Stroke, Vol 23, 697-702, Copyright © 1992 by American Heart Association
C Kessler, AB Kelly, WD Suggs, JD Weissman, CM Epstein, SR Hanson and LA Harker
BACKGROUND AND PURPOSE: To investigate experimental mechanisms of
reversible cerebral dysfunction, we produced transient focal cerebral
ischemia in five baboons by unilateral perfusion of internal carotid
territories with platelet microemboli generated endogenously. METHODS:
Platelet microemboli were formed by incorporating segments of Dacron
vascular graft for 1 hour as unilateral carotid arterio-arterial shunts.
Platelet embolization was assessed by ultrasonography and isotopic imaging;
cerebral function was evaluated by measurements of somatosensory evoked
potentials and clinical motor performance. RESULTS: Platelet microemboli,
detected by transcranial Doppler ultrasonography, accumulated rapidly in
the shunted carotid hemispheric territory. Indium-111-labeled platelets
reached a maximum value of 3.2 +/- 0.8 x 10(9) platelets in the dependent
hemisphere of five animals after 20 minutes of carotid blood flow through
the grafts when measured in real time by continuous scintillation camera
imaging. The retained 111In-platelet microemboli cleared from the cerebral
vasculature within 1 hour after removing the grafts. Corresponding blood
markers of in vivo thrombus formation, beta-thromboglobulin, platelet
factor 4, and fibrinopeptide A, increased eightfold to 20-fold after
incorporating graft segments and normalized within 1 hour after removing
the grafts. Coincidently, focal neurological function was temporarily
impaired, as shown by the ipsilateral loss of somatosensory evoked
potentials 5 minutes after initiating platelet microembolization, with
restoration 1 hour after removing the grafts in five baboons, and
contralateral hemiparesis in two recovered baboons, with complete
resolution by 24 hours. CONCLUSIONS: Endogenously generated platelet
microemboli accumulate transiently in the dependent cerebral circulation
and produce corresponding focal neurological dysfunction that resolves
within hours after microembolization.
ARTICLES
Induction of transient neurological dysfunction in baboons by platelet microemboli
Department of Medicine, Yerkes Regional Primate Research Center, Atlanta, Ga.
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