We investigated the possible protective effect of phenytoin on hypoxic
-ischemic brain damage in neonatal rats. Six-day-old rats underwent li
gation of the left carotid artery followed by exposure to an 8% oxygen
atmosphere for 2.5 hrs. We sacrificed the animals 72 hrs later and as
sessed the hypoxic-ischemic brain damage histologically. Phenytoin (50
mg/kg), administered intraperitoneally 1 hr before the hypoxia, reduc
ed hypoxic-ischemic infarction in the cerebral cortex and striatum, an
d attenuated neuronal necrosis in the hippocampus. The plasma concentr
ation of phenytoin after injection was 11.1+/-1.9 mu g/ml (mean+/-S.E.
M) at 1 hr and 22.9+/-1.4 mu g/ml at 4 hrs. Percent volumes of the inf
arction calculated by dividing the sum of damaged areas by the total a
rea in serial coronal sections were 79+/-3% (mean+/-S.E.M.) in vehicle
controls versus 13+/-6% in phenytoin-treated pups in the cerebral cor
tex, and 79+/-4% in vehicle controls versus 12+/-5% in phenytoin-treat
ed pups in the striatum. We semiquantitatively investigated the hypoxi
c-ischemic change in 5 hippocampal areas: dentate gyrus, CA4, CA3, CA1
, and subiculum, in the dorsal hippocampus. Pre-hypoxic treatment with
phenytoin reduced hypoxic-ischemic damage in all areas examined. When
phenytoin was administered immediately after the hypoxia, there was n
o difference between vehicle-injected controls and phenytoin-treated p
ups. These results demonstrate that phenytoin can reduce neonatal hypo
xic-ischemic brain damage.