Abstract:
:Patterns of anterior border zone (ABZ) and middle cerebral artery (MCA) cerebral blood flow (CBF) asymmetry were readily seen during both normocapnic room air (RA) and induced hypercapnic (CO2) inhalation using fluoro-methane and a multislice, high-resolution positron scanner. Wilcoxon two-sample rank testing showed symptomatic-over-nonsymptomatic CBF ratios for unilateral greater than 75% carotid stenosis patients (n = 8) to be 1.05 +/- 0.07 (p less than 0.008 as compared with control of 0.97 +/- 0.02) ABZ RA, 0.98 +/- 0.11 ABZ Co2, 0.98 +/- 0.04 MCA RA, and 0.98 +/- 0.06 MCA CO2. Unilateral carotid occlusion patients (n = 8) had ratios of 0.90 +/- 0.16 ABZ RA, 0.81 +/- 0.19 (p less than 0.002) ABZ CO2, 0.90 +/- 0.12 and 0.89 +/- 0.13 for MCA RA and CO2, respectively (both p less than 0.008 as compared with control 0.99). These preliminary results suggest an upgrade of autoregulation (ie, very high ratio) in the ABZ of high-grade stenosis patients during normocapnia. CBF was preferentially higher on the symptomatic side and then either did not increase or paradoxically fell in response to hypercapnia. In comparison, carotid occlusion patients had low ABZ and MCA ratios during normocapnia, also unable to increase with hypercapnia. The fall in ratios from normocapnia to hypercapnia indicates that these areas, already subject to maximal vasodilation, fail to increase CBF or actually become hypoperfused following induced hypercapnia. These results aid in understanding the concept of "hemodynamic significance."
journal_name
Angiologyjournal_title
Angiologyauthors
Levine RL,Rozental JM,Nickles RJdoi
10.1177/000331979204300203subject
Has Abstractpub_date
1992-02-01 00:00:00pages
100-9issue
2eissn
0003-3197issn
1940-1574journal_volume
43pub_type
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