Stroke, Vol 23, 15-19, Copyright © 1992 by American Heart Association
A Dahl, KF Lindegaard, D Russell, R Nyberg-Hansen, K Rootwelt, W Sorteberg and H Nornes
BACKGROUND AND PURPOSE: The aim of this study was to determine the ability
of transcranial Doppler ultrasonography when used to assess cerebral
vasoreactivity. The results of this method were compared with regional
cerebral blood flow measurements. METHODS: Forty-three patients with
symptoms suggesting cerebrovascular disease took part. Transcranial Doppler
findings in the middle cerebral arteries were compared with regional
cerebral blood flow in the corresponding perfusion territories before and
after acetazolamide administration. RESULTS: There was a significant
positive correlation between the absolute increase in cerebral blood flow
in milliliters per 100 g per minute and the percent increase in velocity (r
= 0.63). The right-left, side-to-side difference of the acetazolamide
response obtained by the two methods also showed a positive correlation (r
= 0.80). Control limits obtained from healthy subjects were used for both
the blood flow increase (absolute values and asymmetry in absolute values)
and the velocity increase (percent increase and asymmetry in percent
increase). The two methods then agreed in their evaluation of
vasoreactivity in 74 (86%) of the 86 middle cerebral artery perfusion
territories; 20 (23%) were assessed by both methods as having a reduced
vasodilatory reserve. Eleven hemispheres with a slightly reduced regional
cerebral blood flow response to acetazolamide were not detected by
transcranial Doppler, whereas all territories with a marked reduction were
identified by Doppler. Only one hemisphere with a normal cerebral blood
flow increase after acetazolamide administration was assessed by Doppler as
having reduced vasoreactivity. CONCLUSIONS: Transcranial Doppler and the
acetazolamide test may be used in clinical situations to assess cerebral
vasoreactivity.
ARTICLES
A comparison of transcranial Doppler and cerebral blood flow studies to assess cerebral vasoreactivity
Department of Neurology, National Hospital, University of Oslo, Norway.
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