Effect of extracranial-intracranial bypass and pentobarbital on acute stroke in dogs

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Abstract
Mongrel dogs (93) underwent intracranial carotid and middle cerebral artery occlusions. They were randomized into 4 groups. The untreated control group (no surgical or medical therapy) showed significant neurological deficit, 16% mortality and 17% mean hemisphere infarction. In the bypass group (superficial temporal to middle cerebral artery (STA-MCA) anastomosis completed within 3 h of occlusion), neurological deficit was diminished, mortality was 7%, and mean infarction was 5.66%. In the pentobarbital group (single dose of pentobarbital, 35 mg/kg administered i.v. 30 min after occlusion), neurological deficit was essentially the same as in the previous group, there was no mortality and mean infarction was 5.52%. In the pentobarbital/bypass group (pentobarbital dose plus STA-MCA bypass), neurological deficit was slightly lower than in previous treatment groups, there was no mortality and mean hemisphere infarction was 1.78%. Extracranial-intracranial bypass produced an immediate 31.6% increase in regional cortical blood flow. The combination of pentobarbital postocclusive therapy and early extracranial-intracranial bypass showed beneficial synergism.