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University of Texas Health Science Center at San Antonio, San Antonio 78284; and Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, San Antonio, Texas 78236
Altered postictal cerebral blood flow dilatory
responses may contribute to brain injury following neonatal seizures.
We developed an initial series of experiments to characterize the
effects of seizure activity on cerebral vascular dilatory responses
during the immediate postictal period. Significant attenuation of
postictal hypoxic cerebral vasodilation was noted. We hypothesize that
this diminished cerebral dilator response to hypoxia involves depletion of adenosine (Ado) activity resulting from seizure ictus. Additional experiments were designed to evaluate whether the altered postictal responses were related to a depletion of Ado stores or a decreased response to Ado in the postictal state. Farm-bred piglets were equipped
with closed cranial windows. Responses to hypercapnia (10%
CO2), hypoxia (fractional
inspired O2 = 0.10), and topical sodium nitroprusside (10
6
M) were compared before and after bicuculline-induced seizures (1 mg/kg). Hypoxia-induced cerebral vasodilation was significantly attenuated in the first 90 min postictal (control: 56.5 ± 6%, 10 min postictal: 6.3 ± 2%, 60 min postictal: 21.7 ± 6%, and 90 min postictal: 21.6 ± 5%; P < 0.01), whereas the dilator responses to hypercapnia and topical sodium
nitroprusside remained intact. In a separate group of piglets, both a
dilating (10
5 M) and a
nondilating concentration of Ado
(10
11 M) were topically
administered postictally to measure their effects on pial vessel
dilatory response to hypoxia. Dilation to topical Ado
(10
5 M) was not altered
postictally compared with control. Ado
(10
11 M) restored
hypoxia-induced vasodilation to preseizure control values in the
immediate postictal period (control: 51.0 ± 8%, postictal: 46.7 ± 8%; P > 0.05). Postictal
administration of Ado will restore hypoxia-induced cerebral
vasodilation in piglets even when a nondilating concentration is
employed. This suggests that depletion of Ado with seizure activity is
a mechanism for the loss of postictal cerebral vasodilation to hypoxia,
and the role of Ado in hypoxic cerebral vasodilation is permissive.
seizures; hypoxia; hypercapnia
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