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P6 Background: There is active migration of  leukocytes into the brains of patients with cerebral infarctions  directed by several classes of cell surface glycoproteins. Among the  most studied adhesion molecules is ICAM-1 (intercellular adhesion  molecule-1) which is located on the endothelial surface. As the extent  of the infarction and timing of recanalization largely vary between  patients these may be some of the reasons for the differences found in  the soluble adhesion molecule field in previous human studies.  Transcranial Doppler (TCD) offers a continous means of monitoring  vessel patency, therefore we have chosen this tool to correlate the  development of adhesion molecules mediated injury with the  recanalization after middle cerebral artery strokeObjectives: To study  adhesion molecules temporal profile in the acute phase of an homogeneus  sample of stroke patients. To correlate adhesion molecule levels with  the time-to-spontaneous-recanalization.Methods: From all  consecutive stroke patients attended during a year period we selected  and prospectively studied those presenting as a cardioembolic stroke  involving the MCA territory. In 45 patients, serum levels of soluble  ICAM-1 were repeatedly determined by ELISA in the acute phase. Serial  TCD studies were performed to determine the time course of spontaneous  recanalization, at study entry and at 12, 24 and 48 hours of the  symptoms onset, when the blood sample for adhesion molecules  determination was obtained.Results: ICAM-1 levels peaked at  baseline determination (414,44 ng/ml) and decreased by the following  determinations (12h=401,25 ng/ml; 24h=392,08 ng/ml; 48h=379,34 ng/ml).  ICAM-1 levels at 12h of stroke onset were closely related with the MCA  recanalization (p=0,032). Low ICAM-1 levels at 12h (356,81 ng/ml) are  associated with the finding of a patent MCA at the 48h TCD, conversely  high ICAM-1 levels (459,97 ng/ml) are associated with a persistent MCA  occlussion.Conclusions: Patients who develop postischemic  adhesion molecules upregulation are less prone to spontaneous  recanalization. Antiadhesion therapies could facilitate reperfusion  strategies.

ADHESION MOLECULE (ICAM-1) SERUM LEVELS ARE RELATED TO SPONTANEOUS RECANALIZATION IN HUMAN ISCHEMIC STROKE.