Cerebral Blood Flow Disturbances Research Articles

Effect of early vs. delayed extubation on functional outcome among patients with acute ischemic stroke treated with endovascular thrombectomy under general anesthesia: the prospective, randomized controlled EDESTROKE trial study protocol

BackgroundRecent meta-analyses and randomized studies have shown that among patients with acute ischemic stroke undergoing endovascular thrombectomy, general anesthesia with mechanical ventilation is associated with better functional status compared to local anesthesia and sedation, and they recommend its use. But once the procedure is completed, when is the optimal moment for extubation? Currently, there are no guidelines recommending the optimal moment for extubation. Prolonged mechanical ventilation time could potentially be linked to increased complications such as pneumonia or disturbances in cerebral blood flow due to the vasodilatation produced by most anesthetic drugs. However, premature extubation in a patient who has suffered a stroke could led to complications such as agitation, disorientation, abolished reflexes, sudden fluctuations in blood pressure, alterations in cerebral blood flow, respiratory distress, bronchial aspiration, and the need for reintubation. We therefore designed a randomized study hypothesizing that early compared with delayed extubation is associated with a better functional outcome 3 months after endovascular thrombectomy treatment under general anesthesia for acute ischemic stroke.MethodsThis investigator-initiated, single-center, prospective, parallel, evaluated blinded, superiority, randomized controlled trial will include 178 patients with a proximal occlusion of the anterior circulation treated with successful endovascular thrombectomy (TICI 2b-3) under general anesthesia. Patients will be randomly allocated to receive early (< 6 h) or delayed (6–12 h) extubation after the procedure. The primary outcome measure is functional independence (mRS of 0–2) at 90 days, measured with the modified Rankin Score (mRS), ranging from 0 (no symptoms) to 6 (death).DiscussionThis will be the first trial to compare the effect of mechanical ventilation duration (early vs delayed extubation) after satisfactory endovascular thrombectomy for acute ischemic stroke under general anesthesia.Trial registrationThe study protocol was approved April 11, 2023, by the by the Santiago-Lugo Research Ethics Committee (CEI-SL), number 2023/127, and was registered into the clinicaltrials.gov clinical trials registry with No. NCT05847309. Informed consent is required. Participant recruitment begins on April 18, 2023. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences.

Efficacy and safety assessment of different electrode placements during electroconvulsive therapy for the treatment of depression: a comparison of bitemporal, bifrontal and unilateral right-sided stimulation - a narrative review

Introduction: Consequences of depressive syndrome are changes in central nervous system, especially the reduction in volume and disturbances in neuronal metabolism. There are disturbances in cerebral blood flow, in areas responsible for concentration, memory and regulation of behaviour and emotions. ECT method has shown considerable effectiveness in treatment of depression. It has invariably remained effective as a form of treatment in psychiatry for many years. The way in which the method itself is applied and location of stimulation electrodes remains controversial. In clinical practice, bitemporal, bilateral or right unilateral applications are used, each of which activates slightly different regions in brain, resulting in different therapeutic effects. Methods: A review of available literature was performed by searching PubMed and Google Scholar databases, using the following keywords: bifrontal ECT, bitemporal ECT, right unilateral ECT, cognitive function for original papers, meta-analyses and review papers in Polish and English published from 1990 to 2022. The SANRA scale was used to maintain the high quality of the narrative review. Results: All three methods are effective in treating depressive disorders, but differ in impact on cognitive function. Bi-frontal stimulation is the most effective in emergencies, however related to a higher risk of cognitive impairment. Milder cognitive impairment, with similar therapeutic efficacy, is observed with bitemporal and unilateral placement. Conclusions: Individualised selection of ECT method is recommended, depending on patients' needs and clinical condition. The importance of individualising the dose, location of electrodes, and monitoring of cognitive function is emphasised in order to increase the effectiveness and minimise side effects. Keywords: bifrontal ECT, bitemporal ECT, right unilateral ECT, cognitive function

Regional contribution of vascular dysfunction in white matter dementia: clinical and neuropathological insights.

The maintenance of adequate blood supply and vascular integrity is fundamental to ensure cerebral function. A wide range of studies report vascular dysfunction in white matter dementias, a group of cerebral disorders characterized by substantial white matter damage in the brain leading to cognitive impairment. Despite recent advances in imaging, the contribution of vascular-specific regional alterations in white matter dementia has been not extensively reviewed. First, we present an overview of the main components of the vascular system involved in the maintenance of brain function, modulation of cerebral blood flow and integrity of the blood-brain barrier in the healthy brain and during aging. Second, we review the regional contribution of cerebral blood flow and blood-brain barrier disturbances in the pathogenesis of three distinct conditions: the archetypal white matter predominant neurocognitive dementia that is vascular dementia, a neuroinflammatory predominant disease (multiple sclerosis) and a neurodegenerative predominant disease (Alzheimer's). Finally, we then examine the shared landscape of vascular dysfunction in white matter dementia. By emphasizing the involvement of vascular dysfunction in the white matter, we put forward a hypothetical map of vascular dysfunction during disease-specific progression to guide future research aimed to improve diagnostics and facilitate the development of tailored therapies.

Aortic Isthmus Retrograde Blood Flow in Intrauterine Child as a Sign of the Terminal Stage of Placental Dysfunction: Clinical Observation

Background. Aortic isthmus retrograde blood flow in intrauterine children with growth delay and centralization of blood circulation in the late stages of placental dysfunction is associated with a high risk of perinatal death. Timely diagnosis of such condition is crucial to select further obstetric tactics and delivery time. Clinical case description. Growth delay and absent end-diastolic flow in umbilical artery and no A-wave in the venous duct were diagnosed in intrauterine child (gestational age — 36 weeks) at ultrasound study. Peripheral resistance indices in middle cerebral artery in the intrauterine child were lower than peripheral resistance indices in umbilical artery. Color Doppler imaging has revealed aortic isthmus retrograde blood flow. The woman was recommended delivery due to critical circulatory disorder in the intrauterine child. Female child was delivered via Caesarean section, child’s weight — 890 g, APGAR score — 3/4. The newborn girl died due to multi-organ failure within the first day.Conclusion. Revealing the retrograde blood flow in intrauterine child in the aortic isthmus throughout the entire ventricular diastole is an unfavorable prognostic sign of the terminal stage of cerebral blood flow disturbance associated with placental dysfunction.

Perfusion Imaging of Traumatic Brain Injury.

The mechanisms for regulating cerebral blood flow (CBF) are highly sensitive to traumatic brain injury (TBI). The perfusion imaging technique may be used to assess CBF and identify perfusion abnormalities following a TBI. Studies have identified CBF disturbances across the injury severity spectrum and correlations with both acute and long-term indices of clinical outcome. Although not yet widely used in the clinical context, this is an important area of ongoing research.

Cerebral blood flow patterns in preterm and term neonates assessed with pseudo-continuous arterial spin labeling perfusion MRI.

In preterm (PT) infants, regional cerebral blood flow (CBF) disturbances may predispose to abnormal brain maturation even without overt brain injury. Therefore, it would be informative to determine the spatial distribution of grey matter (GM) CBF in PT and full-term (FT) newborns at term-equivalent age (TEA) and to assess the relationship between the features of the CBF pattern and both prematurity and prematurity-related brain lesions. In this prospective study, we obtained measures of CBF in 66 PT (51 without and 15 with prematurity-related brain lesions) and 38 FT newborns through pseudo-continuous arterial spin labeling (pCASL) MRI acquired at TEA. The pattern of GM CBF was characterized by combining an atlas-based automated segmentation of structural MRI with spatial normalization and hierarchical clustering. The effects of gestational age (GA) at birth and brain injury on the CBF pattern were investigated. We identified 4 physiologically-derived clusters of brain regions that were labeled Fronto-Temporal, Parieto-Occipital, Insular-Deep GM (DGM) and Sensorimotor, from the least to the most perfused. We demonstrated that GM perfusion was associated with GA at birth in the Fronto-Temporal and Sensorimotor clusters, positively and negatively, respectively. Moreover, the presence of periventricular leukomalacia was associated with significantly increased Fronto-Temporal GM perfusion and decreased Insular-DGM perfusion, while the presence of germinal matrix hemorrhage appeared to mildly decrease the Insular-DGM perfusion. Prematurity and prematurity-related brain injury heterogeneously affect brain perfusion. ASL MRI may, therefore, have strong potential as a noninvasive tool for the accurate stratification of individuals at risk of domain-specific impairment.

GAMBARAN KARAKTERISTIK DAN RESPON CAREGIVER DALAM MEMBERIKAN PERAWATAN PENDERITA STROKE DI WILAYAH KERJA PUSKESMAS SAWAH LEBAR KOTA BENGKULU

Stroke can be defined as an acute neurological disorder due to disturbances in cerebral blood flow that cause disability or death Caregiver is a caregiver who is responsible for individuals who have limitations due to age, disability, illness or mental disorder and aims to help carry out daily activities. The purpose of this study is to describe the characteristics of caregiver stroke respondents and stroke survivors in the work area of ​​the Sawah Lebar Public Health Center, Bengkulu City . The design of this study was descriptive with purpose sampling with a sample size of 35 people. In this study, the Instrument Reactions To Caregiving Questionnaire was given the number of samples using theformula slovin with a sample of 35 people. The data analysis in this research is descriptive analysis. The results of this study are &gt;75% Responsive with 26 respondents caregiver

BOBATH THERAPY AS AN EARLY STROKE PREVENTION EFFORT

In ischemic stroke patients, the main problem that occurs is cerebral blood flow disturbances. Global Burden Disease data shows that 80% of the population is ischemic stroke and 20% hemorrhagic stroke with a moderate level of neurological deficit of 89%. Nursing actions that can be taken are by providing activities to stroke patients to increase cerebral blood flow. The implementation of this community service activity aims to teach Cadres and the community regarding Bobath Therapy as an early stroke prevention effort. The method used in this community service activity is to provide training and education health services. This activity was carried out during April-May 2022 which was attended by 12 health cadres and 22 residents in RW 06 Wonokromo Village, Surabaya. The results show that the activity has achieved success according to the success indicators that have been set, namely as many as 12 health cadres were successfully recruited; average attendance is 100%, participants participate in activities enthusiastically, knowledge of cadres after training and residents after counseling increases significantly

Overview of Anti-platelet Drug Use in Ischemic Stroke Patients at UKI General Hospital in 2015

Stroke is an acute neuro-deficit disease that occurs when there is a disturbance of cerebral blood flow. There are two kinds of stroke, hemorrhagic stroke and ischemic stroke. Ischemic stroke is a stroke that occurs due to the formation of thrombosis and emboli. Thrombosis and emboli block the bloodstream in small blood vessels or prominent blood vessels. Drugs that can cause disturbance to the hemostasis mechanism, such as antiplatelets, are usually used on stroke management. This study aims to know the types and amounts of antiplatelet drugs used on stroke ischemic patients in UKI General Hospital from January to December 2015. This research showed that stroke ischemic occurs more often at age 61 -70 (43%). There are no significant differences between both genders, the most common drugs are Aspilet 80 mg (22 times). For combination drugs, Clopidogrel with Aspilet is used more often than Clopidogrel with Ascardia.&#x0D; Keywords: stroke, thrombosis, antiplatelet

Dopplerographic features of venous cerebral blood flow disorders in acute period of ischemic stroke

The article analyzes results of a Doppler study of brachiocephalic vessels in the acute period of ischemic stroke. The role of the venous link of blood flow in maintaining the intracerebral constant in the acute period of ischemic stroke was revealed. The features of the reactivity of cerebral venous hemodynamics in patients with different volumes of brain damage during the formation of ischemic foci of various localization are shown. Attention is paid to the importance of a comprehensive assessment of cerebral venous circulation in the acute period of ischemic stroke. It was shown that in patients with ischemic stroke involving one or two lobes of one hemisphere of the brain, there was a significant increase in the size of the areas and a significant decrease in the speed indicators in the internal jugular and vertebral veins, respectively, the localization of the ischemic focus. It was found that in hemispheric ischemic strokes with signs of cerebral edema, cerebral blood flow disturbances were maximal and were accompanied by a paradoxical reaction of hemodynamic compensatory mechanisms, but no lateralization of dysgemia was observed according to the focus of ischemia.

Prospective Pilot Clinical Study of Noninvasive Cerebrovascular Autoregulation Monitoring in Open-Angle Glaucoma Patients and Healthy Subjects.

PurposeTo analyze the cerebrovascular autoregulation (CA) dynamics in patients with normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) as well as healthy subjects using noninvasive ultrasound technologies for the first time.MethodsThe CA status of 10 patients with NTG, 8 patients with HTG, and 10 healthy subjects was assessed, using an innovative noninvasive ultrasonic technique, based on intracranial blood volume slow-wave measurements. Identified in each participant were intraocular pressure, ocular perfusion pressure, and CA-related parameter volumetric reactivity index (VRx), as well as the duration and doses of the longest cerebral autoregulation impairment (LCAI). In addition, we calculated the associations of these parameters with patients’ diagnoses.ResultsThe VRx value, the LCAI dose, and duration in healthy subjects were significantly lower than in patients with NTG (P < 0.05). However, no significant differences were noted in these parameters between healthy subjects and HTG and between NTG and HTG groups.ConclusionsNTG is associated with the disturbed cerebral blood flow and could be diagnosed by performing noninvasive CA assessments.Translational RelevanceThe VRx monitoring method can be applied to a wider range of patient groups, especially patients with normal-tension glaucoma.

Visualization of Carotid Doppler in Patients with Ischemic Stroke at Dr. Hasan Sadikin General Hospital Bandung Year 2016-2019

Background: Various pathological changes in both the intra and extracranial arteries that supply the brain can cause disturbance of cerebral blood flow and perfusion leading to cerebral dysfunction. Doppler ultrasound is able to assess these changes. This study was performed to evaluate the anatomical and physiological changes found in the carotid arteries of patients with ischemic stroke using Doppler ultrasound. Met h ods: The cross-sectional descriptive study design with total sampling method was conducted on the medical records of ischemic stroke patients who had carotid Doppler ultrasound at the Department of Cardiology and Vascular Medicine Dr. Hasan Sadikin General Hospital Bandung from 2016 to 2019. Demographic data, such as stroke diagnoses and plaque characteristics recorded in the Doppler reports were collected. Result s : There were 38 data sets collected. The distribution and characteristics of atherosclerotic plaques were similar between the two carotid systems, with the same percentage of plaque being found in the right (31.6%) and left (36.8%) carotid system. The most common type of plaque found was type III and was located in the common carotid artery. Thrombus was absent in all patients. Intimal media thickening was found in 13.2% right system and 15.8% left system. Stenosis was present in 34.2% of patients, and most had &lt;50% stenosis. Peak systolic velocity increased ( &gt; 125 cm/s) in 5.3% of the right system and 7.9% of the left system of the internal carotid artery. Conclusion s : Most of the atherothrombotic and thromboembolic type of ischemic stroke patients in this study have normal carotid Doppler ultrasound features. Further study on the presence of plaque in ischemic stroke patients in Indonesia is needed.

Increased cerebral endothelium-dependent vasodilation in rats in the postcardiac arrest period.

Cardiovascular lability is common after cardiac arrest. We investigated whether altered endothelial function is present in cerebral and mesenteric arteries 2 and 4 h after resuscitation. Male Sprague-Dawley rats were anesthetized, intubated, ventilated, and intravascularly catheterized whereupon rats were randomized into four groups. Following 7 min of asphyxial cardiac arrest and subsequent resuscitation, cardiac arrest and sham rats were observed for either 2 or 4 h. Neuron-specific enolase levels were measured in blood samples. Middle cerebral artery segments and small mesenteric arteries were isolated and examined in microvascular myographs. qPCR and immunofluorescence analysis were performed on cerebral arteries. In cerebral arteries, bradykinin-induced vasodilation was inhibited in the presence of either calcium-activated K+ channel blockers (UCL1684 and senicapoc) or the nitric oxide (NO) synthase inhibitor, Nω-nitro-L-arginine methyl ester hydrochloride (l-NAME), whereas the combination abolished bradykinin-induced vasodilation across groups. Neuron-specific enolase levels were significantly increased in cardiac arrest rats. Cerebral vasodilation was comparable between the 2-h groups, but markedly enhanced in response to bradykinin, NS309 (an opener of small and intermediate calcium-activated K+ channels), and sodium nitroprusside 4 h after cardiac arrest. Endothelial NO synthase and guanylyl cyclase subunit α-1 mRNA expression was unaltered after 2 h, but significantly decreased 4 h after resuscitation. In mesenteric arteries, the endothelium-dependent vasodilation was comparable between corresponding groups at both 2 and 4 h. Our findings show enhanced cerebral endothelium-dependent vasodilation 4 h after cardiac arrest mediated by potentiated endothelial-derived hyperpolarization and NO pathways. Altered cerebral endothelium-dependent vasodilation may contribute to disturbed cerebral perfusion after cardiac arrest.NEW & NOTEWORTHY This is the first study, to our knowledge, to demonstrate enhanced endothelium-dependent vasodilation in middle cerebral arteries in a cardiac arrest rat model. The increased endothelium-dependent vasodilation was a result of potentiated endothelium-derived hyperpolarization and endothelial nitric oxide pathways. Immunofluorescence microscopy confirmed the presence of relevant receptors and eNOS in cerebral arteries, whereas qPCR showed altered expression of genes related to guanylyl cyclase and eNOS. Altered endothelium-dependent vasoregulation may contribute to disturbed cerebral blood flow in the postcardiac arrest period.

Acute and Chronic Effects of Multiple Concussions on Midline Brain Structures.

To test the hypothesis that a history of concussion (HOC) causes greater disturbances in cerebral blood flow (CBF) and white matter microstructure of midline brain structures after subsequent concussions, during the acute and chronic phases of recovery. In this longitudinal MRI study, 61 athletes with uncomplicated concussion (36 with HOC) were imaged at the acute phase of injury (1-7 days after injury), the subacute phase (8-14 days), medical clearance to return to play (RTP), 1 month after RTP, and 1 year after RTP. A normative group of 167 controls (73 with HOC) were also imaged. Each session assessed CBF of the cingulate cortex, along with fractional anisotropy (FA) and mean diffusivity (MD) of the corpus callosum. Linear mixed models tested for interactions of HOC with time since injury. The Sport Concussion Assessment Tool (SCAT) was also used to evaluate effects of HOC on symptoms, cognition, and balance. Athletes with HOC had significantly greater declines in midcingulate CBF subacutely (z = -3.29, p = 0.002) and greater declines in posterior cingulate CBF at 1 year after RTP (z = -2.42, p = 0.007). No significant effects of HOC were seen for FA, whereas athletes with HOC had higher MD of the splenium at RTP (z = 2.54, p = 0.008). These effects were seen in the absence of significant differences in SCAT domains (|z| ≤ 1.14, p ≥ 0.256) or time to RTP (z = 0.23, p = 0.818). Results indicate subacute and chronic effects of HOC on cingulate CBF and callosal microstructure in the absence of differences in clinical indices. These findings provide new insights into physiologic brain recovery after concussion, with cumulative effects of repeated injury detected among young, healthy athletes.

Usefulness of Cerebral Oximetry in TBI by NIRS.

Measurement of cerebral oximetry by near-infrared spectroscopy provides continuous and non-invasive information about the oxygen saturation of haemoglobin in the central nervous system. This is especially important in the case of patients with traumatic brain injuries. Monitoring of cerebral oximetry in these patients could allow for the diagnosis of inadequate cerebral oxygenation caused by disturbances in cerebral blood flow. It could enable identification of episodes of hypoxia and cerebral ischemia. Continuous bedside measurement could facilitate the rapid diagnosis of intracranial bleeding or cerebrovascular autoregulation disorders and accelerate the implementation of treatment. However, it should be remembered that the method of monitoring cerebral oximetry by means of near-infrared spectroscopy also has its numerous limitations, resulting mainly from its physical properties. This paper summarizes the usefulness of monitoring cerebral oximetry by near-infrared spectroscopy in patients with traumatic brain injury, taking into account the advantages and the disadvantages of this technique.

Impairments in brain perfusion, executive control network, topological characteristics, and neurocognition in adult patients with asymptomatic Moyamoya disease

BackgroundAsymptomatic Moyamoya disease (MMD) impairs hemodynamic and cognitive function. The relationship between these changes, cerebral blood flow (CBF), and network connectivity remains largely unknown. The aim of this study was to increase understanding of the relationship between CBF, functional networks, and neurocognition in adults with asymptomatic MMD. We compared CBF and functional status in 26 patients with MMD and 20 healthy controls using arterial spin labeling and resting state functional magnetic resonance imaging sequences. At the same time, a detailed cognitive test was performed in 15 patients with no cerebral or lumen infarction who were selected by magnetic resonance imaging-T2 FLAIR screening.ResultsCompared to the controls, the patients showed varying degrees of decline in their computational ability (simple subtraction, p = 0.009; complex subtraction, p = 0.006) and short-term memory (p = 0.042). The asymptomatic MMD group also showed decreased CBF in the left anterior central and left inferior frontal gyri of the island flap with multiple node abnormalities in the brain network and reduced network connectivity. There was a significant association of these changes with cognitive decline in the MMD group.ConclusionsIn patients with asymptomatic MMD, disturbance of CBF and impaired brain network connections may be important causes of cognitive decline and appear before clinical symptoms.Clinical trial registration-URL: http://www.chictr.org.cnUnique identifier: ChiCTR1900023610

Single Center Experience in Cerebrospinal Fluid Dynamics Testing.

Normal pressure hydrocephalus is more complex than a simple disturbance of the cerebrospinal fluid (CSF) circulation. Nevertheless, an assessment of CSF dynamics is key to making decisions about shunt insertion, shunt malfunction, and for further management if a patient fails to improve. We summarize our 25years of single center experience in CSF dynamics assessment using pressure measurement and analysis. 4473 computerized infusion tests have been performed. We have shown that CSF infusion studies are safe, with incidence of infection at less than 1%. Raised resistance to CSF outflow positively correlates (p<0.014) with improvement after shunting and is associated with disturbance of cerebral blood flow and its autoregulation (p<0.02). CSF infusion studies are valuable in assessing possible shunt malfunction in vivo and for avoiding unnecessary revisions. Infusion tests are safe and provide useful information for clinical decision-making for the management of patients suffering from hydrocephalus.

Reducing intraventricular hemorrhage in preterm babies less than 30 weeks of gestation in neonatal intensive care unit, level III: A bundle of care

Intraventricular hemorrhage (IVH) is bleeding into the brain's ventricular system or around the ventricles. The etiology of IVH is multifactorial and is primarily attributed to the fragility of the germinal matrix vasculature and disturbance of cerebral blood flow. IVH is rarely present at birth. Infants born before the 30th week of gestation and weighting <1500 g at birth are at risk for this type of bleeding. The smaller and more premature, unstable infants are at the highest risk for IVH. It occurs more often in the first several days of life. This situation creates immense burden and dilemma for health-care providers mainly when challenged by family choice to withdraw support or do-not-resuscitate incompatible with country law. Purpose: To reduce the overall incidence of IVH to <10% among preterm babies born <30 weeks of gestation using a neuro bundle of care. Methodology: A quality descriptive improved project was conducted in one government sector hospital in Abu Dhabi, Level III neonatal intensive care unit. It was a retrospective study where the data were collected from 2018 to 2019. A multidisciplinary team was formed to implement the neurobundle. Descriptive statistics were used to describe the demographic and clinical finding of the project. Results: Five out of 32 infants and 1 out of 17 infants developed IVH (Grade IV), respectively, in 2018 and 2019. Conclusion: The IVH rate in premature neonates has reduced drastically from 19% (preintervention) to 6% (postintervention) due to implementation IVH bundle and staff compliance.

Neuroprotective effects of Apium graveolens against focal cerebral ischemia occur partly via antioxidant, anti-inflammatory, and anti-apoptotic pathways.

Stroke is a neurological disease caused by a sudden disturbance of cerebral blood flow to the brain, leading to loss of brain function. Recently, accumulating lines of evidence have suggested that dietary enrichment with nutritional antioxidants could reduce brain damage and improve cognitive function. In this study, we investigated the possible protective effects of Apium graveolens, a medicinal plant with putative neuroprotective activity, against oxidative-stress-related brain damage and brain damage due to inflammation induced by focal cerebral ischemia. Male adult Wistar rats were administered with an extract of A. graveolens orally 14 days before permanent occlusion of their right middle cerebral artery. The brain infarct volumes of rats in each group were determined by 2,3,5-triphenyltetrazolium chloride staining, and the density of neurons in the cortex and hippocampus of rats was determined by cresyl violet staining. The levels of malondialdehyde, catalase, glutathione peroxidase, and superoxide dismutase in the cerebral cortex and hippocampus of the rats were also quantified at the end of the study period. Our results show that A. graveolens extract significantly decreased infarct volume and improved neuronal density in the cortex and hippocampus of rats receiving A. graveolens extract compared with those rats receiving no treatment. This neuroprotective effect was found to occur partly due to antioxidant, anti-inflammatory, and anti-apoptotic effects. Our study demonstrates that A. graveolens helps to reduce the severity of cognitive damage caused by focal cerebral ischemia. © 2020 Society of Chemical Industry.

Glaucoma and cerebral blood flow autoregulation: Pilot study

Glaucoma is a leading cause of irreversible blindness worldwide. Although high tension glaucoma (HTG) is associated with increased intraocular pressure, the causes of normal tension glaucoma (NTG) are controversial. We hypothesize that NTG can be related with disturbed cerebral blood flow, therefore, our objective was to explore cerebrovascular autoregulation (CA) status in glaucoma patients. Pilot study of non-invasive CA monitoring included 10NTG patients, 8HTG patients and 10 volunteers in control group. All participants were 63–80 y/o. CA status was monitored by using non-invasive ultrasonic CA monitoring technology based on intracranial blood volume (IBV) slow-wave measurement. Real-time recording of volumetric reactivity index (VRx(t)) was used in order to identify dynamics of CA changes. VRx(t) reflects a time dependence of a phase shift between non-invasively measured IBV(t) and arterial blood pressure ABP(t) slow-waves. Mean values of VRx(t) and SD were as follows: control mVRx = −0.179, SD = 0.22; NTG mVRx = 0.056, SD = 0.168 and HTG mVRx = −0.070, SD = 0.249 (Fig. 1). Statistically significant differences were found in comparing mVRx indexes as well as duration of longest CA impairment events in NTG and control group (Mann-Whitney U tests P = 0.025 and P = 0.007, respectively). However, these differences were not significant in HTG and control group. By using this non-invasive technology, it has been shown for the first time that CA status is deteriorated in NTG patients and that mean VRx(t) values are statistically significantly different comparing NTG and control groups. We didn't find statistically significant difference between HTG and control group.