Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs Brendan P Conroy, MD, Marjorie R Grafe,

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Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs Brendan P Conroy, MD, Marjorie R Grafe, MD, PhD, Larry W Jenkins, PhD, Alejandro H Vela, MD, Cheng Y Lin, PhD, Douglas S DeWitt, PhD, William E Johnston, MD The Annals of Thoracic Surgery Volume 71, Issue 4, Pages 1325-1334 (April 2001) DOI: 10.1016/S0003-4975(01)02401-8

Fig 1 Individual neurohistopathology scores for all animals per brain region are depicted. The 31°C animals had consistently higher scores than 34°C or 37°C groups, indicating less ischemic injury with 31°C temperature management. (Circles indicate 31°C; squares indicate 34°C; and triangles indicate 37°C during the period of cerebral ischemia. For the frontal (A), temporal cortex (C), and occipital (D), 3 = normal, 2 = rare (< 10%) ischemic neurons, 1 = frequent (10–50%) ischemic neurons, 0 = majority (> 50%) ischemic neurons. For the hippocampus (B), 3 = normal, 2 = rare ischemic pyramidal or granule cells, 1 = focal ischemic damage, 0 = severe, diffuse ischemic damage. For the cerebellum (E), 3 = normal, 2 = rare ischemic Purkinje cells, 1 = 10 to 50% Purkinje cells, 0 = > 50% ischemic Purkinje cells). The Annals of Thoracic Surgery 2001 71, 1325-1334DOI: (10.1016/S0003-4975(01)02401-8)

Fig 2 The spectrum of injury seen in the frontal cortex; similar changes were seen in other cortical regions. (A) 31°C animal: the cortex is normal. Neurons have a large, round nucleus with a single prominent nucleolus. (B) 31°C animal with scattered clusters of angular ischemic neurons with pyknotic nuclei (examples at arrows). (C) 34°C animal with a laminar zone of ischemic neurons and vacuolization (edema) in the neuropil. At the upper edge of the photograph a few intact neurons are present (curved arrows). (D) 37°C animal: all cells are dead in this region. The animal had a 24-hour survival time and this represents an area of early infarct. (Hematoxylin & eosin stains. Magnification for A–D, ×250.) The Annals of Thoracic Surgery 2001 71, 1325-1334DOI: (10.1016/S0003-4975(01)02401-8)