Y. Sato et al., MORPHOLOGICAL AND HISTOCHEMICAL-STUDY OF NONHEMIPLEGIC MUSCLE IN ACUTE STROKE PATIENTS MANIFESTING RESPIRATORY-FAILURE, European neurology, 36(1), 1996, pp. 13-19
There is little information on skeletal muscle changes in patients wit
h acute stroke. We performed morphological and histochemical examinati
ons of non-hemiplegic sternothyroid muscles biopsied at the time of tr
acheostomy from 13 patients with acute stroke manifesting acute respir
atory failure. Degenerating and regenerating fibers were observed in a
ll 13 specimens. Following characteristic myopathic changes suggestive
of mitochondrial abnormalities were also demonstrated in a majority o
f patients. Namely, ragged-red fibers, focal increase in NADH-TR activ
ity in subsarcolemmal areas and increases in acid phosphate activity w
ere found. The changes were similar but extremely slight in control pa
tients with acute respiratory failure due to causes other than stroke
and were absent in the other control patients with adenomatous thyroid
tumor. The severity and extent of the histopathological changes in th
e muscle fibers in patients with acute stroke were closely correlated
with the duration of hypoxemia but not with such items as type of stro
ke, site of cerebral lesion, consciousness level, days of biopsy after
the stroke, clinical outcome, levels of serum creatine kinase, myoglo
bin and PaO2. This acute nonhemiplegic muscle involvement was consider
ed to be a very common complication in severe Ragged-red fiber stroke
patients.