title: Increased hemorrhagic transformation and altered infarct size and localization after experimental stroke in a rat model type 2 diabetes.
abstract: BACKGROUND
  Interruption of flow through of cerebral blood vessels results in acute ischemic stroke. Subsequent breakdown of the blood brain barrier increases cerebral injury by the development of vasogenic edema and secondary hemorrhage known as hemorrhagic transformation (HT). Diabetes is a risk factor for stroke as well as poor outcome of stroke. The current study tested the hypothesis that diabetes-induced changes in the cerebral vasculature increase the risk of HT and augment ischemic injury.
  
  
  METHODS
  Diabetic Goto-Kakizaki (GK) or control rats underwent 3 hours of middle cerebral artery occlusion and 21 h reperfusion followed by evaluation of infarct size, hemorrhage and neurological outcome.
  
  
  RESULTS
  Infarct size was significantly smaller in GK rats (10 +/- 2 vs 30 +/- 4%, p < 0.001). There was significantly more frequent hematoma formation in the ischemic hemisphere in GK rats as opposed to controls. Cerebrovascular tortuosity index was increased in the GK model (1.13 +/- 0.01 vs 1.34 +/- 0.06, P < 0.001) indicative of changes in vessel architecture.
  
  
  CONCLUSIONS
  These findings provide evidence that there is cerebrovascular remodeling in diabetes. While diabetes-induced remodeling appears to prevent infarct expansion, these changes in blood vessels increase the risk for HT possibly exacerbating neurovascular damage due to cerebral ischemia/reperfusion in diabetes.
authors.affiliation: Program in Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, USA. aergul@mcg.edu
authors.forename: Adviye
authors.initials: A
authors.lastname: Ergul
authors.forename: Mostafa M
authors.initials: MM
authors.lastname: Elgebaly
authors.forename: Mary-Louise
authors.initials: ML
authors.lastname: Middlemore
authors.forename: Weiguo
authors.initials: W
authors.lastname: Li
authors.forename: Hazem
authors.initials: H
authors.lastname: Elewa
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Switzer
authors.forename: Christiana
authors.initials: C
authors.lastname: Hall
authors.forename: Anna
authors.initials: A
authors.lastname: Kozak
authors.forename: Susan C
authors.initials: SC
authors.lastname: Fagan
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000502:physiology; D020520:Brain Infarction / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000503:physiopathology*; D004195:Disease Models, Animal; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000473:pathology*; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000473:pathology; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D009460:Neurologic Examination / Q000379:methods; D051381:Rats; D017208:Rats, Wistar; D015424:Reperfusion; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D020778:Matrix Metalloproteinase 2