title: Critical analysis of hemodynamic insufficiency by head-up tilt in patients with carotid occlusive disease.
abstract: BACKGROUND
  The objective of this study was to evaluate the diagnostic value of the head-up-tilt (HUT) test for detecting cerebral hemodynamic insufficiency in patients with major cerebral artery occlusion disease because such patients may benefit from extracranial - intracranial bypass surgery.
  
  
  RESULTS
  In 13 cases of transient ischemic attacks in patients with carotid or middle cerebral artery occlusive disease, the HUT test was used to determine whether or not the symptoms appear during induced hypotension before investigating cerebral hemodynamics with positron emission tomography. Three of the 13 patients showed focal symptoms such as hemiparesis and limb shaking during the HUT test. In all 3 patients, the oxygen extraction fraction (OEF) increased beyond 53.3% (ie, misery perfusion), whereas only 2 of the other 10 patients without focal symptoms showed an increase in OEF during HUT.
  
  
  CONCLUSIONS
  The HUT test was highly useful for screening patients with cerebral hemodynamic insufficiency in carotid occlusive disease.
authors.affiliation: Division of Strokology, Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Naohiko
authors.initials: N
authors.lastname: Oku
authors.forename: Masao
authors.initials: M
authors.lastname: Imaizumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.forename: Toshiho
authors.initials: T
authors.lastname: Ohtsuki
authors.forename: Kohji
authors.initials: K
authors.lastname: Matsushita
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Hougaku
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011859:Radiography; D018667:Tilt-Table Test / Q000379:methods