ascorbic-acid and Cerebral-Hemorrhage

Ascorbic acid (AA), a plasma antioxidant, is maintained at high levels in premature fetal blood and declines rapidly postpartum. The sudden reduction in blood AA levels secondary to premature delivery may increase the risk of oxidant injury, that is, bronchopulmonary dysplasia and intraventricular hemorrhage. There is concern that administration of AA to premature infants, in an effort to increase antioxidant capacity, may cause hemolysis. We felt that the benefits of early AA administration and prevention of the immediate postnatal drop in blood AA levels, might outweigh the risks of erthrocyte damage. Fifty one high-risk premature infants were randomized to receive either normal saline or 100 mg/kg of AA, daily for the first week of life. Double-blind comparisons were made of hemoglobin, hematocrit, erythrocyte morphology, bilirubin, number of blood transfusions and days of phototherapy, renal function tests, the incidence of infection, bronchopulmonary dysplasia, and intraventricular hemorrhage during the first month of life. The administration of AA prevented the immediate postnatal drop in AA and was not associated with evidence of increased hemolysis. No significant differences in renal function, rate of infection, bronchopulmonary dysplasia, or intraventricular hemorrhage were seen between the two groups. This study suggests that AA administration to the premature infant is safe and supports the designing and performance of larger clinical studies of the antioxidant properties of AA.

Topics: Antioxidants; Ascorbic Acid; Bilirubin; Blood Transfusion; Bronchopulmonary Dysplasia; Cerebral Hemorrhage; Cohort Studies; Double-Blind Method; Erythrocytes; Hematocrit; Hemoglobins; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infections; Kidney; Phototherapy; Reference Values; Safety

There are no prospective studies to determine whether plasma vitamin C modifies the risk of stroke among hypertensive and overweight individuals. We sought to examine whether plasma vitamin C modifies the association between overweight and hypertension and the risk of stroke in middle-aged men from eastern Finland.. We conducted a 10.4-year prospective population-based cohort study of 2419 randomly selected middle-aged men (42 to 60 years) with no history of stroke at baseline examination. A total of 120 men developed a stroke, of which 96 were ischemic and 24 hemorrhagic strokes.. Men with the lowest levels of plasma vitamin C (<28.4 micromol/L, lowest quarter) had a 2.4-fold (95% CI, 1.4 to 4.3; P=0.002) risk of any stroke compared with men with highest levels of plasma vitamin C (>64.96 micromol/L, highest quarter) after adjustment for age and examination months. An additional adjustment for body mass index, systolic blood pressure, smoking, alcohol consumption, serum total cholesterol, diabetes, and exercise-induced myocardial ischemia attenuated the association marginally (relative risk, 2.1; 95% CI, 1.2 to 3.8; P=0.01). Adjustment for prevalent coronary heart disease and atrial fibrillation did not attenuate the association any further. Furthermore, hypertensive men with the lowest vitamin C levels (<28.4 micromol/L) had a 2.6-fold risk (95% CI, 1.52 to 4.48; P<0.001), and overweight men (> or =25 kg/m2) with low plasma vitamin C had a 2.7-fold risk (95% CI, 1.48 to 4.90; P=0.001) for any stroke after adjustment for age, examination months, and other risk factors.. Low plasma vitamin C was associated with increased risk of stroke, especially among hypertensive and overweight men.

Topics: Adult; Ascorbic Acid; Body Mass Index; Brain Ischemia; Cerebral Hemorrhage; Cohort Studies; Demography; Finland; Follow-Up Studies; Humans; Hypertension; Male; Middle Aged; Obesity; Prospective Studies; Risk; Risk Assessment; Risk Factors; Stroke

We sought to investigate the effects of EPC-K1, a free radical scavenger, on reducing heparin-produced cerebral hemorrhage in a rabbit model of middle cerebral artery (MCA) photothrombosis and to investigate whether the combination of EPC-K1 and heparin enhances neuroprotection from cerebral ischemic damage.. In the heparin-alone group (n=8), heparin was administered intravenously for 24 hours, starting from 3 hours after MCA occlusion. In the EPC-K1-alone group (n=8), EPC-K1 was administered as a bolus injection (10 mg/kg) twice at 3 and 6 hours after MCA occlusion. In the combination group (n=8), EPC-K1 and heparin both were administered as in the single-drug procedures. In the vehicle group (n=10), saline were infused for 24 hours.. Heparin prolonged activated partial thromboplastin time by approximately 3 times that of control animals. In the heparin-treated animals, the hemorrhage size was significantly increased (P<0.0001) and neurological symptoms were significantly worse (P<0.01) than in control animals at 48 hours. The combination of EPC-K1 and heparin dramatically reduced heparin-produced cerebral hemorrhage (P<0.0001), with a significant reduction in infarct volume (reduction by 63.2% and 57.2% of heparin-alone and control animals, respectively, P<0.0001) and a significant improvement in neurological symptoms (P<0.01 versus heparin-alone and control animals, respectively).. These data indicate that free radical formation may play a key role in intracerebral hemorrhage exacerbated by heparin treatment and that the combination of a free radical scavenger and heparin augmented neuroprotection from acute brain ischemia. The results of the present study may suggest a potential clinical approach for the treatment of acute stroke.

Topics: Animals; Ascorbic Acid; Blood Flow Velocity; Body Temperature; Cerebral Hemorrhage; Disease Models, Animal; Drug Therapy, Combination; Free Radical Scavengers; Heparin; Infarction, Middle Cerebral Artery; Light Coagulation; Middle Cerebral Artery; Partial Thromboplastin Time; Rabbits; Reperfusion; Treatment Outcome; Vitamin E

To explore the association of risk for human cerebral hemorrhage with blood cholesterol, free radicals, oxidation and lipoperoxidation.. 351 cerebral hemorrhage patients (CHP) in the acute phase and 100 healthy adult volunteers (HAV) were investigated by testing the contents of cholesterol (CH), lipoperoxides (LPO), nitric oxide (NO), vitamin C (VC) and vitamin E (VE) and activities of superoxide dismutase (SOD) in plasma and erythrocytes (RBC), and by assessing the contents of CH and LPO in RBC with spectrophotometric assays.. Compared with the average values (AV) of the above biochemical parameters (BP) in the HAV group, the AV of CH in plasma and RBC, VC and VE in plasma as well as SOD in plasma and RBC in the CHP group were significantly decreased (P = 0.0000), while the AV of the LPO in plasma and RBC as well as NO in plasma in the CHP group were significantly increased (P = 0.0000). The findings of linear correlation analysis for the CHP group showed that the above biochemical parameters were significantly correlated with both intracranial hemorrhagic sizes (IHS) and neurotic functional defective scales (NDS). The findings of stepwise correlation analysis for the CHA group suggested that HIS was closely correlated with the values of CH and LPO in RBC as well as NO and VE in plasma, and that NDS was closely correlated with the values of CH and LPO in RBC as well as NO and VC in plasma.. The findings of the present study suggest that marked low RBC cholesterol and marked high RBC lipoperoxides may constitute the potential main risk factors for human cerebral hemorrhage, and that the oxidative and lipoperoxidative stress in the CHP bodies is pathologically aggravated, leading to the oxidative and lipoperoxidative damages in the CHP.

Topics: Adult; Aged; Aged, 80 and over; Ascorbic Acid; Cerebral Hemorrhage; Cerebral Infarction; Cholesterol; Erythrocytes; Female; Free Radicals; Humans; Lipid Peroxidation; Male; Middle Aged; Nitric Oxide; Oxidative Stress; Risk Factors; Superoxide Dismutase; Vitamin E

Epidemiological evidence suggests that vitamin C may decrease the risk of stroke. The purpose of the present study was to examine the association of serum vitamin C concentration with the subsequent incidence of stroke.. In a Japanese rural community, a cohort of 880 men and 1241 women aged 40 years and older who were initially free of stroke was examined in 1977 and followed until 1997. The baseline examination included a measurement of serum vitamin C concentration. The incidence of stroke was determined by annual follow-up examinations and registry.. During the 20-year observation period, 196 incident cases of all stroke, including 109 cerebral infarctions and 54 hemorrhagic strokes, were documented. Strong inverse associations were observed between serum vitamin C concentration and all stroke (sex- and age-adjusted hazard ratios were 0.93, 0.72, and 0.59, respectively, for the second, third, and fourth quartiles compared with the first quartile; P for trend=0.002), cerebral infarction (0.71, 0.59, and 0.51; P for trend=0.015), and hemorrhagic stroke (0.89, 0.75, and 0. 45; P for trend=0.013). Additional adjustments for blood pressure, serum total cholesterol, body mass index, physical activity, smoking, alcohol drinking, antihypertensive medication, atrial fibrillation, and history of ischemic heart disease did not attenuate these associations markedly.. Serum vitamin C concentration was inversely related to the subsequent incidence of stroke. This relationship was significant for both cerebral infarction and hemorrhagic stroke. Additional mechanistic hypotheses may be required to explain our findings.

Topics: Adult; Age Distribution; Aged; Ascorbic Acid; Cerebral Hemorrhage; Cerebral Infarction; Cohort Studies; Comorbidity; Diet; Female; Follow-Up Studies; Humans; Incidence; Japan; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Risk Factors; Rural Population; Sex Distribution; Stroke

Antioxidants may protect against atherosclerosis and thus prevent cerebrovascular disease. We studied the association between dietary antioxidants and subtypes of stroke.. The study cohort consisted of 26 593 male smokers, aged 50 to 69 years, without a history of stroke. They were participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study in Finland. The men completed a validated dietary questionnaire at baseline. Incident cases were identified through national registers.. During a 6.1-year follow-up, 736 cerebral infarctions, 83 subarachnoid hemorrhages, and 95 intracerebral hemorrhages occurred. Neither dietary flavonols and flavones nor vitamin E were associated with risk for stroke. The dietary intake of beta-carotene was inversely associated with the risk for cerebral infarction (relative risk [RR] of highest versus lowest quartile 0.74, 95% CI 0.60 to 0. 91), lutein plus zeaxanthin with risk for subarachnoid hemorrhage (RR 0.47, 95% CI 0.24 to 0.93), and lycopene with risks of cerebral infarction (RR 0.74, 95% CI 0.59 to 0.92) and intracerebral hemorrhage (RR 0.45, 95% CI 0.24 to 0.86). Vitamin C intake was inversely associated with the risk for intracerebral hemorrhage (RR 0.39, 95% CI 0.21 to 0.74). After simultaneous modeling of the antioxidants, a significant association remained only between beta-carotene intake and risk for cerebral infarction (RR 0.77, 95% CI 0.61 to 0.99).. Dietary intake of beta-carotene was inversely associated with the risk for cerebral infarction. No association was detected between other dietary antioxidants and risk for stroke.

Topics: Aged; Ascorbic Acid; beta Carotene; Carotenoids; Cerebral Hemorrhage; Cerebral Infarction; Cohort Studies; Comorbidity; Diet; Finland; Flavonoids; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Risk; Risk Assessment; Smoking; Stroke; Subarachnoid Hemorrhage; Vitamin E; Vitamins

Iron compounds formed in the degradation of a hematoma can accelerate the formation of free radicals in adjacent ischemic or hypoperfused tissue. The purpose of this study was to examine the efficacy of compounds that quench free radicals in improving the outcome in rats with experimental intracerebral hemorrhage. Intracerebral hemorrhage was induced in rats by injection of bacterial collagenase and heparin into the caudate nucleus. Rats were treated with alpha-tocopherol plus ascorbic acid starting before hemorrhage, or with dimethylthiourea or alpha-phenyl-N-tert-butyl nitrone starting 2 h after hemorrhage, with treatment continued for 10 days after induction of hemorrhage. Outcome was assessed by behavioral analyses, magnetic resonance imaging, and histopathology. A trend towards behavioral improvement was found for rats treated with alpha-tocopherol/ascorbic acid, while behavior was significantly improved following intracerebral hemorrhage in rats treated with dimethylthiourea or alpha-phenyl-N-tert-butyl nitrone. These results suggest that free radicals may play a role in the development of brain injury following intracerebral hemorrhage, and that compounds that interrupt the free radical cascade may improve outcome. However, treatment did not significantly affect edema, resolution of the hematoma, or neuronal injury in tissue adjacent to the hemorrhage.

Topics: Animals; Ascorbic Acid; Behavior, Animal; Body Temperature; Cerebral Hemorrhage; Cyclic N-Oxides; Feeding Behavior; Free Radical Scavengers; Free Radicals; Magnetic Resonance Imaging; Male; Neurologic Examination; Neuroprotective Agents; Nitrogen Oxides; Rats; Rats, Sprague-Dawley; Thiourea; Vitamin E

The authors present their results regarding the use of a buffered solution of glycerol 30%-sodium ascorbate 20% (GLIAS) for the treatment of brain oedema and intracranial hypertension. GLIAS was perfused intravenously in 80 patients with several types of brain oedema. In every patients serum and urinary osmolarity, diuresis, main blood and urine parameters, and ICP were monitored. Following GLIAS infusion an increase in plasma osmolarity was observed, changing the average basal value plus 13.4% after 15 min., 10.5% after 30'. At the same time there was a reduction of ICP and improvement in cerebral compliance. In each case there was a decrease in intracranial hypertension and brain oedema without significant collateral effects.

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Brain Edema; Brain Injuries; Brain Neoplasms; Buffers; Cerebral Hemorrhage; Child; Dose-Response Relationship, Drug; Female; Glycerol; Humans; Hypertonic Solutions; Infusions, Intravenous; Intracranial Aneurysm; Intracranial Pressure; Male; Middle Aged; Postoperative Complications; Pseudotumor Cerebri

Corresponding plasma and cerebrospinal fluid ascorbic acid levels were determined in 13 term and 17 preterm newborn infants during the neonatal period. On the first day of life preterm C.S.F ascorbate value of 5.2 +/- 0.8 mg/dl (mean +/- S.E.) was higher than the 3.8 +/- 0.3 mg/dl value in term infants (P less than 0.1). Later determinations during the neonatal period did not demonstrate a difference between term and preterm C.S.F ascorbate values and levelled at 2.9 +/- 0.2 mg/dl. There was a significant negative correlation between the C.S.F/plasma ascorbate ratio and the plasma ascorbate levels and the shape of the regression line was suggestive of a saturable active ascorbate transport from the plasma into the cerebrospinal fluid. Ascorbic acid in the C.S.F of additional six neonates with a neurological disorder was lower than expected on the basis of their plasma levels, the C.S.F/plasma ascorbate ratios being 8.3 +/- 0.9 in the apparently normal infants and 3.7 +/- 0.6 in the neurological patients, (P less than 0.025). The possible mechanism of ascorbate loss from the central nervous system is discussed and it is speculated that ascorbic acid administration following a neurological insult may prove beneficial.

Topics: Ascorbic Acid; Cerebral Hemorrhage; Homeostasis; Humans; Hydrocephalus; Infant, Newborn; Infant, Premature

Topics: Aged; Ascorbic Acid; Cerebral Hemorrhage; Cerebrovascular Disorders; Female; Fibrinolysis; Fruit; Humans; Intracranial Embolism and Thrombosis; Male; Middle Aged; Social Class; United Kingdom; Vegetables

The accumulation of ascorbic acid in the brain by active transport establishes a high brain-plasma gradient of the vitamin. An insult to the CNS may result in an efflux of ascorbate into the circulation with a consequent rise of plasma levels. We measured plasma ascorbic acid levels in premature neonates on days 1, 3, and 5 of life, and the infants underwent ultrasonographic examination to detect intracranial hemorrhage. Neonates with intraventricular hemorrhage sustained significantly higher plasma ascorbate levels than their controls. Infants with massive bleeding had higher levels than those with a smaller hemorrhage. These results suggest that an efflux of ascorbic acid into the circulation occurs secondary to intracranial hemorrhage.

Topics: Apgar Score; Ascorbic Acid; Biological Transport, Active; Birth Weight; Cerebral Hemorrhage; Gestational Age; Humans; Infant, Newborn; Infant, Premature, Diseases; Time Factors; Urea

The uptake of 99mTc-pertechnetate (TcO4), 99mTc-iron-ascorbic acid (Feasc), 99mTc-Solcocitran (Solcocitran), 99mTc-diphosphonate (HEDP) and 67Ga-citrate (Ga) in various brain lesions was compared. Influence of time from injection was also studied on the first three compounds. A rank correlation method was used to compare the scans which were judged visually by three independent observers. There was good agreement between the observers, as measured by Kendall's tau, but the concordance between rankings within the same type of lesion, as measured by Kendall's W, was rather poor. There was no significant difference in the uptake of TcO4, Feasc and Solcocitran. Ga showed generally poor uptake and its uptake in tumours and infarcts did not differ significantly. However, when HEDP and TcO4 were compared in two groups (I: Infarcts, haemorrhages and bone invading meningiomas, and II: Tumours not invaded into bone) a highly significant difference was obtained with much higher uptake of HEDP in Group I.

Topics: Adult; Ascorbic Acid; Brain Diseases; Brain Neoplasms; Cerebral Hemorrhage; Cerebral Infarction; Citrates; Diphosphonates; Gallium Radioisotopes; Humans; Organotechnetium Compounds; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Compounds

Topics: Acute Disease; Age Factors; Ascorbic Acid; Calcium; Cerebral Hemorrhage; Cortisone; Diet Therapy; Glomerulonephritis; Gluconates; Humans; Male; Middle Aged; Purpura; Rheumatic Diseases; Rutin; Vitamin K

Topics: Ascorbic Acid; Cerebral Hemorrhage; Cerebrovascular Disorders; Humans

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Astrocytoma; Cerebral Hemorrhage; Congenital Abnormalities; Humans; Intracranial Aneurysm; Subarachnoid Hemorrhage

Topics: Ascorbic Acid; Cerebral Hemorrhage; Fetal Diseases; Fetus; Humans; Intracranial Hemorrhages; Rutin

Topics: Aminophylline; Ascorbic Acid; Cerebral Hemorrhage; Ethylenediamines; Flavonoids; Humans; Rutin; Stroke; Theophylline; Vitamins