Evolution and resolution of oedema following severe temporary cerebral ischaemia in the gerbil

Abstract

Regional cerebral blood flow (rCBF) and oedema following profound temporary ischaemia were studied in the gerbil. Ninety-four per cent of animals died within 24 hours of reperfusion; 50% by 4 hours. Regional differences in oedema (specific gravity method), Evans blue (EB) staining and rCBF (hydrogen clearance technique) occurred. Oedema developed during arterial occlusion, being inversely proportional to residual flow and was markedly exacerbated during reperfusion. Reperfusion hyperaemia was maximal in the parietal and hippocampal regions (ischaemic rCBF 4 ml 100 g-1 min-1). Oedema was disappearing in all areas by 3 hours of reperfusion and autoregulation returned in the occipital region (mean ischaemia rCBF 8 ml 100 g-1 min-1). EB staining and haemorrhage appeared in the thalamus (rCBF 10 ml 100 g-1 min-1) as oedema was decreasing. It is suggested that the amount of oedema and hyperaemia during reperfusion are dependent on the severity of the ischaemia. Areas of moderate ischaemia (8-10 ml 100 g-1 min-1) show little hyperaemia and greater oedema resolution during reperfusion as compared to areas of severe ischaemia (circa 4 ml 100 g-1 min-1) where there is marked hyperaemia with less oedema resolution. Early in the reperfusion period, oedema is not associated with EB staining and indicates a cytotoxic mechanism. The vasogenic component, with macroscopic haemorrhages and leakage of EB occurs later. In this model it is concluded that the early cytotoxic oedema formation and hyperaemia are phenomena with little bearing on mortality, which correlates better with later vasogenic changes.