Temporal evolution of neuronal changes in cerebral hypoxia-ischemia in developing rats: a quantitative light microscopic study.

Studies in adult animal models of transient cerebral hypoxia-ischemia (HI) and ischemia suggest that morphologic evidence of neuronal death in some regions such as striatum appears early, while in other regions such as cerebral cortex and CA1 region of hippocampus it is delayed for few days and is referred to as delayed neuronal death (DND). Moreover, in some regions such as CA2/CA3 early 'reactive' neuronal changes occur that are potentially reversible. The aim of this study was to determine whether such changes may also occur in the developing brain. To that end, unilateral cerebral HI was produced in postnatal rats of 13, 21, and 30 days (p13, p21, p30) by right common carotid artery ligation and hypoxemia (breathing 8% O2), and their brains were examined at 24 h, 36 h, 72 h, and 96 h of recovery. The results suggest that: (i) DND is present in developing brain, but its regional distribution varies with animals' age. In cerebral cortex, it is more pronounced in p30 rats than in younger animals. In hippocampus, comparison of lesions of similar severity at different age groups shows a more pronounced DND in CA2/CA3 region of p13 rats than in older animals, but no significant differences exist in the degree of DND in CA1 neurons among different age groups. (ii) 'Reactive' neuronal changes characterized by reduction in Nissl staining and acidophilia of neuronal perikaryon with minimal nuclear abnormality are present at 24 h of recovery. These changes in some regions, such as in CA1 and cortex, progress to neuronal death, while in other regions such as in CA2/CA3 are potentially reversible. (iii) Recovery of reactive neurons in CA2/CA3 region is age dependent in that there is significant recovery in the older age groups, but not in p13 rats. The pathogenetic mechanisms of the reactive neuronal changes, the chain of events leading to DND or neuronal recovery, and the influence of age in these processes remain to be elucidated.