The Protective Effect of Mannitol, Steroid, Phenytoin and Barbiturates on Experimental Acute Focal Cerebral Ischemia

The authors have studied the therapeutic effect of the combinations of mannitol, methylprednisolone(MP), phenytoin and barbiturates on the acute focal cerebral ischemia (AFCI) in cats. The experimental animals were divided into three groups. Group I was the cats with the removal of the orbital contents without occlusion of MCA. Group II was that of 2-hour recirculation after AFCI following the occlusion of MCA for 3 hours. Group C was subdivided into four subgroups as Group III-a, Group III-b, Group III-c and Group III-d. Group III-a was that of treatment of combinations of mannitol and MP, Group III-b that of combinations of mannitol and phenytoin. Group III-c that of combinations of mannitol and barbiturates, and Group III-d that of combinations of mannitol, MP (60mg/kg) phenytoin and barbiturate. As the biochemical studies cytochrome oxidase activities (COA) and the concentrations of lipid peroxidation(LP) were determined, and as the pathohistologic studies the degree of the infarcted areas, hemispheric swellings and the comparative microscopic findings of the infarcted areas were studied. In Group III-a and Group III-b no therapeutic effect on the AFCI was presented. In Group III-c the partial effect of brain protection were demonstrated only in LP and the degree of hemispheric swelling, but Group III-d provided nearly complete protection from ischemic damage. These experimental data suggested that the medical measures of the combinations of mannitol, MP, phenytoin and barbiturates can make the AFCI fully reversible and would applicable in the clinical field.