Cerebral Vasoreactivity in Carotid Stenosis or Occlusion
Cases                                                           
 A Transcranial Doppler Study with Acetazolamide (Diamox) Test

J Korean Neurol Assoc > Volume 16(4); 1998 > Article

Journal of the Korean Neurological Association 1998;16(4): 439-443.

경동맥 협착/폐쇄 환자에서 Acetazolamide를 이용한 뇌혈관 반응성의 평가

박성민, 이광수 . 최재영 . 김영인

가톨릭대학교 의과대학 신경과학교실

Cerebral Vasoreactivity in Carotid Stenosis or Occlusion Cases A Transcranial Doppler Study with Acetazolamide (Diamox) Test

Seong Min Park, M.D., Kwang Soo Lee, M.D., Jae Young Choi, M.D., Yeong In Kim, M.D.

Department of Neurology, Kang-Nam St. Mary's Hospital The Catholic University of Korea

Abstract

Background: The aim of this trial was to evaluate the acetazolamide induced vasoreactivity of the cerebral vasculature in patients with carotid stenosis/occlusion, relative changes of blood flow velocity within the middle cerebral artery were measured by transcranial doppler ultrasonography during acetazolamide challenge. To evaluate the effectiveness of extracranial-intracranial bypass surgery in patients with ICA stenosis/occlusion with decreased vasoreactivity, we studied whether the vasoreactivity could show a significant difference between the territorial infarction and borderzone infarction cases.
Methods: To test vasoreactivity in 21 patients with unilateral carotid stenosis or occlusion, we measured blood flow velocity in the middle cerebral artery by transcranial doppler sonography both at rest and after injection of acetazolamide. Among 21 patients, 13 patients are MCA territorial and 8 patients are borderzone infarction which are angiographically confirmed symptomatic cases.
Results: The increase in blood flow velocity (%ΔVm) after acetazolamide stimulation was significantly different between the both hemisphere (affected side: 24.01±24.44%, contralateral side: 49.39±19.38%, p<0.05). In patients with carotid stenosis/occlusion, vasoreactivity of the borderzone infarction cases was lower than territorial infarction cases(mean±SD: 12.25±11.20% and 29.92±26.42%, p=0.13), but it is not significant statistically.
Conclusion: We concluded that TCD with acetazolamide challenge is a useful method for assessment of the adequacy of hemodynamic reserve in patients with severe stenosis or occlusive cerebrovascular disease but it is very difficult problem apply to EC-IC bypass surgery directly. Keywords: Acetazolamide-Vasoreactivity-Carotid occlusion/stenosis-Transcranial doppler sonography