Short-Duration Hypothermia after Ischemic Stroke Prevents Delayed Intracranial Pressure Rise

Murtha, Lucy A.; McLeod, Damian D.; McCann, Sarah; Pepperall, Debbie; Chung, Shang En; Levi, Christopher; Calford, Michael B.; Spratt, Neil J

doi:10.1111/ijs.12181

Cited by 32 publications

(79 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data for historical controls used in Study III have previously been published. 5 Blood pressure and ICP were measured at baseline, throughout stroke, and 24 hours after MCAo, before the brains were removed for histology.…”

Section: Materials and Methods Animals Experimental Protocolsmentioning

confidence: 99%

“…5 Presence of SAH was assessed by: (a) dramatic sudden ICP rise 450 mm Hg at MCA occlusion/ reperfusion, (b) evidence of SAH at postmortem in animals that died, or (c) evidence of subarachnoid blood seen on saline/paraformaldehydeperfused brains postmortem (masked assessor).…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…[2][3][4] Little is known about the levels of ICP in patients with smaller strokes and volumes of edema, because of the invasiveness of available methods for ICP monitoring in patients. Our group has recently shown that ICP is dramatically elevated 24 hours after relatively minor stroke in rats, 5 raising doubts about the association between ICP and edema.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Our recent study demonstrated that a short duration of moderate hypothermia (32.5°C) administered shortly after stroke, did not affect ICP during the cooling interval, but completely prevented any subsequent rise in ICP 24 hours after stroke onset. 5 If a short duration of mild hypothermia (35°C) was able to limit ICP elevation after stroke, this would be a more achievable target temperature in the clinical setting, and therefore, a more widely applicable potential therapeutic strategy.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intracranial Pressure Elevation after Ischemic Stroke in Rats: Cerebral Edema is Not the Only Cause, and Short-Duration Mild Hypothermia is a Highly Effective Preventive Therapy

Murtha

McLeod

Pepperall

et al. 2014

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

In both the human and animal literature, it has largely been assumed that edema is the primary cause of intracranial pressure (ICP) elevation after stroke and that more edema equates to higher ICP. We recently demonstrated a dramatic ICP elevation 24 hours after small ischemic strokes in rats, with minimal edema. This ICP elevation was completely prevented by short-duration moderate hypothermia soon after stroke. Here, our aims were to determine the importance of edema in ICP elevation after stroke and whether mild hypothermia could prevent the ICP rise. Experimental stroke was performed in rats. ICP was monitored and shortduration mild (35°C) or moderate (32.5°C) hypothermia, or normothermia (37°C) was induced after stroke onset. Edema was measured in three studies, using wet-dry weight calculations, T 2 -weighted magnetic resonance imaging, or histology. ICP increased 24 hours after stroke onset in all normothermic animals. Short-duration mild or moderate hypothermia prevented this rise. No correlation was seen between ΔICP and edema or infarct volumes. Calculated rates of edema growth were orders of magnitude less than normal cerebrospinal fluid production rates. These data challenge current concepts and suggest that factors other than cerebral edema are the primary cause of the ICP elevation 24 hours after stroke onset.

show abstract

Section: Materials and Methods Animals Experimental Protocolsmentioning

confidence: 99%

Section: Exclusion Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intracranial Pressure Elevation after Ischemic Stroke in Rats: Cerebral Edema is Not the Only Cause, and Short-Duration Mild Hypothermia is a Highly Effective Preventive Therapy

Murtha

McLeod

Pepperall

et al. 2014

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

show abstract

“…In this article, we will discuss recent observations from our experimental stroke model, indicating a dramatic increase in intracranial pressure (ICP) occurring around 24 hours after onset of even small stroke. 5,6 We have also shown a significant linear reduction of collateral blood flow in response to progressive ICP elevation. 7 We believe that a similar transient ICP elevation occurring during the first 1 to 2 days post stroke is a likely mechanism to explain delayed infarct expansion in patients with minor stroke.…”

mentioning

confidence: 62%

Intracranial Pressure and Collateral Blood Flow

Beard

Murtha

McLeod

et al. 2016

Stroke

View full text Add to dashboard Cite

Intracranial pressure is elevated at 24 h post‐stroke in mice

Warren,

Hood,

Walker

et al. 2024

Neuroprotection

View full text Add to dashboard Cite

BackgroundIt has long been assumed that post‐stroke intracranial pressure (ICP) elevation occurs because of large infarct and edema volumes. However, we have repeatedly shown ICP elevation at 24 h post‐stroke in the presence of little to no edema in rats. Biological processes are often conserved across species and types of injury. Therefore, we aimed to determine if an ICP rise occurs at 24 h post‐stroke in the presence of small infarct and edema volumes in mice.MethodsMice were randomized by random number table to either photothrombotic stroke or sham surgery (n = 15). Epidural ICP was recorded using a fiber optic catheter at 1 h post‐stroke (baseline) and between 23 and 24 h post‐stroke.ResultsICP was significantly higher at 24 h compared to baseline in stroke animals (n = 6; 10.71 ± 6.45 mmHg vs. 3.74 ± 2.20 mmHg, respectively; p = 0.03). ICP at 24 h was also significantly higher in stroke mice compared to sham (n = 6; 3.45 ± 1.43 mmHg; p = 0.02). There was no change in ICP in sham mice (p = 0.9). Edema volumes in stroke animals were small (0.04 ± 0.04 mm3) and unlikely to have caused significant ICP elevation.ConclusionThis study provides evidence of an edema‐independent ICP elevation following small ischemic stroke in mice. The occurrence of this rise supports our findings in other species and suggests it is caused by a previously undescribed mechanism.

show abstract

Short-Duration Hypothermia after Ischemic Stroke Prevents Delayed Intracranial Pressure Rise

Cited by 32 publications

References 35 publications

Intracranial Pressure Elevation after Ischemic Stroke in Rats: Cerebral Edema is Not the Only Cause, and Short-Duration Mild Hypothermia is a Highly Effective Preventive Therapy

Intracranial Pressure Elevation after Ischemic Stroke in Rats: Cerebral Edema is Not the Only Cause, and Short-Duration Mild Hypothermia is a Highly Effective Preventive Therapy

Intracranial Pressure and Collateral Blood Flow

Intracranial pressure is elevated at 24 h post‐stroke in mice

Contact Info

Product

Resources

About