Physostigmine improves cerebral blood flow in human focal cerebral ischemia.

The effect of intravenous physostigmine on cerebral perfusion of patients with cortical stroke was investigated using hexamethyl-propyleneamine oxime (HMPAO) single-photon emission computed tomography. Each patient was studied twice, afteran intravenous infusion of either 1 mg of physostigmine salicylate or saline. A marked increase in HMPAO activity was observed in all regions of post-physostigmine scans when compared to the corresponding post-saline scans, except for the area of infarction and its mirror area in the contralateral hemisphere. In conclusion, physostigmine improves perfusion in the area of penumbra of patients with cortical infarction.