Ischemia and Hypoxia

Question 1

What microscopic changes are seen at different time intervals in ischemic stroke?

Answer 1

Under 6 hrs: cell swelling and edema

6-12 hrs: shrinking of the cell, incrustations

24 hrs: PMNs accumulate

48 hrs: PMNs peak

3-5 days: macrophages arrive

2 weeks: vessels form around the periphery and enhancement begins

Question 2

Ischemic penumbra is associated with blood flow between ______.

Answer 2

8-23 mL/100g/minute

Question 3

What cerebral areas are most susceptible to ischemia?

Answer 3

hippocampus, cortex (parietooccipital deep sulci third, fifth, and sixth layers), basal ganglia (caudate and putamen), and cerebellum (Purkinje cells)

Question 4

What areas of the hippocampus are most susceptible to ischemia? Most resistant?

Answer 4

CA1 (somner) and CA3 (endplate)

CA2

Question 5

What is hypoxic ischemic encephalopathy?

Answer 5

due to global hypoperfusion or hypoxia; watershed strokes especially parietooccpital area

symptoms are “man in barrel” syndrome with proximal limb weakness

Question 6

What is seen on pathology for hypoxic ischemic encephalopathy?

Answer 6

laminar necrosis of cortical layers 3,5,6 and putamen

Question 7

What neurotransmitter has been associated with cellular necrosis after ischemia and with blockage can increase neuronal survival?

Answer 7

glutamate