Detection of spreading depolarizations in a middle cerebral artery occlusion model in swine.

BACKGROUND: The main objective of this study was to generate a hemodynamically stable swine model to detect spreading depolarizations (SDs) using electrocorticography (ECoG) and intrinsic optical signal (IOS) imaging and laser speckle flowmetry (LSF) after a 30-h middle cerebral artery (MCA) occlusion (MCAo) in German Landrace Swine. METHODS: A total of 21 swine were used. The study comprised a training group (group 1, n = 7), a group that underwent bilateral craniectomy and MCAo (group 2, n = 10) and a group used for 2,3,5-triphenyltetrazolium (TTC) staining (group 3, n = 5). RESULTS: In group 2, nine animals that underwent MCAo survived for 30 h, and one animal survived for 12 h. We detected MCA variants with 2 to 4 vessels. In all cases, all of the MCAs were occluded. The intensity changes exhibited by IOS and LSF after clipping were closely correlated and indicated a lower blood volume and reduced blood flow in the middle cerebral artery territory. Using IOS, we detected a mean of 2.37 ± (STD) 2.35 SDs/h. Using ECoG, we detected a mean of 0.29 ± (STD) 0.53 SDs/h. Infarctions were diagnosed using histological analysis. TTC staining in group 3 confirmed that the MCA territory was compromised and that the anterior and posterior cerebral arteries were preserved. CONCLUSIONS: We confirm the reliability of performing live monitoring of cerebral infarctions using our MCAo protocol to detect SDs.

[The importance of an assessment of dysphagia for patients with a stroke]. / Bedeutung des pflegerischen Assessments von neurogener Dysphagie bei Patienten mit akutem Schlaganfall.

This paper describes a study which was carried out within a project regarding the assessment of dysphagia for patients who had suffered a stroke. The aim of this investigation was to evaluate formatively the implementation of an assessment instrument for the care of patients with dysphagia. By means of a qualitative study semi-structured interviews with six nurses of a stroke unit were carried out. The interviews were analysed using content-analysis described by Mayring. The analysis illustrated that the interviewed nurses perceived the therapeutical value of nursing for patients with dysphagia. Furthermore the participants determined that a training course on the subject of caring for patients with dysphagia was important for the development of systematic knowledge which again added to the nurses' confidence of care for patients affected by dysphagia. However the utilisation of the assessment instrument developed by means of the project was problematic as described by the nurses participating in this study.