This Article Full Text Full Text (PDF) All Versions of this Article: 35/1/64    most recent 01.STR.0000106486.26626.E2v1 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 Vernieri, F. Articles by Silvestrini, M. Search for Related Content PubMed PubMed Citation Articles by Vernieri, F. Articles by Silvestrini, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CARBON DIOXIDE OXYGEN

(Stroke. 2004;35:64.)
© 2004 American Heart Association, Inc.

Original Contributions

Transcranial Doppler and Near-Infrared Spectroscopy Can Evaluate the Hemodynamic Effect of Carotid Artery Occlusion

Fabrizio Vernieri, MD; Francesco Tibuzzi, MD; Patrizio Pasqualetti, PhD; Nicola Rosato, PhD; Francesco Passarelli, MD; Paolo Maria Rossini, MD Mauro Silvestrini, MD

From the AFaR: Dipartimento di Neuroscienze, Ospedale Fatebenefratelli, Isola Tiberina, Roma (F.V., F.T., P.P., N.R., F.P., P.M.R.); Clinica Neurologica, Università Campus Biomedico, Roma (F.V., P.M.R.); Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Università di Roma "Tor Vergata" (N.R.); Clinica Neurologica, Università degli Studi di Ancona (M.S.), Italy.

Correspondence to Dr Fabrizio Vernieri, AFaR: Dipartimento di Neuroscienze, Ospedale "San Giovanni Calibita" Fatebenefratelli, Isola Tiberina 00186 Rome, Italy. E-mail fabriziovernieri{at}tin.it

Background and Purpose— Cerebral hemodynamic and metabolic changes can compensate for the decrease in cerebral blood flow occurring in patients with carotid occlusive disease. At present, a complete assessment of the cerebral adaptive status is only possible with positron-emission tomography. Near-infrared spectroscopy (NIRS) is a noninvasive technique that, providing a real time assessment of fluctuations in cerebral hemoglobin, has been used to estimate the cerebral blood volume and to measure cerebral vasomotor reactivity (VMR). Moreover, NIRS technology, by allowing the absolute measurement of absorption and scattering coefficients of brain, can determine the oxyhemoglobin and deoxyhemoglobin concentrations in situ in the blood stream.

Methods— In order to evaluate different aspects of the cerebral hemodynamic status, 27 subjects with symptomatic and asymptomatic carotid artery occlusion and 30 healthy subjects underwent a simultaneous examination by means of transcranial Doppler (TCD), able to reliably detect collateral circulation and VMR, and NIRS at rest condition and during CO₂ reactivity test.

Results— The main finding of this study was the demonstration of a difference between asymptomatic and symptomatic patients in terms of mean flow velocity increase (52.4% versus 21.0%; P<0.001) estimated by TCD and of hemoglobin saturation increase measured by NIRS (6.8% versus 3.8%; P=0.015).

Conclusions— The opportunity to perform NIRS and TCD simultaneously provides useful information about both hemodynamic and metabolic cerebral adaptive status in patients with occlusive disease in a simple, noninvasive, and reliable way.

Key Words: carotid artery occlusion • hemodynamics • spectroscopy, near-infrared • stroke • ultrasonography, Doppler, transcranial

This article has been cited by other articles:

				A. Denault, A. Deschamps, and J. M. Murkin A Proposed Algorithm for the Intraoperative Use of Cerebral Near-Infrared Spectroscopy Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2007; 11(4): 274 - 281. [Abstract] [PDF]

				K. Imanaka, M. Kato, M. Ogiwara, and S. Kyo Active Cerebral Perfusion During Carotid Endarterectomy Asian Cardiovasc Thorac Ann, June 1, 2006; 14(3): e50 - e52. [Abstract] [Full Text] [PDF]

				R. Schondorf, J. Benoit, and R. Stein Cerebral autoregulation is preserved in postural tachycardia syndrome J Appl Physiol, September 1, 2005; 99(3): 828 - 835. [Abstract] [Full Text] [PDF]

				P. V. G. Katakam, C. D. Tulbert, J. A. Snipes, B. Erdos, A. W. Miller, and D. W. Busija Impaired insulin-induced vasodilation in small coronary arteries of Zucker obese rats is mediated by reactive oxygen species Am J Physiol Heart Circ Physiol, February 1, 2005; 288(2): H854 - H860. [Abstract] [Full Text] [PDF]

				A. Villringer, J. Steinbrink, and H. Obrig Editorial Comment--Cerebral Near-Infrared Spectroscopy: How Far Away From a Routine Diagnostic Tool? Stroke, January 1, 2004; 35(1): 70 - 72. [Full Text] [PDF]