Twenty-four neonatal pigs were exposed to periods of circulatory arrest of between 70 and 120 min under profound hypothermia at 15°C. Brain tissue taken 6h after cardiopulmonary bypass was examined histologically and by electron microscopy for evidence of hypoxic damage. Specimens from control pigs and animals subjected to 70 min arrest showed no morphological changes in the cerebral or cerebellar neurones. The earliest changes were seen after 90-min arrest; these were highly significant after 120 min. The changes involved mainly the Purkinje cells of the cerebellum with vacuolation in the cytoplasm; the inferior half of the cerebellum was particularly affected. The frequency and pattern of selective vulnerability of the cerebellum may be related primarily to the nature of its blood supply.
OsbornJJCohnKGerbodeF.Haemolysis during perfusion: source and means of reduction. J Thorac Cardiovasc Surg1962; 43: 459.
2.
BernsteinEIndegliaRSheaMVarcoR.Sublethal damage to red blood cells from pumping. Circulation1967; 45(Suppl I): 226.
3.
EnglishTAHKirklinJWDigernessS.Changes in colloid osmotic pressure during and shortly after open intracardiac operations. J Thorac Cardiovasc Surg1971; 61: 338.
4.
De LevalMHillJDBramsonMLGerbodeF.Platelet kinetics during extracorporeal circulation. Transactions of the American Society for Artificial and Internal Organs1972; 18: 355.
5.
GomesMMRMcGoonDC. Bleeding patterns after open heart surgery. J Thorac Cardiovasc Surg1970; 60: 87.
6.
ParkerDJCantrellJWKarpRBStroudRMDigernessSB. Changes in serum complement and immunoglobulins following cardiopulmonary bypass. Surgery1972; 71: 824.
7.
KirklinJW. Pulmonary dysfunction after open heart surgery. Med Clin North Am1964; 48: 1063.
8.
DownsJJPierceWSWaldhaussenJA. Acute respiratory failure in infants following cardiovascular surgery. J Thorac Cardiovasc Surg1970; 59: 21.
MeilkeJEHuntJCKirklinJW. Renal performance during clinical cardiopulmonary bypass with and without haemodilation. J Thorac Cardiovasc Surg1966; 51: 229.
11.
JavidJTufoHMNajafiHDyeWSHunterJAJulianOC. Neurological abnormalities following open heart surgery. J Thorac Cardiovasc Surg1969; 58: 502.
12.
FolkerthTLAngellWWFosburgRGOuryJH. Effect of deep hypothermia, limited cardiopulmonary bypass and total arrest on growing puppies. In: RoyPERonaG, eds. Recent Advances in Studies in Cardiac Structure and Metabolism. Vol. 10. Baltimore, Maryland: University Park, 1975: 411–21.
13.
KramerRSSandersAPLesageAMWoodhallBSealyWE. The effect of profound hypothermia on preservation of cerebral ATP content during circulatory arrest. J Thorac Cardiovasc Surg1968; 56: 699.
14.
JohnstonJBUshiroCFinleyKHGerbodeF.Profound hypothermia with prolonged circulatory arrest. An experimental study. Thorax1966; 21: 391–400.
15.
ConnellyJERoyAGuernseyJMStemmerEA. Bloodless surgery by means of profound hypothermia and circulatory arrest. Ann Surg1965; 162: 274.
16.
TreasureTNaftelDCCongerKAGarciaJHKirklinJWBlackstoneEH. The effect of hypothermic circulatory arrest time on cerebral function, morphology and biochemistry. An experimental study. J Thorac Cardiovasc Surg1983; 86: 761–70.
17.
GrahamDI. Pathology of hypoxic brain damage in man. J Clin Pathol1977; 30(Suppl II): 170–80.
18.
BrierlyJBGrahamDI. Hypoxia and vascular disorders of the central nervous system. In: Hume-AdamsJCorsellisJANDuchenLW, eds. Greenfield's Neuropathology. 4th ed.London: Edward Arnold. 1984: 125–207.
19.
QueirozSFariaJL, Evolution of dark neurons in experimental brain stab wounds. Virchows Arch [B] Cell Pathol, 1978; 28: 361–70.
20.
SiesjoBKPlumF.Pathophysiology of anoxic brain damage. In: GaulGE, ed. Biology of Brain Dysfunction. Vol. I. New York: Plenum, 1972: 319.
21.
BrierlyJB. Pathology of cerebral ischaemia. In: McDowellFHBrennanRW, eds. Cerebral Vascular Disease. Eighth Princeton Conference. New York: Grune and Stratton, 1973: 59.
22.
CaronnaJJ. Neurologic syndromes following cardiac arrest and cardiac bypass surgery. In: BarnettHSteinBMohrJYatsuF, eds. Stroke: Pathophysiology, Diagnosis and Management. New York: Churchill Livingstone, 1986: 750.
23.
MaieseKCaronnaJJ. Neurological complications of cardiac arrest. In: AminoffM, ed. Neurology and General Medicine. New York: Churchill Livingstone, 1989: 145–57.
24.
OlesenSP. Rapid increase in blood—brain barrier permeability during severe hypoxia and metabolic inhibition. Brain Res1986; 368: 24.
25.
CopenhavenWMJohnsonDD. Bailey's Textbook of Histology. 14th ed.Baltimore, Maryland: Williams and Wilkins, 1961: 215–16.
26.
WilsonSEPondGHouptKA. The pig as a model in biomedical research. In: Biology of the Pig. Comstock: Cornell University Press, 1978: 13–64.
27.
McCulloughAW. Some anomalies of the cerebral arterial circle of Willis and related vessels. Anat Rec1962; 142: 537–43.
28.
WaddingtonMM. Atlas of Cerebral Angiography with Anatomic Correlation. 1st ed.Boston, Massachusetts: Little, Brown, 1974.
29.
SmithMLAuerRNSiesjoBK. The density and distribution of ischaemic brain injury in the rat following 2–10 min of forebrain ischaemia. Acta Neurdpathol (Berl)1984; 64: 319–32.
30.
NgTGrahamDIAdamsJHFordI.Changes in the hippocampus and the cerebellum resulting from hypoxic insults: frequency and distribution. Acta Neuropathol (Berl)1989; 78: 438–43.
31.
WaltonJ.Brain's Diseases of the Nervous System. Disorders of the Cerebral Circulation. Oxford: Oxford University Press, 1985: 193–6.
32.
AllenAYanushkaJFitzpatrickJHJenkinsLWGilbowDD. Acute ultrastructural response of hypoxic hypoxia with relative ischaemia in the isolated brain. Acta Neuropathol (Berl)1989; 78: 637–48.
33.
SiesjoBKWielockT.Molecular mechanisms of ischaemic brain damage: calcium-related events. In: PlumFPulsinelliW, eds. Cerebrovascular Disease. New York: Raven Press, 1985: 187–97.
