• Title/Summary/Keyword: Cerebral Edema

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Vasogenic Edema in Experimental Cerebral Fat Embolism

  • Park Byung-Rae;Koo Bong-Oh
    • Biomedical Science Letters
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    • v.11 no.1
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    • pp.31-36
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    • 2005
  • To evaluate the magnetic resonance imaging and electron microscopic findings of the hyperacute stage of cerebral fat embolism in cats and the time needed for the development of vasogenic edema. Magnetic resonance imaging was performed at 30 minutes (group 1, n=9) and at 30 minutes and 1, 2, 4, and 6 hours after embolization with triolein (group 2, n= 10). As a control for group 2, the same acquisition was obtained after embolization with polyvinyl alcohol particles (group 3, n=5). Electron microscopic examination was done in all cats. In group 1, the lesions were iso- or slightly hyperintense on T2-weighted (T2W) and diffusion-weighted (DWIs) images, hypointense on the apparent diffusion coefficient (ADC) map image, and markedly enhanced on the gadolinium-enhanced T1-weighted images (Gd-T1WIs). In group 2 at 30 minutes, the lesions were similar to those in group 1. Thereafter, the lesions became more hyperintense on T2WIs and DWIs and more hypoinfense on the ADC map image. In group 3, the lesions showed mild hyperintensity on T2WIs at 6 hours but hypointensity on the ADC map image from 30 minutes, with a tendency toward a greater decrease over time. Electron microscopic findings revealed discontinuity of the capillary endothelial wall, perivascular and interstitial edema, and swelling of glial and neuronal cells in groups 1 and 2. The lesions were hyperintense on T2WIs and DWIs, hypointense on the ADC map image, and enhanced on Gd-T1WIs. On electron microscopy, the lesions showed cytotoxic and vasogenic edema with disruption of the blood-brain barrier.

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Effect of Pioglitazone on Perihematomal Edema in Intracerebral Hemorrhage Mouse Model by Regulating NLRP3 Expression and Energy Metabolism

  • Kim, Hoon;Lee, Jung Eun;Yoo, Hyun Ju;Sung, Jae Hoon;Yang, Seung Ho
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.689-697
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    • 2020
  • Objective : Cerebral edema is the predominant mechanism of secondary inflammation after intracerebral hemorrhage (ICH). Pioglitazone, peroxisome proliferator-activated receptor gamma agonist has been shown to play a role in regulation of central nervous system inflammation. Here, we examined the pharmacological effects of pioglitazone in an ICH mouse model and investigated its regulation on NLRP3 inflammasome and glucose metabolism. Methods : The ICH model was established in C57 BL/6 mice by the stereotactical inoculation of blood (30 µL) into the right frontal lobe. The treatment group was administered i.p. pioglitazone (20 mg/kg) for 1, 3, and 6 days. The control group was administered i.p. phosphate-buffered saline for 1, 3, and 6 days. We investigated brain water contents, NLRP3 expression, and changes in the metabolites in the ICH model using liquid chromatography-tandem mass spectrometry. Results : On day 3, brain edema in the mice treated with pioglitazone was decreased more than that in the control group. Expression levels of NLRP3 in the ICH model treated with pioglitazone were decreased more than those of the control mice on days 3 and 7. The pioglitazone group showed higher levels of glycolytic metabolites than those in the ICH mice. Lactate production was increased in the ICH mice treated with pioglitazone. Conclusion : Our results demonstrated less brain swelling following ICH in mice treated with pioglitazone. Pioglitazone decreased NLRP3-related brain edema and increased anaerobic glycolysis, resulting in the production of lactate in the ICH mice model. NLRP3 might be a therapeutic target for ICH recovery.

Magnetic Resonance Imaging and Pathologic Correlation of Cerebral Fat Embolism using Oleic Acid

  • Park, Byung-Rae
    • Biomedical Science Letters
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    • v.10 no.2
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    • pp.115-120
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    • 2004
  • To investigate the correlation between the magnetic resonance imaging (MRI) of cerebral fat embolism that is induced by injecting oleic acid into 10 cats, and a pathologic diagnosis. Using a microcatheter, 30 ${mu}ell$ of oleic acid was injected into the internal carotid artery of 10 cats. MR T2-weighted image (T2WI), diffusion-weighted image (DWI) and Gadolinium-enhanced T1-weighted image (Gd-enhanced T1WI) were obtained after 30 minutes and 2 hours of embolization. After 30 minutes of the embolization, lesions of very high signal intensity were detected by T2WI in 6 cats, and of slightly high signal intensity in 2 cats; in the remaining 2 cats, signal intensity was normal. DWI showed lesions of very high intensity in 9 cats and of slightly high intensity in one cat. According to the findings of light microscopic examination, infarcted lesions mainly involved the gray matter, but also some white matter. A magnetic resonance imaging diagnosis for cerebral fat embolism that was induced by oleic acid through the internal carotid artery in cats showed high signal intensity on the T2WI and the DWI within an initial 2 hours, and with a well enhancement on the Gd-enhanced T1WI. Considering cellular edema, cerebrovascular injury and extracellular space widening, we assumed pathologically that cytotoxic and vasogenic edema exists at the same time.

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Radiological Characteristics of Peritumoral Edema in Meningiomas

  • Lee, Ki-Yeul;Joo, Won-Il;Rha, Hyung-Kyun;Park, Hae-Kwan;Lee, Kyung-Jin;Choi, Chang-Rak
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.427-431
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    • 2005
  • Objective: The purpose of this study is to evaluate the radiological charactersitics related to the formation of peritumoral edema in meningiomas. Methods: Fifty patients with meningioma were examined by magnetic resonance images and cerebral angiography. The predictive factors associated peritumoral edema, such as, tumor size, peritumoral rim (cerebrospinal fluid cleft), shape of tumor margin, signal intensity of tumor in T2WI, and pial blood supply were evaluated. Results: Tumor size, peritumoral rim and pial blood supply correlated with peritumoral edema on univariate analyses. But in multivariate analyses, pial blood supply was statistically significant as a factor for peritumoral edema in meningioma. Conclusion: In our results, pial blood supply is significant contributing factor for peritumoral edema in meningioma.

Effects of Dendrobii herba against Intracerebral Hemorrhage in Rats (석곡(石斛)이 흰쥐의 뇌조직출혈에 미치는 영향)

  • Lee, Jung-Dong;Kim, Youn-Sub
    • The Korea Journal of Herbology
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    • v.27 no.3
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    • pp.83-88
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    • 2012
  • Objects : This study was performed in order to observe the effects of water extract of Dendrobii herba on intracerebral hemorrhage(ICH), Method : ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type IV in Sprague-Dawley rats. After the water extracts of Dendrobii herba were administrated orally once a day for 3 days, hematoma volume, percentage of brain edema, expression of iNOS and MPO were observed using immunohistochemistry. Results : Rats fed with water extracts of Dendrobii herba showed reduction of hematoma volume and percentage of brain edema compared with controls. In addition, Infiltration of myeloperoxidase (MPO) expressing neutrophil and expression of inducible nitric oxide synthatase(iNOS) were significantly reduced in rats fed with water extracts of Dendrobii herba. Conclusion : These results demonstrated that water extracts of Dendrobii herba reduced brain damage of intracerebral hemorrhage(ICH) and subsequent ICH-induced cerebral edema, and inhibited neutrophil infiltration.

Influence of Ischemic Duration on Extent of Focal Ischemic Brain Injury Induced by Middle Cerebral Artery Occlusion in Rats (백서의 중대뇌동맥 페쇄에 의한 국소 허혈성 뇌손상의 정도에 미치는 허혈 시간의 영향)

  • 구희정;정경자;김명수;진창배
    • Biomolecules & Therapeutics
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    • v.8 no.2
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    • pp.160-166
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    • 2000
  • The present study examined influence of various ischemic duration on extent of focal ischemic brain injury induced by middle cerebral artery occlusion (MCAO) in rats. The MCAO was produced by insertion of a 17 mm silicone-coated 4-0 nylon surgical thread to the origin of MCA through the internal carotid artery for 30, 60, 90, 120 min (transient) or 24 hr (permanent) in male Sprague-Dawley rats under isoflurane anesthesia. Reperfusion in transient MCAO models was achieved by pulling the thread out of the internal carotid artery. Only rats showing neurological deficits characterized by left hemiparesis and/or circling to the left, were included in cerebral ischemic groups. The rats were sacrificed 24 hr after MCAO and seven serial coronal slices of the brain were stained with 2,3,5-triphenyltetrazolium chloride. Infarct size was measured using a computerized image analyzer. Ischemic damage was common in the frontoparietal cortex (somatosensory area) and the lateral segment of the striatum while damage to the medial segment of the striatum depended on the duration of the occlusion. In the 30-min MCAO grouts, however, infarcted region was primarily confined to the striatum and it was difficult to clearly delineate the region since there was mixed population of live and dead cells in the nucleus. Infarct volume was generally increased depending on the duration of MCAO, showing the most severe damage in the permanent MCAO group. However, there was no significant difference in infarct size between the 90-min and 120-min MCAO groups. % Edema also tended to increase depending on the duration of MCAO. The results suggest that the various focal ischemic rat models established in the present study can be used to evaluate in vivo neuroprotective activities of candidate compounds or to elucidate pathophysiological mechanisms of ischemic neuronal cell death.

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Postoperative Brain Swelling after Resection of Olfactory Groove Meningiomas

  • Song, Sang-Woo;Park, Chul-Kee;Paek, Sun-Ha;Kim, Dong-Gyu;Jung, Hee-Won;Chung, Young-Seob
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.423-427
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    • 2006
  • Objective : Postoperative brain swelling after resection of olfactory groove meningiomas by bifrontal interhemispheric transbasal approach is a knotty subject. Pathogenesis and predictive factors were investigated to prevent the problem. Methods : Eighteen patients of olfactory groove meningiomas who had undergone surgery were enrolled and retrospectively analyzed using their clinical and radiological data. Bifrontal inter hemispheric transbasal approach was used in all patients. Magnetic resonance imaging and transfemoral cerebral angiography were available for investigation in 18 and 14 patients respectively. Postoperative clinical course, tumor volume, peritumoral edema, tumor supplying vessels, and venous drainage patterns were carefully investigated in relation to postoperative brain swelling. Results : Seven patients [39%] developed clinically overt brain swelling after surgery. Among them, 4 patients had to undergo decompression surgery. In three patients, attempted bone flap removal was done by way of prevention of increased intracranial pressure resulted from intractable brain swelling and two of them eventually developed brain swelling which could be recovered without sequellae. Abnormal frontal base venous channel observed in preoperative angiography was significant predictive factor for postoperative brain swelling [p=0.031]. However, tumor volume, peritumoral edema, and existence of pial tumor supplying vessels from anterior cerebral arteries were failed to show statistical significances. Conclusion : To prevent postoperative brain swelling in olfactory groove meningioma surgery, unilateral approach to preserve frontal base venous channels or temporal bone flap removal is recommended when it is indicated.

Acute High-Altitude Cerebral Edema Presenting as Extensive Microbleeds along the Corpus Callosum without T2 Hyperintensity: A Case Report and Literature Review (T2 고신호강도가 동반되지 않은 뇌량의 광범위한 미세출혈의 형태로 나타난 고산병: 증례 보고 및 문헌 고찰)

  • Jin Young Son;Jee Young Kim;Sanghyuk Im
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.953-958
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    • 2021
  • High-altitude cerebral edema (HACE) is a potentially fatal neurological syndrome that develops in persons traveling to a high altitude. We report the case of a 49-year-old male who had traveled to a high altitude, and lost consciousness for a few hours. Susceptibility-weighted images revealed multiple, fine black pepper like microbleeds along the corpus callosum with several microbleeds in the left frontal and parietal subcortical white matter. The T2-weighted images did not show any abnormal signal intensities along the corpus callosum. The diffusion-weighted images revealed small nodular high signal intensities in the basal ganglia. This report describes the atypical radiologic findings of HACE showing multiple microbleeds along the corpus callosum, without abnormal high-signal intensity on T2-weighted images.

The Effect of Sosokmyung-tang extract on Global cerebral ischemia·Cerebral Infarction by MCA occlusion in vivo (소속명탕(小續命湯) 추출물(抽出物)이 전뇌허혈(全腦虛血)및 국소뇌허혈(局所腦虛血)에 미치는 영향(影響))

  • Lee, Kyung-Ae;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.107-116
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    • 1999
  • The effects of Sosokmyung-tang(小續命湯) on global cerebral ischemia and cerebral in farction by MCA(middle cerebral artery) occlusion were evaluated in this study. This study was performed to investigate that Sosokmyung-tang would be useful for cerebrovascular diseases. In the case of global cerebral ischemia, ICR mice were used and divided into three group at random. Control group was treated after oral administration of normal saline, experimental group was treated after oral administration of 10.4mg/20g/day of Sosokmyung-tang extract. The multiple parameter of global cerebral ischemia included the duration of coma of KCN(potassium cyanide)-injected(1.2mg/kg, i.v) group and the survival time of KCN-injected(3.0mg/kg, i.v) group. In the case of cerebral infarction by MCA occlusion, Sprague-Dawley rats were used and divided into three group at random. Control group was given nothing before MCA occlusion, experimental group was given 157.2mg/250g/day of Sosokrnyung-tang extract before MCA occlusion. We investigated edema and ischemic ratio in 8 slices of rats' brain after MCA occlusion. The results were obtained as follows : 1. Sosokrnyung-tang significantly shortened the duration of coma of KCN-injected(1.2mg/kg,i.v) group and lengthened the survival time of KCN-injected(3.0mg/kg, i.v) group. 2. Sosokmyung-tang significantly decreased cerebral edema and ischemic ratio in rats after MCA occlusion. From the above results, it was concluded that Sosokmyung-tang can be effectively applied to cerebrovascular diseases.

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Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

  • Chen, Po-Chuan;Tsai, Shih-Hung;Chen, Yu-Long;Liao, Wen-I
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.293-295
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    • 2014
  • Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompressive craniectomy, but permanent neurological damage occurred. This is the first case of profound PTCI following a low-energy penetrating craniocerebral nail injury and reminds clinicians of possibility this rare dreadful complication for care of head-injured patients.