Selective neuronal damage and chronic hemodynamic cerebral ischemia

Abstract

In atherothrombotic internal carotid artery or MCA occlusive disease, misery perfusion may cause selective neuronal damage, and statins might have beneficial effects against neuronal damage.

Selective Neuronal Loss in Ischemic Stroke and Cerebrovascular Disease

“…They also demonstrated a correlation between higher oxygen extraction fraction and progression of SNL in a longitudinal study. 160 These findings strongly suggest that misery perfusion may contribute to SNL. This hemodynamic mechanism was also supported by the correlation of cortical neuronal damage with low-flow infarcts.…”

Perfusion criteria of the EICMA efficacy in patients with symptomatic occlusion of the internal carotid artery

“…Тем не ме-нее сохраняющаяся локальная олигемия в данных областях могла объяснять стойкий неврологический дефицит вследствие угнетения проводящих путей и развития диашиза [8,14]. Подобные состояния яв-ляются патологическими, так как могут приводить к селективному некрозу нейронов и прогрессирую-щей церебральной дегенерации [17][18][19][20].…”

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

“…Four patients with MP and 4 patients without MP were part of a previously published dataset. 16 Inclusion criteria for the present study were as follows: 1) occlusion of the extracranial ICA or occlusion or stenosis (Ͼ50% diameter reduction) of the intracranial ICA or MCA as documented by conventional or MR angiography 18 ; 2) functional independence in daily life (a modified Rankin Scale score of Ͻ3); 3) surgically treated patients with no intervening stroke since the first PET examination; 4) availability and willingness of the patients to return for a PET examination after surgery; and 5) for symptomatic patients, a history of TIA or minor completed stroke in the ICA or MCA distribution. TIA was defined as focal symptoms of presumed ischemic cerebrovascular origin lasting Ͻ24…”

“…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.…”