospital stay, brain dysfunction, and increased mortality, especially in the rst 24 hours [17][18][19][20]. One study found that post-craniotomy intracranial hematoma was associated with intraoperative and postoperative hypertension [21].…”