This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dahl, A. Articles by Kerty, E. Search for Related Content PubMed PubMed Citation Articles by Dahl, A. Articles by Kerty, E. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB ACETAZOLAMIDE

(Stroke. 1995;26:2302-2306.)
© 1995 American Heart Association, Inc.

Articles

Cerebral Vasoreactivity Assessed With Transcranial Doppler and Regional Cerebral Blood Flow Measurements

Dose, Serum Concentration, and Time Course of the Response to Acetazolamide

Arve Dahl, MD; David Russell, MD, PhD, FRCPE; Kjell Rootwelt, MD, PhD; Rolf Nyberg-Hansen, MD, PhD Emilia Kerty, MD

From the Department of Neurology (D.R., R.N.-H., E.K.) and Institute for Clinical Biochemistry (K.R.), Rikshospitalet, The National Hospital, University of Oslo, and the Department of Neurology (A.D.), University Hospital, Tromsø, Norway.

Correspondence to Arve Dahl, MD, Department of Neurology, University Hospital, 9038 Tromsø, Norway.

Background and Purpose To improve the assessment of cerebral vasoreactivity using acetazolamide (ACZ), we studied the time course of the response and the relationship between dose, response, and serum concentration.

Methods Blood flow velocities were measured with the use of transcranial Doppler ultrasonography in one of the middle cerebral arteries of 48 healthy subjects after the intravenous administration of 1 to 1.6 g ACZ. In 34 subjects (group 1), velocities were measured every second minute to detect the maximum middle cerebral artery velocity increase. We also measured regional cerebral blood flow using single-photon emission computed tomography in 27 of the subjects in group 1 before and approximately 15 to 20 minutes after the ACZ injection. The serum concentration of ACZ was measured in 15 subjects. In the remaining 14 subjects (group 2), middle cerebral artery velocity measurements were made 10, 25, 30, and 45 minutes after ACZ administration to obtain information regarding the late time course of the response.

Results In group 1 the plateau phase of the velocity response was reached 8 to 15 minutes after ACZ administration. A large range of velocity increase was observed, and a significant correlation was found between the maximum velocity increase and the dose and serum concentration of ACZ. In group 2 subjects, maximum velocities were maintained 30 minutes after the injection, but after 45 minutes velocities had decreased to 68% of their highest level. No significant relationship was found between dose or serum concentration of ACZ and the regional cerebral blood flow increase. The velocity increase after ACZ was similar in both older and younger subjects.

Conclusions This study shows that cerebral vasoreactivity is best assessed 10 to 30 minutes after ACZ administration and that the dose should probably exceed 15 mg/kg if a maximum vasodilatory response in the cerebral circulation is to be obtained.

Key Words: acetazolamide • blood flow velocity • cerebral blood flow • ultrasonics

This article has been cited by other articles:

				P. Neu, P. Schlattmann, A. Schilling, and A. Hartmann Cerebrovascular Reactivity in Major Depression: A Pilot Study Psychosom Med, January 1, 2004; 66(1): 6 - 8. [Abstract] [Full Text] [PDF]

				H. Chabriat, S. Pappata, L. Ostergaard, C. A. Clark, M. Pachot-Clouard, K. Vahedi, A. Jobert, D. Le Bihan, and M. G. Bousser Cerebral Hemodynamics in CADASIL Before and After Acetazolamide Challenge Assessed With MRI Bolus Tracking Stroke, August 1, 2000; 31(8): 1904 - 1912. [Abstract] [Full Text] [PDF]

				S. J. Schreiber, S. Gottschalk, M. Weih, A. Villringer, and J. M. Valdueza Assessment of Blood Flow Velocity and Diameter of the Middle Cerebral Artery during the Acetazolamide Provocation Test by Use of Transcranial Doppler Sonography and MR Imaging AJNR Am. J. Neuroradiol., July 1, 2000; 21(7): 1207 - 1211. [Abstract] [Full Text] [PDF]

				C. Molina, J. A. Sabin, J. Montaner, A. Rovira, S. Abilleira, and A. Codina Impaired Cerebrovascular Reactivity as a Risk Marker for First-Ever Lacunar Infarction : A Case-Control Study Stroke, November 1, 1999; 30 (11): 2296 - 2301. [Abstract] [Full Text] [PDF]

				B. M. Eicke, E. Buss, R. R. Bahr, G. Hajak, and W. Paulus Influence of Acetazolamide and CO2 on Extracranial Flow Volume and Intracranial Blood Flow Velocity Stroke, January 1, 1999; 30(1): 76 - 80. [Abstract] [Full Text] [PDF]

				A. Y. Gur, I. Bova, and N. M. Bornstein Is Impaired Cerebral Vasomotor Reactivity a Predictive Factor of Stroke in Asymptomatic Patients? Stroke, December 1, 1996; 27(12): 2188 - 2190. [Abstract] [Full Text]