Abstract

Introduction: Hemorrhagic transformation (HT) is an uncommon but adverse complication after a stroke that can cause secondary injury. We sought to determine whether glyburide can reduce HT in an ischemia/reperfusion model of stroke. Materials and Methods: We used a transient filament occlusion of the middle cerebral artery (tMCAo), with three hours of cerebral ischemia. Glyburide (n=10) was administered as an intravenous bolus followed by a subcutaneous continuous infusion using an osmotic pump to deliver a dose of 39.5 ug/day. Control animals (n=10) were administered dimethyl sulfoxide vehicle. At 48 hours, infarct size, brain edema and HT were analyzed. HT was quantified using three methods, 1) a categorical designation based on European Cooperative Acute Stroke Study (ECASS) criteria, 2) densitometry of color images and 3) direct measurement of the hemoglobin concentration using spectrophotometry. Results: Compared to vehicle control, continuous glyburide treatment improved neurological outcome (7.6±1.0 vs. 6.0±0.9, P<0.01), reduced infarct volume (323±42 vs. 484±60mm 3 , P<0.01), swelling volume (10±4 vs. 28±7%, P<0.01) and water content (84±1 vs. 85±1%, P<0.05). Glyburide administration also reduced HT based on ECASS categories, densitometry on color images (0.9±0.1 vs. 1.1±0.1, P<0.01) and quantitative evaluation of hemoglobin (2.7±1.5 vs. 5.1±2.6uL, P<0.05). Conclusion: In a prolonged ischemia/reperfusion model, glyburide reduced the amount of hemorrhagic transformation. Clinical evaluation of glyburide in combination with mechanical thrombectomy may be warranted in patients.

Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call