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Ital J Neurol Sci ; 12(4): 383-8, 1991 Aug.
Article in English | MEDLINE | ID: mdl-1791132

ABSTRACT

Cerebral blood flow (CBF) was studied at rest by 133-Xenon inhalation method in 15 normal subjects, in 10 patients with cerebral infarction and normal angiograms of major cerebral arteries and in 28 patients with unilateral stenosis-occlusion of the internal carotid artery (ICA), with or without cerebral infarction. All the normals and 20 patients with ICA stenosis-occlusion were tested again after cerebral vasodilatation induced by an intravenous bolus of acetazolamide. At rest the patients with cerebral infarction, irrespective of whether ICa stenosis-occlusion was present or not, showed abnormal side-to-side CBF asymmetry. After cerebral vasodilation variations in side-to-side asymmetry were shown to depend on the inefficiency of the collaterals and not on the degree of ICA obstruction or on the presence of cerebral infarction. These data indicate that at rest side-to-side CBF distribution is influenced more by the presence of an ischemic zone than by a ICA stenosis-occlusion and that under these circumstances the hemodynamic effect of the vascular stenosis cannot be assessed. After cerebral vasodilatation a subset of patients--irrespective of the degree of ICA obstruction and of whether or not cerebral infarction is present--with true cerebrovascular insufficiency can be isolated.


Subject(s)
Carotid Stenosis/physiopathology , Cerebral Infarction/physiopathology , Cerebrovascular Circulation , Collateral Circulation , Tomography, X-Ray Computed , Acetazolamide/pharmacology , Adult , Aged , Carotid Artery, Internal , Carotid Stenosis/complications , Carotid Stenosis/diagnostic imaging , Cerebral Infarction/complications , Cerebral Infarction/diagnostic imaging , Cerebrovascular Circulation/drug effects , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/prevention & control , Female , Humans , Male , Middle Aged , Oxygen Consumption , Radionuclide Imaging , Xenon Radioisotopes
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