Stroke, Vol 12, 598-607, Copyright © 1981 by American Heart Association
TS Olsen, B Larsen, EB Skriver, M Herning, E Enevoldsen and NA Lassen
In a consecutive study comprising 41 patients with completed stroke of less
than 72 hours duration, cerebral angiography and measurements of the
regional cerebral blood flow (rCBF) were performed within 24 hours after
admission. The rCBF study was done using the 133-Xenon intracarotid
injection method and a 254 multi-detector camera. CT scan was done 24 hours
after the rCBF study. Focal cerebral hyperemia was found in 16 patients.
The study revealed 3 different types of hyperemia: Border-zone hyperemia,
surrounding ischemic areas, was seen in patients with occluded arteries on
angiography, presumably resulting from accumulation of acid metabolites in
the border-zone of acute infarcts. Postischemic hyperemia was seen in
patients without occlusion, presumably due to recanalization of a prior
occluded artery. Remote hyperemia was found distant from the infarcted
area, presumably due to local tissue pressure on brain tissue. Cortical
infarcts (10 patients) all had extensive hyperemic areas. Because the 254
detector camera has an excellent resolution in the cortical surface, our
findings strongly suggest that all acute cerebral infarcts are, in fact,
associated with hyperemic areas. The hyperemic areas are often extensive
and vascular reactivity is commonly impaired. It is suggested that
treatment aimed at reducing blood flow in hyperemic areas might improve
prognosis.
ARTICLES
Focal cerebral hyperemia in acute stroke. Incidence, pathophysiology and clinical significance
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