Sequential development of reversible and irreversible neuronal damage following cerebral ischemia.

The ultrastructure of reversibly injured cortical neurons and irreversibly injured striatal neurons was studied at 3, 15, 30, and 120 minutes (min) and 24 hours (h) following severe cerebral ischemia produced in rats by permanent occlusion of the vertebral arteries and 30 min occlusion of the carotid arteries. Animals meeting the established criterion of unresponsiveness had widespread neuronal death in the dorsolateral striatum, but no permanent damage in the paramedian cortex. Reversible mitochondrial swelling at three min was followed by dissociation of polyribosomes, decrease in rough endoplasmic reticulum (RER) profiles, and transformation of Golgi apparatus into large clusters of small vesicles without cisterns in both cortical and striatal neurons. Reaccumulation of RER was seen in cortical neurons by 30-120 min and all cortical neurons appeared normal at 24 h. In contrast, most striatal neurons developed dilatation of the Golgi vesicles by 120 min after reperfusion, followed by progressive cell shrinkage and ischemic cell change. Approximately 10-15% of striatal neurons contained cytoplasmic membranous whorls, some continuous with the plasma membrane. The results suggest that structural abnormalities in the Golgi apparatus and in plasma membranes may participate in functional changes critical to irreversible neuronal injury following cerebral ischemia.