Cerebralcare Granule, a Chinese herb compound preparation, improves cerebral microcirculatory disorder and hippocampal CA1 neuron injury in gerbils after ischemia-reperfusion.

AIM OF THE STUDY: Cerebralcare Granule (CG) is a Chinese herb compound preparation that has been used for treatment of cerebrovascular related diseases. However, the effect of post-treatment with CG on ischemia and reperfusion (I/R) induced cerebral injury is so far unclear. MATERIALS AND METHODS: In present study, cerebral global I/R was induced in Mongolian gerbils by clamping bilateral carotid arteries for 30 min followed by reperfusion for 5 days, and CG (0.4 g/kg or 0.8 g/kg) was administrated 3h after the initiation of reperfusion. RESULTS: Post-treatment with CG for 5 days attenuated the I/R-induced production of hydrogen peroxide in, leukocyte adhesion to, and albumin leakage from cerebral microvessels, and, meanwhile, protected neuron from death, reduced the number of caspase-3- and Bax-positive cells, and increased Bcl-2-positive cells in hippocampal CA1 region. CONCLUSION: The results suggest that CG given after initiation of reperfusion is able to ameliorate cerebral microvascular dysfunction and hippocampal CA1 neuron damage caused by I/R.

Iron stores and cerebral veins in MS studied by susceptibility weighted imaging.

AIM: In this paper, we seek to determine whether the iron deposition as seen by susceptibility weighted imaging (SWI) in the basal ganglia and thalamus of patients with multiple sclerosis is greater than the iron content measured in normal subjects (individuals unaffected by multiple sclerosis). As increased iron content may result from increased venous pressure, such information would add credence to the concept of Zamboni et al (1) that MS is caused by chronic cerebrospinal venous insufficiency. METHODS: Fourteen MS patients were recruited for this study with a mean age of 38 years ranging from 19 to 66 year-old. A velocity compensated 3D gradient echo sequence was used to generate SW images with a high sensitivity to iron content. We evaluated iron in the following structures: substantia nigra, red nucleus, globus pallidus, putamen, caudate nucleus, thalamus and pulvinar thalamus. Each structure was broken into two parts, a high iron content region and a low iron content region. The measured values were compared to previously established baseline iron content in these structures as a function of age. RESULTS: Twelve of fourteen patients had an increase in iron above normal levels and with a particular pattern of iron deposition in the medial venous drainage system that was associated with the confluence of the veins draining that structure. CONCLUSION: Iron may serve as a biomarker of venous vascular damage in multiple sclerosis. The backward iron accumulation pattern seen in the basal ganglia and thalamus of most MS patients is consistent with the hypothesis of venous hypertension.

Susceptibility-weighted magnetic resonance imaging detects impaired cerebral hemodynamics in the superior sagittal sinus thrombosis--case report.

An 11-year-old female receiving treatment for acute lymphoblastic leukemia presented with superior sagittal sinus (SSS) thrombosis. T(1)-weighted, T(2)-weighted, and fluid-attenuated inversion recovery magnetic resonance (MR) imaging, and MR venography showed that the SSS was totally occluded by thrombus. Susceptibility-weighted MR imaging showed hypointense thrombus in the SSS and markedly dilated cortical veins over the bilateral cerebral hemispheres. Two days later, her symptoms had slightly resolved. Iodine-123 N-isopropyl-p-iodoamphetamine single photon emission computed tomography showed marked decrease of cerebral blood flow in the bilateral frontal lobes, indicating that venous congestion had disturbed the cerebral hemodynamics. MR venography showed that the SSS was still mostly occluded, but susceptibility-weighted imaging showed that the dilation of the cortical veins was less marked, suggesting that collateral venous routes had gradually developed. The finding of dilated cortical veins had almost disappeared at 28 days after the onset. Susceptibility-weighted imaging can be used as a non-invasive method to monitor the severity of venous congestion caused by cerebral venous sinus thrombosis.

Cerebral venous thrombosis associated with iron deficiency anemia.

A 55-year-old man presented with generalized seizures and postictal left hemiparesis. Computed tomography scanning of his head showed a low density area in the right frontal lobe. Cerebral angiography demonstrated a partial defect in the superior sagittal sinus and cortical veins, indicating the presence of cerebral venous thrombosis. He had bleeding from a peptic ulcer and the laboratory data revealed iron deficiency anemia concomitant with an elevation of D-dimer and thrombin-antithrombin III complex (TAT). After the anemia resolved with the treatment of the peptic ulcer and iron supplementation, the TAT and D-dimer levels were normalized, and the occluded veins were recanalized. In a cerebral venous thrombosis associated with iron deficiency anemia, treatment for the anemia may improve hypercoagulable state without antithrombotic therapy, although the long-term monitoring of TAT and D-dimer levels is required.

Accidental cerebral venous gas embolism in a young patient with congenital heart disease.

This article describes an 11-year-old girl with a diagnosis of Ebstein's anomaly. Glenn and Fontan surgeries were performed successfully. She had a generalized tonic-clonic seizure after peripheral intravenous infusion under pressure. A computed tomography brain scan performed 30 minutes later showed multiple serpiginous hypodensities in the cortical sulci and in the superior longitudinal sinus compatible with cerebral venous gas embolism. At follow-up 1 month later, the girl had severe motor impairment. Cerebral gas embolism should be considered in a patient with risk factors and acute neurological symptoms in order to select the treatment of choice, hyperbaric oxygen, and reduce damage to brain tissues.

Single photon emission computed tomography of reversible magnetic resonance imaging abnormalities of deep cerebral venous thrombosis accompanied with malignant glioma.

BACKGROUND: Deep cerebral venous thrombosis with reversible MRI findings in bilateral thalamus have been scarcely described in the literature, but none mentioned the SPECT findings such as in our case. CASE DESCRIPTION: A 43-year-old woman presented with cerebral venous thrombosis accompanied with malignant glioma. T(2)- and diffusion-weighted MRI showed high intensity with a mass lesion in the left frontal lobe and mild high and high intensity in the right frontal lobe, parietal lobe, and bilateral thalamus. Cerebral angiography showed occlusions of the SSS and the DCVs. Furthermore, the initial SPECT showed apparent hypoperfusion in the same lesions on MRI. After the treatment involving infusion therapy and surgery, she recovered with a mild cognitive deficit. Although the repeat T(2)- and diffusion-weighted MRI revealed the disappearance of high intensity, the repeat SPECT showed the persistent hypoperfusion in the infarcted lesions. CONCLUSION: There might be a discrepancy between MRI and SPECT findings of the reversible case of DCVT, and SPECT also could be useful for the evaluation of the amelioration of DCVT.

The spectrum of presentations of venous infarction caused by deep cerebral vein thrombosis.

The classic features of thrombosis of the deep cerebral venous system are severe dysfunction of the diencephalon, reflected by coma and disturbances of eye movements and pupillary reflexes, resulting in poor outcome. However, partial syndromes without a decrease in the level of consciousness or brainstem signs exist, which may lead to initial misdiagnoses. The spectrum of clinical symptoms reflects the degree of venous congestion, which depends not only on the extent of thrombosis in the deep veins but also on the territory of the involved vessels and the establishment of venous collaterals. For example, thrombosis of the internal cerebral veins with (partially) patent basal veins and sufficient collaterals may result in relatively mild symptoms. Deep cerebral venous system thrombosis is an underdiagnosed condition when symptoms are mild, even in the presence of a venous hemorrhagic congestion. Identification of venous obstruction has important therapeutic implications. The diagnosis should be strongly suspected if the patient is a young woman, if the lesion is within the basal ganglia or thalamus, and especially if it is bilateral.

[The effect of transcranial electroanalgesia on the neurophysiological indices in patients with cerebral venous dystonia]. / Vliianie transkranial'noi élektroanalgezii na nekotorye neirofiziologicheskie pokazateli u bol'nykh s tserebral'noi venoznoi distoniei.

In the paper, results are presented of investigation into the effects of transcranial electroanalgesia (TCEA), a novel nonmedicamentous method of treatment, on certain neurophysiological parameters in patients with cerebral venous dystonia. TCEA is shown to be an efficient treatment option in the above group of patients.

[The effect of 3-hydroxypyridine derivatives on postischemic disorders in the autoregulatory reactions of the cerebral vessels]. / Vliianie proizvodnykh 3-oksipiridina na postishemicheskie narusheniia autoreguliatornykh reaktsii mozgovykh sosudov.

Acute experiments on nembutal anesthetized rats showed improvement of cerebral blood flow autoregulation in the postischemic period under the effect of mexidol and the new 3-hydroxypyridine (3-HOP) derivatives LBK-10 and LBK-38 administered for prophylactic and therapeutic, purposes. The role of dopaminergic activity, solubility in lipids, and other factors in the mechanism of the activity of 3-HOP derivatives is analysed.