Malignant edema formation following transient MCA occlusion : decrease of cerebral perfusion pressure causes secondary elevation of glutamate

Abstract

Malignant, space-occupying brain edema is a relevant, serious complication in various clinical situations including large hemispheric stroke. In the search for intensive monitoring tools that permit early identification of such fatal outcome, microdialysis has recently been introduced in patient care. Furthermore, to date, the role of neuroactive substances in malignant edema remains obscure. We therefore examined the correlation between secondary perfusional disturbance assessed by monitoring cerebral perfusion pressure (CPP) and secondary elevation of glutamate and other neuroactive substrates in a reperfusion injury model in cats that was produced by 3 hours middle cerebral artery occlusion followed by 6 hours reperfusion.