Vol. 38, No. 5, 1995 Printed in U.S.A.The purpose of this study was to compa re the effects of dizocilipine maleate (MK-801) and W -nitro-L-arginine methyl ester (L-NAME) on focal excitotoxic brain injury and associated hemod ynamic response in the newborn lamb. A 27 gauge needle was placed into the right striatum in 28 anesthetized newborn lambs. Seven animals were placed in each group. A negative control group received 0.2 mL of buffered saline, a positive control group received 5 /Lmol of N-methyl-D-aspartic acid (NMDA) alone, and two groups received NMDA and pretreatment with L-NAME. Ultrasound images and cerebral blood flow determinations (microspheres) were obtained before, and at 20, 40, and 60 min after, intrastrial injection. Three animals in each group underwent histopathologic evaluation. Sonographic lesions were visible immediatel y after intracerebral injection . Saline injection resulted in small lesions (mean volume; 13.6 :t 5 mrrr') without hyperemia. NMDA alone resulted in larger lesions (92.9 :t 24 mrrr') and hyperemia to both hemispheres, whereas pretreatment with MK-801 reduced lesion size (11.7 :t 6 mm") and completely ablated cerebral hyperemia . Pretreatment with L-NAME showed no effect on lesion size (69.9 :t 20 mm") and hyperemia only in the ipsilateral hemisphere. Sonogr aphic lesions correlated well with gross and histopathologic appearance. We concluded that NMDA-induced focal brain injury and associated hyperemia in the newborn lamb appear to be specific NMDA receptor-mediated events. NO production probab ly does not play a major part in NMDA-indu ced neonatal neuronal injury, and may be only partly responsible for regional hyperemia during NMDA injection. (Pediatr Res 38: 644-651 , 1995) Abbr eviations NM DA, N-methyl-D-aspartic acid L-NAME, AP-nitro-L-arginine methyl ester MK-801, dizoci lipine maleate NO, nitric oxide CVR, cerebrovascula r resistance CBF, cerebral blood flow ANOVA, analysis of variance There is considerable evidence now suggesting that glutamate may mediate the neurotoxicity observe d in hypoxicischemic brain injury. Several source s of data support this hypothesis: (i) glutamate produces neurona l injury similar to that observed after cerebra l hypoxia-ischemia; (ii) elevated extracellu lar levels of glutamate and aspartate are present during cerebral ischemia; (iii) excitatory deafferentation results in improved neuronal survival; and (iv) NMDA receptor an-