title: Cerebrovascular reserve capacity in ischemia due to occlusion of a major arterial trunk: studies by Xe-CT and the acetazolamide test.
abstract: Classifications based on clinical and radiographic criteria have proved to be inadequate predictors of the course of cerebral ischemia or its response to therapy. In this study the cerebrovascular reserve capacity (CRC) of 46 patients with symptomatic cerebrovascular ischemia was studied by stable xenon-enhanced CT (Xe-CT) combined with the acetazolamide test. Fifteen patients had internal carotid artery (ICA) occlusion, 10 had ICA stenosis, 10 had middle cerebral artery (MCA) occlusion, and 11 had MCA stenosis. In the patients with chronic cerebral ischemia due to occlusive lesions of the ICA and MCA, the CRC was reduced most in those with MCA occlusion, followed, in descending order, by those with ICA stenosis, MCA stenosis, and ICA occlusion. Our results indicate that measurement of the CRC elucidates cerebral hemodynamic factors that cannot be detected by angiography in patients with chronic cerebral ischemia and that Xe-CT combined with the acetazolamide test is useful for this purpose.
authors.affiliation: Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamashita
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.forename: S
authors.initials: S
authors.lastname: Kashiwagi
authors.forename: S
authors.initials: S
authors.lastname: Nakano
authors.forename: Y
authors.initials: Y
authors.lastname: Eguchi
authors.forename: T
authors.initials: T
authors.lastname: Takasago
authors.forename: M
authors.initials: M
authors.lastname: Urakawa
authors.forename: H
authors.initials: H
authors.lastname: Ito
mesh_terms: D000086:Acetazolamide; D000293:Adolescent; D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002343:Carotid Artery, Internal; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014979:Xenon Isotopes
chemical_list: D014979:Xenon Isotopes; D000086:Acetazolamide