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Kentar, Modar; Mann, Martina; Sahm, Felix; Olivares-Rivera, Arturo; Sanchez-Porras, Renan; Zerelles, Roland; Sakowitz, Oliver W.; Unterberg, Andreas W. and Santos, Edgar (2020): Detection of spreading depolarizations in a middle cerebral artery occlusion model in swine. In: Acta Neurochirurgica, Vol. 162, No. 3: pp. 581-592

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Background: The main objective of this study was to generate a hemodynamically stable swine model to detect spreading depolarizations (SDs) using electrocorticography (ECoG) and intrinsic optical signal (IOS) imaging and laser speckle flowmetry (LSF) after a 30-h middle cerebral artery (MCA) occlusion (MCAo) in German Landrace Swine. Methods A total of 21 swine were used. The study comprised a training group (group 1, n = 7), a group that underwent bilateral craniectomy and MCAo (group 2, n = 10) and a group used for 2,3,5-triphenyltetrazolium (TTC) staining (group 3, n = 5). Results: In group 2, nine animals that underwent MCAo survived for 30 h, and one animal survived for 12 h. We detected MCA variants with 2 to 4 vessels. In all cases, all of the MCAs were occluded. The intensity changes exhibited by IOS and LSF after clipping were closely correlated and indicated a lower blood volume and reduced blood flow in the middle cerebral artery territory. Using IOS, we detected a mean of 2.37 +/- (STD) 2.35 SDs/h. Using ECoG, we detected a mean of 0.29 +/- (STD) 0.53 SDs/h. Infarctions were diagnosed using histological analysis. TTC staining in group 3 confirmed that the MCA territory was compromised and that the anterior and posterior cerebral arteries were preserved. Conclusions: We confirm the reliability of performing live monitoring of cerebral infarctions using our MCAo protocol to detect SDs.

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