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  • 1
    Electronic Resource
    Electronic Resource
    Spontaneous improvement in reduced vasodilatory capacity in major cerebral arterial occlusive disease (2000)
    Springer
    Neuroradiology 42 (2000), S. 19-25 
    Details
    ISSN: 1432-1920
    Keywords: Key words Single photon emission tomography ; Acetazolamide ; Cerebral ischaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Reduced vasodilatory capacity resulting from occlusive lesions of the major cerebral arteries may return to normal without surgical revascularisation. We aimed to determine prospectively the frequency and predictors of recovery of impaired haemodynamics as demonstrated by acetazolamide (ACZ) reactivity on single-photon emission computed tomography (SPECT). Vasoreactivity was measured by 123I-IMP SPECT with an ACZ challenge, in 37 medically treated patients with unilateral occlusive disease of the internal carotid or middle cerebral artery at an interval of 1–2 years. Each ACZ challenge test was analysed semiquantitatively by calculating the degree of increase in cerebral blood flow (CBF) asymmetry after ACZ administration (ΔAI). Vasodilatory capacity was abnormal initially in 20 patients (65 %); eight of whom (40 %) exhibited spontaneous normalisation on follow-up. Although the baseline characteristics did not differ significantly between patients with or without increase in reactivity, logistic regression analysis revealed that the initial ΔAI (P 〈 0.05) and the type of vascular lesion (stenosis or occlusion) (P 〈 0.05) correlated significantly with a return towards normal of reduced ACZ reactivity. Spontaneous improvement of impaired vasodilatory capacity may not be a rare phenomenon. We found that mild reduction in the initial ACZ reactivity and a stenosis, but not complete occlusion, were independent factors contributing to normalisation of impaired cerebral haemodynamics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050004
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Sequential change of hemodynamic reserve in patients with major cerebral artery occlusion or severe stenosis (1992)
    Springer
    Neuroradiology 34 (1992), S. 15-21 
    Details
    ISSN: 1432-1920
    Keywords: Single photon emission computed tomography ; 123I-IMP ; Cerebral infarction ; Cerebral thrombosis ; Acetazolamide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To identify regional vasodilatory capacity and its sequential change, we evaluated prospectively a total of 78 acetazolamide tests in 51 patients with occlusion or greater than 75% stenosis of the carotid or middle cerebral arteries. The relative distribution of cerebral blood flow was determined by single photon emission computed tomography usingN-isopropyl-p-[123I]-iodoamphetamine before and after intravenous injection of acetazolamide. Reduced vasodilatory capacity was demonstrated in 20 patients (38%), including 5 patients with hemodynamic transient ischemic attacks or infarction. Follow-up acetazolamide tests revealed asymptomatic progression of the arterial lesion (from stenosis to occlusion) in 1 patient and almost complete improvement of vasodilatory capacity in 5 patients, including 3 without surgical intervention. During an average follow-up period of 18.5 months, 4 patients died from cardiac causes or neoplasm; no neurovascular events occurred. Much larger numbers of patients with longer observation periods will be necessary to clarify the contribution of chronic hemodynamic failure to subsequent stroke. However, the present data indicate that the acetazolamide test is useful for assesssing the course of high grade stenosis or occlusion of major cerebral arteries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588426
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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