Impaired perfusion following cerebrovascular stasis. A review.

Abstract

The possibility that a vascular phenomenon might contribute to the brain's inability to survive ischemia for more than several minutes was initially suggested by observations such as those of Ames and Gurian1and Neely and Youmans.2The former noted that isolated rabbit retina and optic nerve recovered nearly normal electrical activity following a 20-minute deprivation of oxygen and glucose at 37 C. The latter group demonstrated recovery of dogs from periods of up to 25 minutes of total cerebral ischemia, when produced by intrathecal infusion of saline to a pressure of 400 mm Hg resulting in exsanguination of the brain. This report summarizes the pertinent work done by the group based mostly at the Massachusetts General Hospital, demonstrating and characterizing an impairment of cerebrovascular perfusion, which begins within the first five to ten minutes of total cerebral circulatory arrest. In addition, it discusses the mechanisms that have thus