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Cerebrovascular reactivity after treatment of unruptured intracranial aneurysms--A transcranial Doppler sonography and acetazolamide study.

Abstract：

BACKGROUND:Cerebrovascular reactivity (CVR) is defined as the change in cerebral blood flow, or blood velocity, in response to a vasoactive stimulus. There is a possible association between impaired CVR and vasospasm after aneurysmal subarachnoid hemorrhage. Most studies on CVR and vasospasm have used healthy subjects as reference. However, due to potential different vascular features, CVR in persons with intracranial aneurysms may differ from CVR in healthy subjects. Therefore, our aim was to examine CVR in patients with unruptured intracranial aneurysms (UIA). METHODS:CVR was examined in 37 patients in the first postoperative week after treatment for UIA, using acetazolamide (AZ) test with transcranial Doppler monitoring of blood flow velocities. RESULTS:Mean blood flow velocity in the middle cerebral arteries was 58.5 (SD 12.8) cm/s at baseline, and 94.3 (SD 19.5) cm/s after stimulation with AZ. Mean CVR was 62.6 (SD 16.8) %. There was no significant difference when comparing right and left sides, and treated and untreated sides. A simple regression analysis suggested that CVR increased with 0.7% points for each year a patient aged (p=0.004). However, the significance disappeared in a multiple analysis (increase of 0.6% points per year, p=0.055). Other possible influencing factors (gender, smoking, hypertension, body mass index, aneurysm location and treatment modality) were not significantly associated with CVR. CONCLUSIONS:CVR in patients with UIA is not different from normal values reported in healthy subjects, and does not indicate a systemically impaired vascular system in patients with UIA. We suggest that CVR in age and gender matched healthy controls can be used as reference for persons with intracranial aneurysms.

journal_name

J Neurol Sci

journal_title

Journal of the neurological sciences

authors

Bøthun ML,Haaland ØA,Logallo N,Svendsen F,Thomassen L,Helland CA

doi

10.1016/j.jns.2015.12.024

subject

Has Abstract

pub_date

2016-04-15 00:00:00

pages

97-103

eissn

0022-510X

issn

1878-5883

pii

S0022-510X(15)30090-3

journal_volume

363

pub_type

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Cerebrovascular reactivity after treatment of unruptured intracranial aneurysms--A transcranial Doppler sonography and acetazolamide study.