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Moderate hyperglycemia augments ischemic brain damage

A neuropathologic study in the rat

Department of Neurology, Cornell University Medical College, New York, NY.

We compared the effects of glucose injection with those of saline or mannitol on ischemic brain damage and brain water content in a four-vessel occlusion (4-VO) rat model, which simultaneously causes severe forebrain ischemia and moderate hindbrain ischemia. Glucose given before onset of ischemia was followed by severe brain injury, with necrosis of the majority of neocortical neurons and glia, substantial neuronal damage throughout the remainder of forebrain, and severe brain edema. By comparison, saline injection before forebrain ischemia resulted in only scattered ischemic damage confined to neurons and no change in the brain water content. Mannitol injection before 4-VO or D-glucose injection during or after 4-VO produced no greater forebrain damage than did the saline injection. Morphologic damage in the cerebellum, however, was increased by D-glucose injection given either before or during 4-VO. The results demonstrate that hyperglycemia before severe brain ischemia or during moderate ischemia markedly augments morphologic brain damage.

Address correspondence and reprint requests to Dr. Pulsinelli, Department of Neurology, Cornell University Medical College, 1300 York Avenue, New York, NY 10021.

This investigation was supported in part by U.S. Public Health Service Grant No. NS-03346. Dr. Pulsinelli is a recipient of the NINCDS Teacher Investigation Award NS-00406.

A preliminary report of these data was presented at the thirty-second annual meeting of the American Academy of Neurology, New Orleans, LA, April 1980.

Accepted for publication April 8, 1982.

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