title: Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography in patients with major cerebral artery steno-occlusive diseases.
abstract: Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography (SPECT) were prospectively investigated in 100 patients with major cerebral artery, atherosclerotic, and steno-occlusive diseases. All patients underwent two SPECT studies (with and without acetazolamide challenge) at an interval of 2 or 3 days, received a questionnaire immediately after each SPECT study, and returned the answered questionnaire within 7 days after the study. None of the 100 patients studied experienced any symptoms during the SPECT study without acetazolamide challenge. Sixty-three patients (63%) developed symptoms during the SPECT study with acetazolamide challenge, such as headache, nausea, dizziness, tinnitus, numbness of the extremities, motor weakness of the extremities, and general malaise 1-3 hours (mean 1.6 hours) after administration of acetazolamide, and these symptoms lasted for 0.5-72 hours (mean 7.9 hours). Multivariate statistical analysis revealed that younger age (95% confidence interval [CI] 0.896-0.980, p = 0.0047) and female sex (95% CI 1.178-16.129, p = 0.0274) were significantly associated with development of symptoms with acetazolamide challenge. The incidences of the development of symptoms with acetazolamide challenge were 91% (21/23) and 41% (12/29) in subgroups of women <70 years and men ≥70 years, respectively. Patients should be informed of such adverse effects of intravenous acetazolamide administration prior to the acetazolamide challenge test for evaluation of cerebrovascular reactivity.
authors.affiliation: Department of Neurosurgery, Iwate Medical University, Morioka, Iwate, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Saito
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Taro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kubo
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
mesh_terms: D000086:Acetazolamide / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000503:physiopathology; D002257:Carbonic Anhydrase Inhibitors / Q000009:adverse effects; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide