Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography
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Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography. / Vorstrup, S; Paulson, O B; Lassen, N A.
I: Acta Neurologica Scandinavica, Bind 74, Nr. 6, 12.1986, s. 439-51.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography
AU - Vorstrup, S
AU - Paulson, O B
AU - Lassen, N A
PY - 1986/12
Y1 - 1986/12
N2 - Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They showed in the acute phase (Days 1-3) very large low-flow areas, larger than the hypodense areas seen on the CT scan. The cerebral vasoconstrictor and vasodilator capacity was tested in the acute phase following aminophylline and acetazolamide, respectively. A preserved but reduced reactivity was seen at both tests in all 6 cases in the infarct and the peri-infarct areas. On Days 5-25, 4 of the patients had transitory increases (59-108%) of CBF, probably corresponding to lysis of an intracerebral embolic occlusion. The other 2 patients showed on Days 7-15 only a moderate CBF increase (appr. 20%), both had occlusion of the relevant internal carotid artery. In all 6 patients, CBF studies at 2 and 6 months resembled the acute phase, showing large areas with reduced flow. At the 6 months follow-up, the vasodilatory stress test was repeated, and all but one showed a preserved but reduced vasoreactivity in the infarct and peri-infarct tissue. Of the remaining 6 patients, one had a pontine infarct and one had no lesions on the CT scan, both having normal angiograms and CBF maps. Four patients had small deep or subcortical CT lesions, and showed a slight, but persistent CBF reduction of about 6-8% in the parietal region on the affected side. No changes in the flow pattern were seen at the vasoreactive studies. A likely explanation for the finding of superjacent low-flow areas is an intrahemispheric uncrossed diaschisis. This interpretation is discussed in relation to the peri-infarct low-flow area seen in the 6 cases with large infarcts.
AB - Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They showed in the acute phase (Days 1-3) very large low-flow areas, larger than the hypodense areas seen on the CT scan. The cerebral vasoconstrictor and vasodilator capacity was tested in the acute phase following aminophylline and acetazolamide, respectively. A preserved but reduced reactivity was seen at both tests in all 6 cases in the infarct and the peri-infarct areas. On Days 5-25, 4 of the patients had transitory increases (59-108%) of CBF, probably corresponding to lysis of an intracerebral embolic occlusion. The other 2 patients showed on Days 7-15 only a moderate CBF increase (appr. 20%), both had occlusion of the relevant internal carotid artery. In all 6 patients, CBF studies at 2 and 6 months resembled the acute phase, showing large areas with reduced flow. At the 6 months follow-up, the vasodilatory stress test was repeated, and all but one showed a preserved but reduced vasoreactivity in the infarct and peri-infarct tissue. Of the remaining 6 patients, one had a pontine infarct and one had no lesions on the CT scan, both having normal angiograms and CBF maps. Four patients had small deep or subcortical CT lesions, and showed a slight, but persistent CBF reduction of about 6-8% in the parietal region on the affected side. No changes in the flow pattern were seen at the vasoreactive studies. A likely explanation for the finding of superjacent low-flow areas is an intrahemispheric uncrossed diaschisis. This interpretation is discussed in relation to the peri-infarct low-flow area seen in the 6 cases with large infarcts.
KW - Adult
KW - Aged
KW - Brain/pathology
KW - Brain Ischemia/physiopathology
KW - Cerebral Infarction/physiopathology
KW - Cerebrovascular Circulation
KW - Cerebrovascular Disorders/pathology
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Tomography, Emission-Computed
KW - Tomography, X-Ray Computed
KW - Xenon Radioisotopes
U2 - 10.1111/j.1600-0404.1986.tb07869.x
DO - 10.1111/j.1600-0404.1986.tb07869.x
M3 - Journal article
C2 - 3493616
VL - 74
SP - 439
EP - 451
JO - Acta Neurologica Scandinavica, Supplement
JF - Acta Neurologica Scandinavica, Supplement
SN - 0065-1427
IS - 6
ER -
ID: 275604741