Changes in brain volume 2 years after extracranial-intracranial bypass surgery: A preliminary subanalysis of the Japanese EC-IC trial.
METHODS
We studied changes in brain volume on magnetic resonance imaging in 10 patients with and without extracranial-intracranial (EC-IC) bypass surgery who met the inclusion criteria for the Japanese EC-IC Bypass Trial, a multicenter, randomized, prospective study of patients with hemodynamic brain ischemia due to cerebral artery occlusive disease. We also examined the association of cerebral hemodynamics on single-photon emission computed tomography with the changes in brain volume.


RESULTS
The affected/unaffected ratio of the percent brain volume declined in patients without EC-IC bypass surgery (p < 0.02, n = 4), and the affected/unaffected percent regional cerebral blood flow ratio increased in patients with the surgery (p < 0.03, n = 6). Acetazolamide reactivity increased in the affected hemisphere of patients with surgery (p < 0.01). Two-year increase (decrease) in acetazolamide reactivity of the affected hemisphere showed a significant positive correlation with 2-year changes in the affected/unaffected percent brain volume ratio (R2 = 0.737, p = 0.0007).


CONCLUSIONS
Change in acetazolamide reactivity might be a good predictor for brain atrophy in cerebral artery occlusive disease.
Jinnouchi
Juro
J
Department of Cerebrovascular Disease, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Toyoda
Kazunori
K
Inoue
Tooru
T
Fujimoto
Shigeru
S
Gotoh
Seiji
S
Yasumori
Kotaro
K
Ibayashi
Setsuro
S
Iida
Mitsuo
M
Okada
Yasushi
Y
D000086:Acetazolamide; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002545:Brain Ischemia / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002539:Cerebral Arterial Diseases / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D016032:Randomized Controlled Trials as Topic; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D007457:Iodine Radioisotopes; D000086:Acetazolamide