Hemodilution increases cerebral blood flow in acute ischemic stroke

Journal Article · Sat Jul 01 04:00:00 EDT 1989 · Stroke; (United States)

DOI:https://doi.org/10.1161/01.STR.20.7.884· OSTI ID:5601416

Vorstrup, S; Andersen, A; Juhler, M; Brun, B; Boysen, G

We measured cerebral blood flow in 10 consecutive, but selected, patients with acute ischemic stroke (less than 48 hours after onset) before and after hemodilution. Cerebral blood flow was measured by xenon-133 inhalation and emission tomography, and only patients with focal hypoperfusion in clinically relevant areas were included. Hemodilution was done according to the hematocrit level: for a hematocrit greater than or equal to 42%, 500 ml whole blood was drawn and replaced by the same volume of dextran 40; for a hematocrit between 37% and 42%, only 250 ml whole blood was drawn and replaced by 500 cc of dextran 40. Mean hematocrit was reduced by 16%, from 46 +/- 5% (SD) to 39 +/- 5% (SD) (p less than 0.001). Cerebral blood flow increased in both hemispheres by an average of 20.9% (p less than 0.001). Regional cerebral blood flow increased in the ischemic areas in all cases, on an average of 21.4 +/- 12.0% (SD) (p less than 0.001). In three patients, a significant redistribution of flow in favor of the hypoperfused areas was observed, and in six patients, the fractional cerebral blood flow increase in the hypoperfused areas was of the same magnitude as in the remainder of the brain. In the last patient, cerebral blood flow increased relatively less in the ischemic areas. Our findings show that cerebral blood flow increases in the ischemic areas after hemodilution therapy in stroke patients. The marked regional cerebral blood flow increase seen in some patients could imply an improved oxygen delivery to the ischemic tissue.

• Research Organization: Department of Neurology Hospital, Copenhagen (Denmark)
• OSTI ID: 5601416
• Journal Information: Stroke; (United States), Journal Name: Stroke; (United States) Vol. 20:7; ISSN SJCCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD COUNT
BLOOD FLOW
BODY
BRAIN
CARDIOVASCULAR DISEASES
CENTRAL NERVOUS SYSTEM
CEREBRAL CORTEX
CEREBRUM
COMPUTERIZED TOMOGRAPHY
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
EMISSION COMPUTED TOMOGRAPHY
EVEN-ODD NUCLEI
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NERVOUS SYSTEM
NUCLEI
ORGANS
PATIENTS
RADIOISOTOPES
TOMOGRAPHY
VASCULAR DISEASES
XENON 133
XENON ISOTOPES