The Effect of Acetazolamide on Regional Cerebral Blood Flow in Patients with Ischemic Cerebrovascular Disease

J Korean Neurol Assoc > Volume 9(3); 1991 > Article

Journal of the Korean Neurological Association 1991;9(3): 269-276.

허혈성 뇌혈관질환 환자에서 Acetazolamide가 국소 뇌혈류에 미치는 영향

이상수, 윤병우,노재규,이상복,명호진,김상은,이명철

서울대학교 신경과, 핵의학.

The Effect of Acetazolamide on Regional Cerebral Blood Flow in Patients with Ischemic Cerebrovascular Disease

Sang Soo Lee, M.D.*, Byoung Woo Yoon, M.D., Jae Kyu Roh, M.D., Sang Bok Lee, M.D., Ho Jin Myung, M.D. Sang Eun Kim, M.D.*, Myung Chul Lee, M.D.*

Dep. Of Neurology Department of Nuclear Medicine, Seoul National University*

Abstract

Acetazolamide, a selective-inhibitor of carbonic anhydrase. Has been shown to induce a rapid increase in cerebral blood flow by acidifying cerebral extracellular tluid in large doses. In order to assess the cerebral blood flow reserve, we investigated 14 patients with ischemic cerebrovascular disease using Tc-99m HMPAO SPECT before and after administration of acetazolamide.The patients after acetazolamide challenge showed variable pattems of vasodilating capacity which were classified as follows: group I. Accentuation of abnormal perfusion pattem; group II, no change in abnormal perfusion pattem: and group III. Blunting of abnormal perfusion pattem. Thirty-six percent of the patients studied qualified for group I. The p?tients in group I seem to have decreased vasodilating reserve in the area of cerebral ischemia. They are most likely to benefit by medical or surgical efforts to augment CBF delivery. Tc-99m HMPAO-SPECT with acetazolamide flow challenge may serve as an objective. Clinically accessible method for assessing blood flow reserve and as a kind of guide for the therapeutic strategy.