Estrogens have previously been shown to protect the brain against acute
ischemic insults, by potentially augmenting cerebrovascular function after
ischemic stroke. The current study hypothesized that treatment with sustained
release of high-dose 17β-estradiol (E2) at the time of reperfusion from
middle cerebral artery occlusion (MCAO) in rats would attenuate reperfusion
injury, augment post-stroke angiogenesis and cerebral blood flow, and attenuate
lesion volume. Female Wistar rats underwent ovariectomy, followed two weeks
later by transient, two-hour right MCAO (tMCAO) and treatment with E2 (n = 13)
or placebo (P; n = 12) pellets starting at reperfusion. E2 treatment resulted in
significantly smaller total lesion volume, smaller lesions within striatal and
cortical brain regions, and less atrophy of the ipsilateral hemisphere after six
weeks of recovery. E2-treated animals exhibited accelerated recovery of
contralateral forelimb sensorimotor function in the cylinder test. Magnetic
resonance imaging (MRI) showed that E2 treatment reduced the formation of lesion
cysts, decreased lesion volume, and increased lesional cerebral blood flow
(CBF). Ktrans, a measure of vascular permeability, was increased in
the lesions. This finding, which represents lesion neovascularization, was not
altered by E2 treatment. Ischemic stroke–related angiogenesis and vessel
formation was confirmed with immunolabeling of brain tissue and was not altered
with E2 treatment. In summary, E2 treatment administered immediately following
reperfusion significantly reduced lesion size, cyst formation, and brain atrophy
while improving lesional CBF and accelerating recovery of functional deficits in
a rat model of ischemic stroke.