Experimental And Clinical Study On The Treatment Of Pressor Perfusion For Hypodynamics Ischemia Of Brain

ObjectiveTo analysis the pathology and image characteristics of hypoperfusional cerebral ischemia. To evaluate the reliability and effect of intermittent pressor perfusion with using selected catheterzing for hypodynamic cerebral ischemia by the way of carotid and vertebral arteries, To investigate the principle of enhancing perfusion. Data and Methods1. Focal cerebral infarction was produced by obstructing cerebral middle artery by means of operation in rabbits .The rabbits were divided into four groups, according to different administration. After 72 hours,to group A we catheterized the internal carotid artery and injected urokinase quickly,then investigated behavior of rabbits , studied the ischemic area ,observed pathological form and explored the histological feature of apoptotic neuron death of the ischemic cerebral tissues.2. To summarize the information of 30 cases with cerebral ischemia.3. Perfusion weighted imaging(PWI) was performed in 30 cases of cerebral ischemia. The ratios of side-to-side were measured at duty lesion in the regional cerebral ischemia. To definite the hypoperfusion cerebral areas and judge the stages of ischemic period were made as the following: compensation period: rCBF was normal, rCBVwas increased, MTT was delayed; decompensation period: rCBF was slightly decreased, rCBV was normal or increased, MTT was delayed; pre-infarction period: rCBF and rCBV were decreased , MTT was delayed. After enhancing perfusion therapy, binding DSA, PWI was performed again ,then compared the parametes and evaluate therapeuticefficacy.4. To summarize and contrast the pre- and post- NIHSS of 30 cases of cerebral ischemia.5. To study characteristics of hypoperfusional cerebral ischemia in DSA image and analyze the indication of the enhancing perfusion therapy.Results1. The clinical symptom improved distinctly in enhancing perfusion group ( effective rate=83.3%). At the same time ,the number of apoptotic neurons in area surrounding the ischemic core in group A less than those in group B and C greatly(p<0.05).2.There were 30 cases of 8 TIA and 22 former CI. Analyzing their DSA image ,we could see hypoperfusional regions were located in watershed regions or terminal artery donor area.3. There were 8 cases of 4 TIA patients and 4 former CI ones in compensation period, compared with pre-therapy, the areas of shortened MTT were found and rCBF remained identical in all 8 cases ;8 cases manifested decreased rCBV after therapy;There were 7 cases with 2 TIA patients and 5 former CI ones in decompensation period, compared with pre-therapy, the areas of decreased MTT were revealed; rCBF and o rCBV showed increased in all the 7 patients relatively;There were 13 former CI cases in pre-ihfarction period, compared with pre-therapy, MTT remained identical in 6 cases and 7 cases decreased; rCBF remained identical in 8 cases and 5 cases increased relatively ; 5 cases showed the same rCBV and another 8 cases increased .Two cases who showed negative were in none of period.4. In 22 former CI cases, NIHSS score displayed descent in 17 cases , the pre-median and post-one were 10, 8 respectively. The 8 TIA cases remained zero in pre- and post- NIHSS.