DNA fragmentation in ischemic core and penumbra in focal cerebral ischemia in rats

Although apoptotic cell death has been suggested to be involved in ischemic injury of the brain, the precise mechanisms of ischemic neuronal cell death are unknown. Here, we examined the biochemical feature of apoptosis (i.e. DNA fragmentation) in male spontaneously hypertensive rats (5-7 months old) subjected to photothrombotic distal middle cerebral artery (MCA) occlusion. After MCA occlusion, the brain was cut in a cryostat to produce a standard coronal block and samples were dissected from the regions corresponding to the ischemic core, penumbra and contralateral control areas. Changes in cerebral blood flow (CBF) were monitored at 1 mm posterior and 2-4 mm lateral to the bregma by means of a laser-Doppler flowmetry. After MCA occlusion, CBF was decreased to 72+/-18 (+/-S.D.), 50+/-14, and 35+/-11% of the control values at 2, 3, and 4 mm from the midline, respectively. DNA fragmentation characteristics of apoptosis were examined in these samples by conventional and pulse-field gel electrophoresis. On the conventional gel electrophoresis, nucleosomal DNA fragmentation was detected in the penumbral zone at 6 h after MCA occlusion. Large DNA fragments of 50 and 20 kbp were detected in the penumbral zone and also in the ischemic core region at 3 h after distal MCA occlusion. The large DNA fragments seen on the pulse-field gel elecrophoresis were further degraded to small DNA fragments at 6 h after MCA occlusion in the penumbral zone but not in the core regions. The evolving DNA fragmentation was observed between 3 and 6 h after the onset of brain ischemia in the penumbra, suggesting that apoptosis may contribute to the development of ischemic infarction.

[YAG laser-induced reperfusion of photothrombotic middle cerebral artery occlusion in rats]

The laser-driven photochemical occlusion of middle cerebral artery(MCA) is much easier, and less traumatic than standard electrocautery or even clip methods, while the infarct size is fairly reproducible. This study aimed to establish the system for YAG laser-induced reperfusion of photothrombotic MCA occlusion. Male spontaneously hypertensive rats(5-7 months old, 350-450 g) were anesthetized with halothane, endotracheally intubated, and mechanically ventilated. The photosensitizing dye rose bengal(20 mg/kg body weight) was administered intravenously over 90 sec starting simultaneously with 3 min of krypton laser irradiation(568 nm, 20 mW). The irradiated middle cerebral artery was completely occluded by an intraluminal thrombus. A YAG laser operating at 355 nm(16 mW, 15 Hz) was focused with a cylindrical lens and positioned with a mirror onto the occluded distal MCA. This YAG laser irradiation for approximately 3 min caused reperfusion of the thrombosed distal MCA. We demonstrated a novel method of reperfusion in the photothrombotic MCA occlusion model. This reperfusion model should facilitate study of the therapeutic window for reversibility in thrombotic stroke.

[A case of severe stenosis of bilateral distal vertebral artery successfully treated with anastomosis operation]

A 65-year-old male complained of loss of consciousness for several minutes, transient diplopia and dizziness. He had no neurological deficits nor abnormalities in MR imaging. However, flow velocity of bilateral vertebral artery on ultrasonography indicated severe stenosis of bilateral distal vertebral artery. Brain angiography revealed severe stenosis of bilateral distal vertebral artery as well as occlusion of right middle cerebral artery (MCA). Single photon emission CT (SPECT: ECD-RVR method with acetazolamide loading) showed decreased cerebral blood flow and poor perfusion reserve in bilateral cerebellar hemisphere and right MCA territory. Superficial temporal artery-superior cerebellar artery (STA-SCA) anastomosis was performed. The patient turned out to have no episodes of unconsciousness attack, transient diplopia and dizziness after operation. Cerebral blood flow (CBF) in the posterior circulation was also improved. Evaluating quantitative CBF measurement by means of ECD-RVR method was useful for evaluating CBF. In cases who have severe stenosis of bilateral distal vertebral artery with complaints of vertebrobasilar insufficiency, STA-SCA anastomosis may be one of the most effective treatments.