Severe Blood-Brain Barrier Disruption in Cardioembolic Stroke
Related Experiment Video
Updated: Feb 14, 2026
An In Vivo Assessment of Blood-Brain Barrier Disruption in a Rat Model of Ischemic Stroke
Published on: March 11, 2018
Chang Liu1, Feina Shi1, Zhicai Chen1
1Department of Neurology, School of Medicine, The 2nd Affiliated Hospital of Zhejiang University, Hangzhou, China.
Insights
Cardioembolic stroke patients show higher blood-brain barrier permeability than other stroke types. This increased permeability in the hyperacute stage may contribute to hemorrhagic transformation in cardioembolic stroke.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Cardioembolism (CE) is linked to hemorrhagic transformation (HT) in stroke.
- Blood-brain barrier (BBB) hyper-permeability is a potential cause of HT.
- Investigating BBB permeability in different acute ischemic stroke (AIS) subtypes is crucial.
Purpose of the Study:
- To determine if BBB permeability is elevated in CE stroke compared to other AIS subtypes.
- To assess the relationship between BBB permeability and CE in AIS patients.
Main Methods:
- Retrospective analysis of prospectively collected AIS patient data with CT perfusion.
- Calculation of average relative permeability-surface area product (rPShypo) in hypoperfusion regions.
- Diagnosis of CE using international criteria and statistical analysis including ROC curves and logistic regression.
Main Results:
- 187 AIS patients analyzed; 51.9% diagnosed with CE.
- Median rPShypo was significantly higher in CE patients compared to other stroke subtypes (p < 0.05).
- An rPShypo threshold of 86.71% showed predictive value for CE.
Conclusions:
- Blood-brain barrier disruption is more severe in CE stroke during the hyperacute phase.
- Elevated BBB permeability is a key characteristic differentiating CE stroke.
Background:
Previous studies demonstrated that cardioembolism (CE) was prone to develop hemorrhagic transformation (HT), whereas hyper-permeability of blood-brain barrier (BBB) might be one reason for the development of HT. We, thus, aimed to investigate whether the BBB permeability (BBBP) was higher in CE stroke than other stroke subtypes in acute ischemic stroke (AIS) patients.
Methods:
This study was a retrospective review of prospectively collected clinical and imaging database of AIS patients who underwent CT perfusion. Hypoperfusion was defined as Tmax >6 s. The average relative permeability-surface area product (rPS), reflecting the BBBP, was calculated within the hypoperfusion region (rPShypo). CE was diagnosed according to the international Trial of Org 10172 in Acute Stroke Treatment criteria. Receiver operating characteristics (ROC) curve analysis was used to determine predictive value of rPShypo for CE. Logistic regression was used to identify independent predictors for CE.
Results:
A total of 187 patients were included in the final analysis [median age, 73 (61-80) years; 75 (40.1%) females; median baseline National Institutes of Health Stroke Scale score, 12 (7-16)]. Median rPShypo was 65.5 (35.8-110.1)%. Ninety-seven (51.9%) patients were diagnosed as CE. ROC analysis revealed that the optimal rPShypo threshold for CE was 86.71%. The value of rPShypo and the rate of rPShypo>86.71% were significantly higher in patients with CE than other stroke subtypes (p < 0.05), after adjusting for the potential confounds.
Conclusion:
The extent of BBB disruption is more severe in CE stroke than other stroke subtypes during the hyperacute stage.
More Related Videos
08:43Rat Model of Blood-brain Barrier Disruption to Allow Targeted Neurovascular Therapeutics
Published on: November 30, 2012
05:31Author Spotlight: Modeling an Aspect of Preeclampsia in Female Mice Using Hypoxic Human Placenta-Derived Small Extracellular Vesicles
Published on: January 26, 2024
Related Concept Videos
00:49The Blood-brain Barrier
01:25Physiological Barriers
The blood endothelial barrier is the most porous of these. It allows all small ionized, un-ionized, and lipophilic molecules to pass through the endothelial lining into the interstitial space...
01:25Mucosal Barrier of the Stomach
Within parietal cells, carbonic acid is first formed through the reaction of water and carbon dioxide. The dissociation of carbonic acid releases bicarbonate and hydrogen ions. The bicarbonate...
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:18Surface Membrane Barriers
The outer layer of the skin, the epidermis, is a robust barrier comprising layers of closely packed keratinized cells. This dense arrangement prevents microbes from penetrating the body. The periodic shedding of epidermal cells...
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...