Serial observations on the pathophysiology of acute stroke. The transition from ischaemia to infarction as reflected in regional oxygen extraction.

Details

Serval ID
serval:BIB_A249F1E3EC32
Type
Article: article from journal or magazin.
Collection
Publications
Title
Serial observations on the pathophysiology of acute stroke. The transition from ischaemia to infarction as reflected in regional oxygen extraction.
Journal
Brain
Author(s)
Wise R.J., Bernardi S., Frackowiak R.S., Legg N.J., Jones T.
ISSN
0006-8950 (Print)
ISSN-L
0006-8950
Publication state
Published
Issued date
1983
Volume
106 (Pt 1)
Pages
197-222
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
Regional cerebral blood flow, fractional oxygen extraction and oxygen metabolism have been measured in 34 patients after acute nonhaemorrhagic cerebral hemispheric infarction. Nine cases showed elevated oxygen extraction in the region of the early infarct, and these were the patients studied earliest after the onset of stroke. The results of serial studies to follow the evolution of the pathophysiology of acute stroke in these 9 patients are presented. The elevated oxygen extraction within the early infarct showed a significant reduction over the week following the onset of stroke. The reason for this fall in the fractional use of available oxygen varied in individual cases, and at the extremes was associated with a marked reduction in oxygen metabolism with a further small fall in residual blood flow, or a return of flow without recovery of oxygen metabolism. The significance of oxygen extraction in terms of potential viability of the tissue is discussed. The finding of a lower oxygen extraction in subcortical grey and white matter compared to cortex within the first hours or days of a major stroke is considered indicative of an earlier change from ischaemia to infarction in the deep tissues, probably related to the anatomy of the microvasculature. The interpretation of the results in the light of knowledge accumulated from studies of ischaemia in animals is presented, and problems imposed on data analysis by current limitations in positron emission tomography are discussed.
Keywords
Adult, Aged, Blood Pressure, Brain Ischemia/complications, Brain Ischemia/physiopathology, Cerebral Infarction/etiology, Cerebral Infarction/metabolism, Cerebrovascular Circulation, Cerebrovascular Disorders/physiopathology, Female, Humans, Ischemic Attack, Transient/radionuclide imaging, Male, Oxygen Consumption, Thalamus/physiopathology, Tomography, Emission-Computed
Pubmed
Web of science
Create date
09/10/2011 17:48
Last modification date
20/08/2019 15:08
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