OBJECTIVE: Although the effects of acute ischemic insults to the brain
are well known, the effects related to chronic ischemia are poorly de
lineated. The pathological and behavioral changes induced by a chronic
noninfarctional reduction in cerebral blood flow of 25 to 50% maintai
ned for 6 months were assessed. METHODS: In each of 18 male Sprague-Da
wley rats, an arteriovenous fistula was created in the neck via an ana
stomosis between the right external jugular vein and the right common
carotid artery to induce cerebral hypoperfusion. Nineteen age-matched
animals comprised a control group. Six months after surgery, the anima
ls were examined using light and electron microscopic techniques, as w
ell as via a battery of behavioral tests (motor, open field, and T-maz
e). RESULTS: Examination of the hippocampus by using light microscopy
revealed disorganization of the CA1 sector with an increased number of
astrocytes. Transmission electron microscopy of the CA1 region demons
trated neurons with increased lipofuscin pigment and central nucleoli
and astrocytes with more numerous cytosolic mitochondria. Motor perfor
mance testing revealed no gross motor deficits, although open-field as
sessment demonstrated increased exploratory behavior in rats with fist
ulas. Finally, T-maze testing results suggested that errors in working
memory were more common in rats undergoing chronic cerebral hypoperfu
sion (P < 0.05). CONCLUSIONS: These findings suggest that chronic redu
ctions in cerebral blood flow of a magnitude previously thought to be
harmless to neurons (i.e., reduced by 25-50%) do alter neuronal struct
ure and affect whole animal behavior. Such a scenario may be responsib
le for a symptomatology secondary to arteriovenous steal and severe ca
rotid stenoses. The mechanisms are still unknown.