Extracellular concentrations of non-transmitter amino acids in peri-infarct tissue of patients predict malignant middle cerebral artery infarction
Space-occupying brain edema is a life-threatening complication in patients with large middle cerebral artery (MCA) infarction. To determine predictors of this detrimental process, we investigated alterations of extracellular non-transmitter amino acid concentrations in peri-infarct tissue. Thirty-on...
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| Veröffentlicht in: | Stroke (1970) 2003-12, Vol.34 (12), p.2908-2913 |
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| container_title | Stroke (1970) |
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| creator | Bosche, Bert Dohmen, Christian Graf, Rudolf Neveling, Michael Staub, Frank Kracht, Lutz Sobesky, Jan Lehnhardt, Fritz-Georg Heiss, Wolf-Dieter |
| description | Space-occupying brain edema is a life-threatening complication in patients with large middle cerebral artery (MCA) infarction. To determine predictors of this detrimental process, we investigated alterations of extracellular non-transmitter amino acid concentrations in peri-infarct tissue.
Thirty-one patients with infarctions covering >50% of the MCA territory in early cranial CT scans were included in the study. Probes for microdialysis, intracranial pressure, and tissue oxygen pressure were placed into the noninfarcted ipsilateral frontal lobe. Positron emission tomography imaging was performed in 16 of these patients to measure cerebral blood flow in the tissue around the neuromonitoring probes.
Fourteen of the 31 patients developed a malignant MCA infarction, and 17 did not. The patients in the malignant group had significantly lower extracellular concentrations of non-transmitter amino acids than those in the benign group in the first 12 hours of neuromonitoring. At this time, CBF values determined in regions of interest around the probes by positron emission tomography and tissue oxygen pressure showed that the monitored tissues were not yet infarcted, and no differences in transmitter amino acids concentrations were found between the 2 groups. Furthermore, extracellular concentrations of non-transmitter amino acids were negatively correlated with size of infarction.
We assume that reduction of non-transmitter amino acid concentrations reflects an expansion of the extracellular space by vasogenic edema formation in peri-infarct tissue of patients with malignant MCA infarction. Our findings facilitate early prediction of malignant edema formation and may help to increase knowledge of the pathophysiology of the peri-infarct zone of large MCA infarction. |
| doi_str_mv | 10.1161/01.STR.0000100158.51986.EB |
| format | Article |
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Thirty-one patients with infarctions covering >50% of the MCA territory in early cranial CT scans were included in the study. Probes for microdialysis, intracranial pressure, and tissue oxygen pressure were placed into the noninfarcted ipsilateral frontal lobe. Positron emission tomography imaging was performed in 16 of these patients to measure cerebral blood flow in the tissue around the neuromonitoring probes.
Fourteen of the 31 patients developed a malignant MCA infarction, and 17 did not. The patients in the malignant group had significantly lower extracellular concentrations of non-transmitter amino acids than those in the benign group in the first 12 hours of neuromonitoring. At this time, CBF values determined in regions of interest around the probes by positron emission tomography and tissue oxygen pressure showed that the monitored tissues were not yet infarcted, and no differences in transmitter amino acids concentrations were found between the 2 groups. Furthermore, extracellular concentrations of non-transmitter amino acids were negatively correlated with size of infarction.
We assume that reduction of non-transmitter amino acid concentrations reflects an expansion of the extracellular space by vasogenic edema formation in peri-infarct tissue of patients with malignant MCA infarction. Our findings facilitate early prediction of malignant edema formation and may help to increase knowledge of the pathophysiology of the peri-infarct zone of large MCA infarction.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000100158.51986.EB</identifier><identifier>PMID: 14631090</identifier><language>eng</language><publisher>United States</publisher><subject>Amino Acids - analysis ; Amino Acids - metabolism ; Brain - diagnostic imaging ; Brain - physiopathology ; Brain Edema - diagnosis ; Brain Edema - etiology ; Disease Progression ; Extracellular Fluid - chemistry ; Extracellular Fluid - metabolism ; Female ; Humans ; Infarction, Middle Cerebral Artery - complications ; Infarction, Middle Cerebral Artery - diagnosis ; Infarction, Middle Cerebral Artery - physiopathology ; Male ; Microdialysis ; Middle Aged ; Monitoring, Physiologic - methods ; Predictive Value of Tests ; ROC Curve ; Tomography, Emission-Computed ; Tomography, X-Ray Computed</subject><ispartof>Stroke (1970), 2003-12, Vol.34 (12), p.2908-2913</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-91a5ddf69dabb87e5d6028791de42ae4c4ab8f98982bc46d3d7ed74f1e49bd353</citedby><cites>FETCH-LOGICAL-c404t-91a5ddf69dabb87e5d6028791de42ae4c4ab8f98982bc46d3d7ed74f1e49bd353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14631090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bosche, Bert</creatorcontrib><creatorcontrib>Dohmen, Christian</creatorcontrib><creatorcontrib>Graf, Rudolf</creatorcontrib><creatorcontrib>Neveling, Michael</creatorcontrib><creatorcontrib>Staub, Frank</creatorcontrib><creatorcontrib>Kracht, Lutz</creatorcontrib><creatorcontrib>Sobesky, Jan</creatorcontrib><creatorcontrib>Lehnhardt, Fritz-Georg</creatorcontrib><creatorcontrib>Heiss, Wolf-Dieter</creatorcontrib><title>Extracellular concentrations of non-transmitter amino acids in peri-infarct tissue of patients predict malignant middle cerebral artery infarction</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Space-occupying brain edema is a life-threatening complication in patients with large middle cerebral artery (MCA) infarction. To determine predictors of this detrimental process, we investigated alterations of extracellular non-transmitter amino acid concentrations in peri-infarct tissue.
Thirty-one patients with infarctions covering >50% of the MCA territory in early cranial CT scans were included in the study. Probes for microdialysis, intracranial pressure, and tissue oxygen pressure were placed into the noninfarcted ipsilateral frontal lobe. Positron emission tomography imaging was performed in 16 of these patients to measure cerebral blood flow in the tissue around the neuromonitoring probes.
Fourteen of the 31 patients developed a malignant MCA infarction, and 17 did not. The patients in the malignant group had significantly lower extracellular concentrations of non-transmitter amino acids than those in the benign group in the first 12 hours of neuromonitoring. At this time, CBF values determined in regions of interest around the probes by positron emission tomography and tissue oxygen pressure showed that the monitored tissues were not yet infarcted, and no differences in transmitter amino acids concentrations were found between the 2 groups. Furthermore, extracellular concentrations of non-transmitter amino acids were negatively correlated with size of infarction.
We assume that reduction of non-transmitter amino acid concentrations reflects an expansion of the extracellular space by vasogenic edema formation in peri-infarct tissue of patients with malignant MCA infarction. Our findings facilitate early prediction of malignant edema formation and may help to increase knowledge of the pathophysiology of the peri-infarct zone of large MCA infarction.</description><subject>Amino Acids - analysis</subject><subject>Amino Acids - metabolism</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - physiopathology</subject><subject>Brain Edema - diagnosis</subject><subject>Brain Edema - etiology</subject><subject>Disease Progression</subject><subject>Extracellular Fluid - chemistry</subject><subject>Extracellular Fluid - metabolism</subject><subject>Female</subject><subject>Humans</subject><subject>Infarction, Middle Cerebral Artery - complications</subject><subject>Infarction, Middle Cerebral Artery - diagnosis</subject><subject>Infarction, Middle Cerebral Artery - physiopathology</subject><subject>Male</subject><subject>Microdialysis</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic - methods</subject><subject>Predictive Value of Tests</subject><subject>ROC Curve</subject><subject>Tomography, Emission-Computed</subject><subject>Tomography, X-Ray Computed</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkd1KxDAQhYMouq6-ggQvvGtNmrRNvNNl_QFB0PU6pMlUIm1akxb0NXxis7pgGMjfOd_AHITOKckpreglofnL5jknadFUpchLKkWVr2_20IKWBc94VYh9tCCEyazgUh6h4xjfk75gojxER5RXjBJJFuh7_TkFbaDr5k4HbAZvwKeXyQ0-4qHFfvBZuvvYu2mCgHXv_IC1cTZi5_EIwWXOtzqYCU8uxhm2rjEBEifiMYB16avXnXvz2qeTs7YDbCBAE3SHdUjYL7xjpLYn6KDVXYTT3b5Er7frzeo-e3y6e1hdP2aGEz5lkurS2raSVjeNqKG0FSlELakFXmjghutGtFJIUTSGV5bZGmzNWwpcNpaVbIku_rhjGD5miJPqXdxOQnsY5qhqynnJCpaEV39CE4YYA7RqDK7X4UtRoraJKEJVSkT9J6J-E1Hrm2Q-23WZmx7sv3UXAfsBBgGNCQ</recordid><startdate>200312</startdate><enddate>200312</enddate><creator>Bosche, Bert</creator><creator>Dohmen, Christian</creator><creator>Graf, Rudolf</creator><creator>Neveling, Michael</creator><creator>Staub, Frank</creator><creator>Kracht, Lutz</creator><creator>Sobesky, Jan</creator><creator>Lehnhardt, Fritz-Georg</creator><creator>Heiss, Wolf-Dieter</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200312</creationdate><title>Extracellular concentrations of non-transmitter amino acids in peri-infarct tissue of patients predict malignant middle cerebral artery infarction</title><author>Bosche, Bert ; Dohmen, Christian ; Graf, Rudolf ; Neveling, Michael ; Staub, Frank ; Kracht, Lutz ; Sobesky, Jan ; Lehnhardt, Fritz-Georg ; Heiss, Wolf-Dieter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-91a5ddf69dabb87e5d6028791de42ae4c4ab8f98982bc46d3d7ed74f1e49bd353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Amino Acids - analysis</topic><topic>Amino Acids - metabolism</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - physiopathology</topic><topic>Brain Edema - diagnosis</topic><topic>Brain Edema - etiology</topic><topic>Disease Progression</topic><topic>Extracellular Fluid - chemistry</topic><topic>Extracellular Fluid - metabolism</topic><topic>Female</topic><topic>Humans</topic><topic>Infarction, Middle Cerebral Artery - complications</topic><topic>Infarction, Middle Cerebral Artery - diagnosis</topic><topic>Infarction, Middle Cerebral Artery - physiopathology</topic><topic>Male</topic><topic>Microdialysis</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic - methods</topic><topic>Predictive Value of Tests</topic><topic>ROC Curve</topic><topic>Tomography, Emission-Computed</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bosche, Bert</creatorcontrib><creatorcontrib>Dohmen, Christian</creatorcontrib><creatorcontrib>Graf, Rudolf</creatorcontrib><creatorcontrib>Neveling, Michael</creatorcontrib><creatorcontrib>Staub, Frank</creatorcontrib><creatorcontrib>Kracht, Lutz</creatorcontrib><creatorcontrib>Sobesky, Jan</creatorcontrib><creatorcontrib>Lehnhardt, Fritz-Georg</creatorcontrib><creatorcontrib>Heiss, Wolf-Dieter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bosche, Bert</au><au>Dohmen, Christian</au><au>Graf, Rudolf</au><au>Neveling, Michael</au><au>Staub, Frank</au><au>Kracht, Lutz</au><au>Sobesky, Jan</au><au>Lehnhardt, Fritz-Georg</au><au>Heiss, Wolf-Dieter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extracellular concentrations of non-transmitter amino acids in peri-infarct tissue of patients predict malignant middle cerebral artery infarction</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2003-12</date><risdate>2003</risdate><volume>34</volume><issue>12</issue><spage>2908</spage><epage>2913</epage><pages>2908-2913</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><abstract>Space-occupying brain edema is a life-threatening complication in patients with large middle cerebral artery (MCA) infarction. To determine predictors of this detrimental process, we investigated alterations of extracellular non-transmitter amino acid concentrations in peri-infarct tissue.
Thirty-one patients with infarctions covering >50% of the MCA territory in early cranial CT scans were included in the study. Probes for microdialysis, intracranial pressure, and tissue oxygen pressure were placed into the noninfarcted ipsilateral frontal lobe. Positron emission tomography imaging was performed in 16 of these patients to measure cerebral blood flow in the tissue around the neuromonitoring probes.
Fourteen of the 31 patients developed a malignant MCA infarction, and 17 did not. The patients in the malignant group had significantly lower extracellular concentrations of non-transmitter amino acids than those in the benign group in the first 12 hours of neuromonitoring. At this time, CBF values determined in regions of interest around the probes by positron emission tomography and tissue oxygen pressure showed that the monitored tissues were not yet infarcted, and no differences in transmitter amino acids concentrations were found between the 2 groups. Furthermore, extracellular concentrations of non-transmitter amino acids were negatively correlated with size of infarction.
We assume that reduction of non-transmitter amino acid concentrations reflects an expansion of the extracellular space by vasogenic edema formation in peri-infarct tissue of patients with malignant MCA infarction. Our findings facilitate early prediction of malignant edema formation and may help to increase knowledge of the pathophysiology of the peri-infarct zone of large MCA infarction.</abstract><cop>United States</cop><pmid>14631090</pmid><doi>10.1161/01.STR.0000100158.51986.EB</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete; Alma/SFX Local Collection |
| subjects | Amino Acids - analysis Amino Acids - metabolism Brain - diagnostic imaging Brain - physiopathology Brain Edema - diagnosis Brain Edema - etiology Disease Progression Extracellular Fluid - chemistry Extracellular Fluid - metabolism Female Humans Infarction, Middle Cerebral Artery - complications Infarction, Middle Cerebral Artery - diagnosis Infarction, Middle Cerebral Artery - physiopathology Male Microdialysis Middle Aged Monitoring, Physiologic - methods Predictive Value of Tests ROC Curve Tomography, Emission-Computed Tomography, X-Ray Computed |
| title | Extracellular concentrations of non-transmitter amino acids in peri-infarct tissue of patients predict malignant middle cerebral artery infarction |
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