Long-term prognosis in ischemic cerebrovascular disease in relation to cerebral blood flow and metabolism.
The correlation between long-term prognosis and cerebral hemodynamics and oxygen consumption was investigated in 46 patients with ischemic supratentorial cerebrovascular disease. Cerebral blood flow (CBF) and cerebral oxygen consumption (CMRO2) were measured by the N2O method 1-6 months (mean 68 days) after disease onset. No significant correlation was observed among CBF, CMRO2 and activities of daily living at the time of measurement. The patients' physical condition was reevaluated by the questionnaire method 2 years or more (mean 53 months) later. The CBF values in patients who were independent after completion of the follow-up period significantly exceeded those of patients dying during the period (P less than 0.05). No correlation was observed in CMRO2. The relationship among CBF, CMRO2 and changes in physical condition during the period was evaluated. Mean CBF values in patients with better prognosis exceeded those of patients with poor prognosis. Notably, CBF values in the "improved" group significantly exceeded those in the "unchanged" or "died" group (P less than 0.05, P less than 0.01). CMRO2 was not significantly correlated with changes of physical condition. These results emphasize the importance of total CBF for long-term prognosis and indicate that flow values, rather than metabolic indices, obtained in the chronic stage can usefully predict the long-term prognosis.
D000368:Aged; D001921:Brain / Q000378:metabolism*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000378:metabolism; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000378:metabolism; D004734:Energy Metabolism; D006801:Humans; D008875:Middle Aged; D010101:Oxygen Consumption; D011379:Prognosis