Table Of ContentCerebral Ischemia
and Hemorheology
Edited by
Alexander Hartmann and
Wolfgang Kuschinsky
With 143 Figures
Springer-Verlag Berlin Heidelberg New York
London Paris Tokyo
Professor Dr. ALEXANDER HARTMANN
Neurologische Universitätsklinik
Sigmund-Freud-Str. 25
D-5300 Bonn 1, FRG
Professor Dr. WOLFGANG KUSCHINSKY
Physiologisches Institut I
der Universität Bonn
Nußallee 11
D-5300 Bonn 1, FRG
ISBN-13:978-3-642-71789-S e-ISBN-13:978-3-642-71787-1
DOI: 10.1007/978-3-642-71787-1
Library of Congress Cataloging-in-Publication Data. Cerebral ischemia and hemorheology. IncIudes index
J. Cerebral ischemia. 2. Blood flow. 3. Rheology (Biology) 1. Hartmann, A. (Alexander), 1943-
Ir. Kuschinsky, W. (Wolfgang), 1944-
[DNLM: J. Cardiovascular Circulation. 2. Cerebral Ischemia. 3. Rheology. WL 355 C41 14]
RC388.5.C3965 1987 616.8'1 87-23241
ISBN -13: 978-3-642-71789-5 (U .S.)
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© Springer-Verlag Berlin Heidelberg 1987
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2122/3130-543210
List of Contributors
You will find the addresses at the beginning ofthe respective contribution
Ackerman, R.H. 356 Czernicki, Z. 394 Hallenbeck, J.M. 257
Adams, R.J. 502 Davis, S.M. 356 Hamano, H. 514
Akiyama, M. 90 De Matteis, G. 366 Hartmann, A 398,
Alavi, A 326 Dettmers, C. 423 423
Alpert, N.M. 356 Djouchadar, D. 386 Heiss, W.-D. 121,186
Ames III, A 241 Dormandy, J. 51 Hellums, J.D. 80
Anderson, J. 496 Dorsey, F.C. 356 Herholz, K. 186
Asplund, K. 472 Driessen, G. 23,131 Heros, R.C. 315
Aue1, H. 121 Dutka, AJ. 257 Hill, S. 502
Babikian, V.L. 356 Edvinsson, L. 13 Hossmann, K.-A 233
Badimon, L. 102 Ehrly, AM. 76 Hossmann, V. 121
Baessler, G. 429 Engler, R.L. 464 Hoyer, S. 163
Baethmann, A 217 Eriksson, S. 472 Hoymann, G. 131
Barbenel, J. C. 496 Ernst, E. 51 Hudetz, AG. 173
Baumgartner, H.R. Eskin, S.G. 280 Hütt, M. 429
102 Fieschi, C. 366 Hufnagel, M. 459
Beamer, N.B. 520 Figols, J. 386 Hughes, D. 502
Berkelbach v.d. Fisher, M. 445 Hyodo, A 315
Sprenkel, J.W. 371 Frackowiak, R.SJ. Ido, T. 342
Bewermeyer, H. 121 202 Ikemoto, S. 90
Boisseau, M.R. 69 Frangos, J.A 280 Inhoffen, W. 131
Brooks, D.J. 202 Frei, A 436 Isogai, Y. 90
Burbank, K.M. 356 Forbes, C.D. 496 Izumiyama, M. 342
Buxton, R.B. 356 Fuster, V. 102 Jäger, H. 487
Candia, G. 315 Gallasch, H. 23 Jansen, M. 217
Carolei, A. 366 Garcia, J.H. 173 Jurkiewicz, J. 394
Cervos-Navarro, J. Giorgio, T.D. 80 Kameyama, M. 508
386 Gjedde, A 186 Karacostas, D. 315
Chawluk, J. 326 Glöckner, W.M. 452 Katz, P.M. 356
Chien, S. 57 Gotoh, F. 222,377 Kawamura, J. 222
Clarke Ha1ey, E. 356 Gottstein, U. 416 Kempski, O. 217
Conger, K.A 173 Greenberg, J. 326 Kobari, M. 377
Copley, A.L. 306 Grosse, W. 452 Kochanek, P.M. 257
Correia, J.A. 356 Grotta, J.c. 266, 272, Kogure, K. 342
Cottier, C. 436 334 Koto, A 222
Coull, B.M. 520 Haass, A 487 Kroemer, H. 487
Cuny, G. 113 Hall, E.R. 272, 280 Krogstad, D.J. 143
VI List ofContributors
Kuchiba, K. 90 Paschen, W. 233 Stoltz, lF. 113
Kumaroo, K.K. 257 Pawlik, G. 186 Strong, Al 362
K uschinsky, W. 1 Penin, F. 113 Sutera, S.P. 143
Kushner, M. 326 Peterson, D.M. 80 Suzuki, N. 222
La CelIe, P.L. 154 Pettigrew, L.c. 266, Symon, L. 249
Lagreze, H. 423 272,334 Tanahashi, N. 377
Lammertsma, AA Pfafferott, C. 528 Tanaka,l 342
202 Prencipe, M. 366 Tanaka, K. 222
Lazzaro, M.P. 366 Reivich, M. 326 Tanishima, T. 257
LeGree, K. 315 Ringelstein, E.B. 452 Tazaki, Y. 210
Leniger-Follert, E. Rosenblum, W.!. 96 Terayama, Y. 377
459 Rosner, B. 356 Thomas, D.J. 301
Leuwer, R. 459 Saitoh, H. 514 Thompson, T.N. 154
Loettgen,l 121 Saitoh, S. 514 Tobita, M. 342
Loutfi,!. 202 Sakai, F. 210 Tomita, M. 377
Lowe, G.D.O. 496 Sampaolo, S. 386 Tsuda, Y. 398, 423
Maeda, T. 90 Scandinavian Stroke Tu, Y.-K. 315
MarshalI, J. 411 Study Group 472 Tulleken, C.AF. 371
Matentzoglu, S. 452 Schlierf, G. 429 Turitto, V.T. 102
Matrai, A 51 Schimrigk, K. 487 Uematsu, D. 222
Mauckner, A 452 Schmid-Schönbein, Ulrich, F. 290
McIntire, L.V. 280 H. 23,131 Venables, G.S. 362
Mechtersheimer, U. Schmid-Schönbein, Voisin, P. 113
429 G.W. 464 Voiger, E. 528
Meiseiman, HJ. 445 Schneider, R. 452 Weiand, J. 398
Mies, G. 233 Schuier, FJ. 290 Weiss, HJ. 103
Mihara, B. 377 Schultheiss, R. 459 Wienhard, K. 186
Miller, S.A 362 Seaman, G.V.F. 520 Wu, K.K. 272,334,
Moake, lL. 80 Seufzer, U. 429 349
Mörl, H. 429 Shinohara, Y. 514 Wüllenweber, R. 459
Nichols, F.T. 502 Shio, H. 508 Wunderlich, P. 436
Nordt, F. 520 Silver, F. 326 Yamamoto, M. 514
O'Brien, M.D. 297 Solymosi, L. 398 Yamawaki, T. 222
Oest, A 487 Spiltoir, G. 371 Yatsu, F.M. 266
Ohsuga, H. 514 Staedt, U. 429 Yokose, T. 90
Ohta, K. 377 Stathopoulos, N.A Yoshitoshi, M. 514
Orlandi, B. 366 80 Zager, E.L. 241
Oster, P. 429 Staub, F. 217 Zervas, N.T. 315
Preface
This book contains the scientific contributions presented during the inter
national symposium "Cerebral Ischemia and Hemorheology", held in Germany
in June 1987. The purpose of the symposium was to bring together experts in
the fields of cerebral circulation and rheology, in order to increase the knowl
edge and scope of both of these groups by making the members of each group
more aware of work in the complementary field. The organizers hoped to
stimulate the discussion between both groups and to reach adecision about
whether the alteration of rheologie parameters might change the course and
fate of cerebral ischemia.
The contributions also report on clinical and basic studies pertinent to the
topic of the symposium. The book is a comprehensive description of the state
of the art wich may help to define what is known and to find new strategies to
better und erstand metabolie, circulatory, and rheologie changes during cerebral
ischemia.
The selection of papers for publication was the task of the advisory board.
The editors would like to thank the members for their critical analyses and
suggestions; they are: Shu Chien, New York; F. Gotoh, Tokio; K.A. Hossmann,
Cologne; G. Schmid-Schönbein, Aachen; L. Symon, London; and F. Yatsu,
Houston.
Bonn ALEXANDER HARTMANN
WOLFGANG KUSCHINSKY
Contents
Local Control ofthe Cerebral Circulation. W. KUSCHINSKY
(With 2 Figures) . . . . . . . . . . . . . . . . . .
Neurogenie Control of Cerebral Circulation. L. EDVINSSON
(With 2 Figures) . . . . . . . . . . . . . . . . . . 13
Physiology and Pathophysiology of Hemorheology
Hemorheology and Cerebral Infarction: On the Role of Pathological
Blood Thixotropy in the Pathogenesis of and Therapy for States of Acute
Cerebral Hypoperfusion. H. SCHMID-SCHÖNBEIN, G. DRIESSEN,
and H. GALLASCH (With 8 Figures) .............. 27
Blood Cells and the Control of the Circulation. E. ERNST, A MATRAI,
and 1. DORMANDY (With 3 Figures) . . . . . . . . . . . . 51
The Role of White Blood Cells in the Control of Blood Rheology
S. CHIEN (With 4 Figures) . . . . . . . . . . . . . . . 57
Hemorheological Disorders in Cerebrovascular Accident:
Relationship to Inflammatory Processes and Thrombogenesis
M.R. BOISSEAU (With 2 Figures) ........... . 69
Pathophysiology ofBlood Rheology in Ischemic Diseases. AM. EHRLY
(With 2 Figures) . . . . . . . . . . . . . . . . . . . . . 76
Studies on the Mechanisms of Shear-Induced Platelet Activation
J.D. HELLUMS, D.M. PETERSON, N.A STATHOPOULOS, J.L. MOAKE,
and T.D. GIORGIO (With 3 Figures) . . . . . . . . . . . . 80
Filterability and the Shape of Platelets: The Effect of Stimulant
y. ISOGAI, T. YOKOSE, S. lKEMOTO, T. MAEDA, M. AKlYAMA,
and K. KUCHIBA (With 3 Figures) ........... . 90
Complex Microvascular Effects Involving Plasma and Red Cell
Movement in Brain Following Alterations ofViscosity. W.!. ROSENBLUM
(With 2 Figures) . . . . . . . . . . . . . . . . . . . . . 96
Fluid Dynamics, The Factor VIII/vWF Complex, and Thrombosis
on Vessel Walls. V.T. TURITTO, H.J. WEISS, H.R. BAUMGARTNER,
L. BADIMON, and V. FUSTER (With 3 Figures) . . . . . . . . . . . . 102
x
Contents
Blood Viscosity and Platelet Functions During Cerebrovascular
Accidents. PH. VOISIN, F. PENIN, D. GUNY, and J.F. STOLTZ . . 113
Blood Coagulation and Anticoagulation in Ischemic Stroke
V. HOSSMANN, J. LOETTGEN, H. AUEL, H. BEWERMEYER, and W.-D. HEISS
(With 4 Figures) . . . . . . . . . . . . . . . . . . . . . . . . 121
Concerning the Influence of Hematocrit and Red Blood Cell Aggregation
on Blood Viscosity In Vivo. G. DRIESSEN, G. HOYMANN, W. INHOFFEN,
and H. SCHMID-SCHÖNBEIN (With 7 Figures) .......... 131
Microrheological Studies of the Effects of Intraerythrocytic Parasites
on Red Cell Deformability. S.P. SUTERA and D.J. KROGSTAD
(With 1 Figure) .................... 143
Effects of Leukocytes on Microvascular Rheology. P.L. LA CELLE
and T.N. THOMPSON (With 3 Figures) . . . . . . . . . . . 154
Physiology and Pathophysiology of Cerebral Circulation and Metabolism
Biochemical Aspects of Cerebral Ischemia as Related to Age. S. HOYER
(With 3 Figures) . . . . . . . . . . . . . . . . . . . . . . . . 163
Patterns ofIschemic Injury to the Brain: The Influence ofLocal
Hemodynamic Factors. J.H. GARCIA, K.A. CONGER, and A.G. HUDETZ
(With 4 Figures) . . . . . . . . . . . . . . . . . . . . . . . . 173
Improved Measurement of Regional Glucose Metabolism by Individual
Determination of the Lumped and Kinetic Constants in Stroke Patients
K. WIENHARD, A. GJEDDE, W.-D. HEISS, K. HERHOLZ, and G. PAWLIK
(With 4 Figures) . . . . . . . . . . . . . . . . . . . .. . 186
Estimation of Local Cerebral Hematocrit with Positron Emission
Tomographyand Single Photon Emission Computed Tomography
RSJ. FRACKOWIAK, 1. LOUTFI, A.A. LAMMERTSMA, and D.J. BROOKS
(With 1 Figure) ...................... 202
Regional Cerebral Blood Flow, Volume, and Hematocrit Measured by
Single Photon Emission Computed Tomography. F. SAKAI and Y. TAZAKI
(With 3 Figures) . . . . . . . . . . . . . . . . . . . . . . . . 210
Mechanisms of Ischemic Cell Swelling in the Brain. O. KEMPSKI,
A. BAETHMANN, M. JANSEN, and F. STAUB ......... 217
Rheological Behavior of Platelets In Situ in Middle Cerebral Artery
Occlusion. F. GOTOH, A. KOTO, K. TANAKA, N. SUZUKI, D. UEMATSU,
J. KAWAMURA, and T. YAMAWAKI (With 7 Figures) ....... . 222
Regional Hemodynamic and Metabolie Disturbances in Experimental
Cerebral Ischemia. W. PASCHEN, G. MIES, and K.-A. HOSSMANN
(With 2 Figures) . . . . . . . . . . . . . . . . . . . . . .. 233
Reducing Cellular Energy Requirements as Proteetion Against
CNS Ischemia. A. AMES III and E.L. ZAGER (With 3 Figures) 241
Contents XI
Biochemical Aspects of Cerebral Ischemia. L. SYMON 249
Leukotrienes, Prostaglandins, and Granulocyte Accumulation in Cerebral
Ischemia. P.M. KOCHANEK, A.J. DUTKA, K.K. KUMAROO, T. TANISHlMA,
and J.M. HALLENBECK . . . . . . . . . . . . . . . . . . . .. 257
Baseline Hemodynamic State and Response to Hemodilution in Patients
with Acute Cerebral Ischemia. L.e. PETTIGREW, J.e. GROTTA,
and F.M. YATSU ....................... 266
Arachidonic Acid Metabolism in Cerebral Ischemia. L.e. PETTIGREW,
E.R HALL, J.e. GROTTA, and K.K. Wu (With 1 Figure) ..... 272
Effect ofHemodynamic Shear on Arachidonic Acid Metabolism
ofVascular Endothelium. L.V. McINTlRE, J.A. FRANGOS, S.G. ESKIN,
and E.R HALL (With 3 Figures) ................. 280
Cerebral Blood Flow and Energy Metabolism in Severe Subarachnoid
Hemorrhage in the Cat: Effect ofCalcium Antagonist Vasodilation
F.J. SCHUIER and F. ULRICH (With 3 Figures) . . . . . . . . . . . . 290
Hemorheology in Cerebral Ischemia (Part I)
The Effect of Brain Edema on the Microcirculation. M.D. O'BRIEN 297
Blood Viscosity and Cerebral Blood Flow. D.J. THOMAS 301
Hemorheological and Perihemorheological Aspects ofthe Vessel-
Blood Organ Affecting Ischemia. A.L. COPLEY (With I Figure) 306
Viscosity Effects on Blood Flow Dynamics: Influence ofIsovolemic
Hemodilution on Focal Cerebral Ischemia. Y.-K. Tu, Re. HEROS,
G. CANDIA, D. KARACOSTAS, A. HYODO, K. LEGREE, and N.T. ZERVAS
(With I Figure) ........................ 315
Focal and Remote Dysmetabolism in Stroke. M. KUSHNER, e. FIESCHI,
M. REIVICH, A. ALAVI, F. SILVER, J. CHAWLUK, and J. GREENBERG
(With I Figure) ....................... 326
Clinical Aspects ofReversible Cerebral Ischemia. F.M. YATSU,
L.e. PETTIGREW, J.C. GROTTA, and K.K. Wu . . . . . . . 334
An Autoradiographic Study ofPlasma Skimming in Cerebral Ischemia
K. KOGURE, M. IZUMIYAMA, J. TANAKA, M. TOBITA, and T. IDO
(With 3 Figures) . . . . . . . . . . . . . . . . . . . . . 342
Defective Serum PGI Binding in Thrombotic Stroke:
2
A Potential Mechanism for Platelet Hyperaggregability in Stroke
K.K. Wu (With 1 Figure) ................ 349
Relationships Between Viscosity and Factors and Cerebral Blood Flow
and Porous Bed Viscometry in Normals and Stroke Prone Subjects
RH. ACKERMAN, K.M. BURBANK, RB. BUXTON, E. CLARKE HALEY,
V.L. BABIKIAN, J.A. CORREIA, N.M. ALPERT, S.M. DAVIS, P.M. KATZ,
B. ROSNER, and F.e. DORSEY (With 1 Figure) . . . . . . . . . . . . 356
XII Contents
Comparisons of Regional Topography and Flow Reactivity in Cerebral
Ischemic Boundary Zones. A.J. STRONG, S.A. MILLER and G.S. VENABLES
(With 2 Figures) . . . . . . . . . . . . . . . . . . . . . . . . 362
Chronic Platelet Abnormalities in TIA Patients. M. PRENCIPE, C. FIESCHI,
M.P. LAZZARO, B. ORLANDI, G. DE MATTEIS, and A. CAROLEI 366
The Rheological Effect ofFluosol FC 43 on Focal Cerebral Ischemia
in the Rat. J.W. BERKELBACH v. D. SPRENKEL, C.A.F. TULLEKEN,
and G. SPILTOIR (With 1 Figure) ............... 371
Intravascular RBC Aggregation and Transient Diminution of
Cerebrovascular Volume Following Middle Cerebral Artery Occlusion in
Cats. M. TOMITA, F. GOTOH, N. TANAHASHI, M. KOBARI, Y. TERAYAMA,
B. MIHARA, and K. OHTA (With 3 Figures) . . . . . . . . . .. 377
Clinical and Experimental Evidence of Microthrombosis in CerebraI
Ischemia. S. SAMPAOLO, J. CERvos-NAVARRO, D. DJOUCHADAR,
and J. FIGOLS (With 4 Figures) . . . . . . . . . . . . . . .. 386
Effect of Hemodilution on Cerebral Ischemia Caused by Intracranial
Hypertension. Z. CZERNICKI and J. JURKIEWICZ (With 3 Figures) 394
Effect of Hydroxyethyl Starch and Low Molecular Weight Dextran on
Cerebral Blood Flow and Hemorheology in Normal Baboons. Y. TSUDA,
A. HARTMANN, J. WEIAND, and L. SOLYMOSI (With 6 Figures) . . . . . 398
Hemorheology in Cerebral Ischemia (Part 11)
The Role of Hemodilution in the Management of Cerebral Ischemia
J. MARSHALL ....................... 411
Hemodilution in Cerebral Infarction. U. GOTTSTEIN (With 3 Figures) 416
Effect ofHemodilution on Regional Cerebral Blood Flow in Patients
with Acute Cerebral Infarction. A. HARTMANN, Y. TSUDA, H. LAGREZE,
and CH. DETTMERS (With 2 Figures) . . . . . . . . . . . . . .. 423
Hypervolemic Hemodilution with 10% HES 200/0.5 and 10% Dextran 40
in Patients with Ischemic Stroke. U. STAEDT, G. SCHLIERF, P. OSTER,
U. MECHTERSHEIMER, G. BAESSLER, U. SEUFZER, M. HÜTT, and H. MÖRL 429
Glycerol and Rheomacrodex in the Treatment ofthe Acute Ischemic
Insult: A Placebo-Controlled Double-Blind Trial. A. FREI, C. COTTIER,
and P. WUNDERLICH (With 2 Figures) . . . . . . . . . . . . .. 436
Hemorheological Abnormalities in Acute Cerebral Ischemia
M. FISHER and HJ. MEISELMAN . . . . . . . . . . . . 445
Do Hemorheological Properties Influence Vasomotor Reactivity of the
Brain Arteries? A Transcranial Doppler Study During Hypo-, Normo
and Hypercapnia. E.B. RINGELSTEIN, W. GROSSE, A. MAUCKNER,
R. SCHNEIDER, W.M. GLÖCKNER, and S. MATENTZOGLU (With 2 Figures). 452
