MORPHOLOGICAL AND HISTOCHEMICAL-STUDY OF NONHEMIPLEGIC MUSCLE IN ACUTE STROKE PATIENTS MANIFESTING RESPIRATORY-FAILURE

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.