Hatakeyama T, Matsumoto M, Brengman J M, Yanagihara T
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Stroke. 1988 Dec;19(12):1526-34. doi: 10.1161/01.str.19.12.1526.
We investigated progression and recovery of neuronal damage during and after global cerebral ischemia in gerbils after bilateral occlusion of the common carotid arteries, using the immunohistochemical method (reaction for tubulin and creatine kinase BB-isoenzyme). The earliest, but reversible, ischemic lesions occurred after 3 minutes' ischemia in the subiculum-CA1 and CA2 regions of the hippocampus. The lesions became irreversible after 4 minutes' ischemia. The ischemic and postischemic lesions in the cerebral cortex, thalamus, and caudoputamen were partially or completely reversible if the ischemic period was 5 minutes, whereas delayed degeneration occurred in the pyramidal cells of the medial CA1 region after reperfusion for 48 hours (delayed neuronal death). After 10 minutes' ischemia and subsequent reperfusion, delayed neuronal death extended from the medial to the lateral CA1 region; the ischemic and postischemic lesions in the cerebral cortex, thalamus, and caudoputamen also expanded during reperfusion. Our investigation demonstrates that selective vulnerability existed in global cerebral ischemia as in incomplete or regional ischemia and suggests that neurons in many areas of the brain possessed the potential for recovery, progressive deterioration, and even delayed neuronal death depending on the severity and duration of cerebral ischemia.
我们采用免疫组织化学方法(针对微管蛋白和肌酸激酶BB同工酶的反应),研究了沙土鼠双侧颈总动脉闭塞后全脑缺血期间及之后神经元损伤的进展和恢复情况。最早但可逆的缺血性损伤发生在海马体下托 - CA1和CA2区域缺血3分钟后。缺血4分钟后,损伤变为不可逆。如果缺血时间为5分钟,大脑皮质、丘脑和尾状壳核的缺血性和缺血后损伤部分或完全可逆,而在再灌注48小时后,内侧CA1区域的锥体细胞出现延迟性变性(延迟性神经元死亡)。缺血10分钟并随后再灌注后,延迟性神经元死亡从内侧CA1区域扩展到外侧CA1区域;大脑皮质、丘脑和尾状壳核的缺血性和缺血后损伤在再灌注期间也会扩大。我们的研究表明,全脑缺血中存在与不完全或局部缺血一样的选择性易损性,并提示大脑许多区域的神经元具有根据脑缺血的严重程度和持续时间进行恢复、逐渐恶化甚至延迟性神经元死亡的潜力。