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Variability and reversibility of focal cerebral ischemia in unanesthetized monkeys

Stroke Laboratory, Neurosurgical Service, Massachusetts General Hospital (Drs. Crowell and Marcoux), Boston, and Department of Pathology (Neuropathology) and Neurology, University of Massachusetts Medical School (Dr. DeGirolami), Worcester, MA.

To assess reversibility of focal cerebral ischemia, we performed a neurologic and pathologic study of 27 monkeys subjected to temporary middle cerebral artery occlusion. An implanted snare ligature occluded the artery in awake monkeys for 30 minutes, 4 hours, 8 hours, 16 hours, 24 hours, or permanently. Serial neurologic observations were made for 2 weeks, and systematic neuropathologic examination estimated extent of infarction. Deficits from ischemia were commonly reversible at 30 minutes and 4 hours, but were rarely reversible after 8 hours. Neurologic deficit and infarct size showed remarkable variability. Maximum irreversible infarction evolved in about 4 to 8 hours in most awake monkeys. Variability and reversibility of focal ischemia were probably related to variable collateral circulation. The results suggested that emergency surgical revascularization might help some cases of acute ischemic stroke.

Address correspondence and reprint requests to Dr. Crowell, chairman, Division of Neurological Surgery, Barrow Neurological Institute, 350 W. Thomas Rd. Phoenix, A2 85013.

Supported in part by Grant NS18028 and NS13165 and by Teacher-Investigator Award NS11001 (to Dr. Crowell) from the National Institute of Neurological and Cmmunicative Disorders and Stroke.

Accepted for publication July 30, 1980.

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