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Early identification of the potentially salvageable penumbra is critical for the determination of therapeutic intervention strategies in acute focal cerebral ischemia. This study differentiates the ischemic penumbra from the core on the basis of the dynamics of lactate formation. This was tested in a rat model of focal cerebral ischemia by infusion of [1- 13 C]-glucose, using lactate-edited magnetic resonance spectroscopic imaging techniques. The authors detected essentially no enrichment of lactate with  13 C-label from the infused  13 C-glucose in the ischemic core. However, in borderzone areas,  13 C was incorporated into lactate, which could point toward compromised but potentially viable tissue. The authors' findings suggest that this combination of  13 C-glucose infusion with the proposed magnetic resonance methods may aid in differentiating the penumbra from the core in cerebral ischemia.

Spatial Assessment of the Dynamics of Lactate Formation in Focal Ischemic Rat Brain