Temporary Arrest of the Circulation to the Central Nervous System

History of the Letzte Wiese/Last Meadow Concept of Brain Ischemia

“…It turned out that with this procedure, a semicircular strip of cerebral cortex covering parts of gyrus sigmoideus posterior, gyrus lateralis, and gyrus postlateralis remained intensely stainednot only in anoxic but also in normoxic control animals-and that the staining was caused by aggregation of dye particles in vessels in which the blood was not properly washed out. The topical pattern of washout failure resembled the previously described histopathological pattern of brain injury after transient experimental occlusion of the pulmonary artery, 5 as well as the pattern of granular atrophy in the cerebral form of von Winiwarter-Buerger's disease, 6 both of which localized to the border zones between the supplying territories of the anterior, middle, and posterior cerebral arteries. The authors, therefore, cautiously raised the question, whether this similarity might be mehr als eine äußere (more than apparent).…”

“…This explains the occasional evolution of border zone lesions after complete circulatory arrest, as documented already in the early literature on global ischemia. 5 In our laboratory, prolonged interruption of blood flow in the primate brain also resulted in sharply demarcated outer and inner border zone lesions despite unambiguous evidence of functional and biochemical recovery in most other parts of the brain. 28 In this context, the well-known phenomenon of selective vulnerability of hippocampal CA 1 sector after brief periods of global ischemia is of historical interest because it evoked a sharp scientific dispute between 2 prominent neuroscientists: Oskar Vogt 29 and Walter Spielmeyer.…”

History of the Letzte Wiese/Last Meadow Concept of Brain Ischemia

“…It turned out that with this procedure, a semicircular strip of cerebral cortex covering parts of gyrus sigmoideus posterior, gyrus lateralis, and gyrus postlateralis remained intensely stainednot only in anoxic but also in normoxic control animals-and that the staining was caused by aggregation of dye particles in vessels in which the blood was not properly washed out. The topical pattern of washout failure resembled the previously described histopathological pattern of brain injury after transient experimental occlusion of the pulmonary artery, 5 as well as the pattern of granular atrophy in the cerebral form of von Winiwarter-Buerger's disease, 6 both of which localized to the border zones between the supplying territories of the anterior, middle, and posterior cerebral arteries. The authors, therefore, cautiously raised the question, whether this similarity might be mehr als eine äußere (more than apparent).…”

“…This explains the occasional evolution of border zone lesions after complete circulatory arrest, as documented already in the early literature on global ischemia. 5 In our laboratory, prolonged interruption of blood flow in the primate brain also resulted in sharply demarcated outer and inner border zone lesions despite unambiguous evidence of functional and biochemical recovery in most other parts of the brain. 28 In this context, the well-known phenomenon of selective vulnerability of hippocampal CA 1 sector after brief periods of global ischemia is of historical interest because it evoked a sharp scientific dispute between 2 prominent neuroscientists: Oskar Vogt 29 and Walter Spielmeyer.…”

Prognosis of deeply comatose patients on ventilators.

“…Other rare intracranial conditions included brain abscess and encephalitis. Although severe brain damage may be sustained by patients with cardiopulmonary arrest (if resuscitation fails within five minutes), such insult usually predominantly damages the cerebral cortex and cerebellum.20 21 Brainstem death due to cardiac and respiratory arrest and hypoperfusion of the brain is relatively rare.7 In our series, most patients with cerebral hypoxia or ischaemia developed asystole or ended up in a vegetative state. Only two of the 21 patients in this category met the criteria for brainstem death.…”

Differential regional vulnerability in transient focal cerebral ischemia.

“…3,5 The concept of selective vulnerability in the nervous system is not new. 19, w It has been observed in human 21 and experimental 2,22,23 cerebro-vascular disease. In renal 24 and cerebral ischemia, (both heterogeneous tissues), gradations of tissue destruction can be appreciated as selective necrosis of differentially susceptible elements.…”

History of the Letzte Wiese/Last Meadow Concept of Brain Ischemia

“…It turned out that with this procedure, a semicircular strip of cerebral cortex covering parts of gyrus sigmoideus posterior, gyrus lateralis, and gyrus postlateralis remained intensely stainednot only in anoxic but also in normoxic control animals-and that the staining was caused by aggregation of dye particles in vessels in which the blood was not properly washed out. The topical pattern of washout failure resembled the previously described histopathological pattern of brain injury after transient experimental occlusion of the pulmonary artery, 5 as well as the pattern of granular atrophy in the cerebral form of von Winiwarter-Buerger's disease, 6 both of which localized to the border zones between the supplying territories of the anterior, middle, and posterior cerebral arteries. The authors, therefore, cautiously raised the question, whether this similarity might be mehr als eine äußere (more than apparent).…”

“…This explains the occasional evolution of border zone lesions after complete circulatory arrest, as documented already in the early literature on global ischemia. 5 In our laboratory, prolonged interruption of blood flow in the primate brain also resulted in sharply demarcated outer and inner border zone lesions despite unambiguous evidence of functional and biochemical recovery in most other parts of the brain. 28 In this context, the well-known phenomenon of selective vulnerability of hippocampal CA 1 sector after brief periods of global ischemia is of historical interest because it evoked a sharp scientific dispute between 2 prominent neuroscientists: Oskar Vogt 29 and Walter Spielmeyer.…”

Prognosis of deeply comatose patients on ventilators.

“…Other rare intracranial conditions included brain abscess and encephalitis. Although severe brain damage may be sustained by patients with cardiopulmonary arrest (if resuscitation fails within five minutes), such insult usually predominantly damages the cerebral cortex and cerebellum.20 21 Brainstem death due to cardiac and respiratory arrest and hypoperfusion of the brain is relatively rare.7 In our series, most patients with cerebral hypoxia or ischaemia developed asystole or ended up in a vegetative state. Only two of the 21 patients in this category met the criteria for brainstem death.…”

Differential regional vulnerability in transient focal cerebral ischemia.

“…3,5 The concept of selective vulnerability in the nervous system is not new. 19, w It has been observed in human 21 and experimental 2,22,23 cerebro-vascular disease. In renal 24 and cerebral ischemia, (both heterogeneous tissues), gradations of tissue destruction can be appreciated as selective necrosis of differentially susceptible elements.…”

History of the Letzte Wiese/Last Meadow Concept of Brain Ischemia

“…It turned out that with this procedure, a semicircular strip of cerebral cortex covering parts of gyrus sigmoideus posterior, gyrus lateralis, and gyrus postlateralis remained intensely stainednot only in anoxic but also in normoxic control animals-and that the staining was caused by aggregation of dye particles in vessels in which the blood was not properly washed out. The topical pattern of washout failure resembled the previously described histopathological pattern of brain injury after transient experimental occlusion of the pulmonary artery, 5 as well as the pattern of granular atrophy in the cerebral form of von Winiwarter-Buerger's disease, 6 both of which localized to the border zones between the supplying territories of the anterior, middle, and posterior cerebral arteries. The authors, therefore, cautiously raised the question, whether this similarity might be mehr als eine äußere (more than apparent).…”

“…This explains the occasional evolution of border zone lesions after complete circulatory arrest, as documented already in the early literature on global ischemia. 5 In our laboratory, prolonged interruption of blood flow in the primate brain also resulted in sharply demarcated outer and inner border zone lesions despite unambiguous evidence of functional and biochemical recovery in most other parts of the brain. 28 In this context, the well-known phenomenon of selective vulnerability of hippocampal CA 1 sector after brief periods of global ischemia is of historical interest because it evoked a sharp scientific dispute between 2 prominent neuroscientists: Oskar Vogt 29 and Walter Spielmeyer.…”

Prognosis of deeply comatose patients on ventilators.

“…Other rare intracranial conditions included brain abscess and encephalitis. Although severe brain damage may be sustained by patients with cardiopulmonary arrest (if resuscitation fails within five minutes), such insult usually predominantly damages the cerebral cortex and cerebellum.20 21 Brainstem death due to cardiac and respiratory arrest and hypoperfusion of the brain is relatively rare.7 In our series, most patients with cerebral hypoxia or ischaemia developed asystole or ended up in a vegetative state. Only two of the 21 patients in this category met the criteria for brainstem death.…”

Differential regional vulnerability in transient focal cerebral ischemia.

“…3,5 The concept of selective vulnerability in the nervous system is not new. 19, w It has been observed in human 21 and experimental 2,22,23 cerebro-vascular disease. In renal 24 and cerebral ischemia, (both heterogeneous tissues), gradations of tissue destruction can be appreciated as selective necrosis of differentially susceptible elements.…”