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Krypton-81m single photon emission tomography and the collateral circulation in carotid occlusion: the role of the circle of Willis and leptomeningeal anastomosis

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Summary

Cerebral perfusion images were investigated in patients with carotid artery occlusion, using single photon emission computed tomography with the infusion of krypton-81m into the internal, common carotid and vertebral arteries. The contribution of the circle of Willis and cerebral cortical anastomoses to the maintenance of adequate blood supply into the involved hemisphere was analysed. It was concluded that the cerebral perfusion image is superior to angiography in evaluating collateral circulation, and in the case of carotid occlusion, the circle of Willis is important in preventing infarction in the territory of the perforating arteries, while the cerebral cortex mainly receives its blood supply through the cortical leptomeningeal anastomoses, illustrating the major role of the leptomeningeal anastomosis as a collateral channel.

Zusammenfassung

Zerebrale Perfusionsbilder wurden bei Patienten mit Halsschlagaderverschluß untersucht. Dazu wurde eine Infusion mit Krypton 81m in die A. carotis comm., A. carotis int. und in die A. vertebralis vorgenommen und dann computergesteuerte Einzelphotonenemissionstomogramme angefertigt. Analysiert wurde, welchen Beitrag der Gefäßkranz an der Hirnbasis und die Anastomosen der Großhirnrinde leisten, um eine angemessene Blutversorgung des betroffenen Gebietes aufrechtzuerhalten. Man kam zu dem Schluß, daß das zerebrale Perfusionsbild in der Abschätzung von Nebenkreisläufen der Angiographie überlegen ist. Im Fall eines Halsschlagaderverschlusses ist der Gefäßkranz an der Hirnbasis von Bedeutung, einen Infarkt im Gebiet der perforierenden Arterien zu verhüten, während die Großhirnrinde vorwiegend über die Anastomosen der weichen Hirnhaut mit Blut versorgt wird, was die Hauptrolle der Anastomosen der weichen Hirnhaut beweist.

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Fukuyama, H., Akiguchi, I., Kameyama, M. et al. Krypton-81m single photon emission tomography and the collateral circulation in carotid occlusion: the role of the circle of Willis and leptomeningeal anastomosis. J Neurol 230, 7–17 (1983). https://doi.org/10.1007/BF00313592

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  • DOI: https://doi.org/10.1007/BF00313592

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