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Reactivit ofCerebral BloodFlowtoCarbon Dioxide inVarious TypesofIschemic Cerebrovascular Disease: Evaluation bythe Transcranial Doppler Method

Reactivit ofCerebral BloodFlowtoCarbon Dioxide inVarious TypesofIschemic Cerebrovascular Disease: Evaluation bythe Transcranial Doppler Method,Hiroaki

Reactivit ofCerebral BloodFlowtoCarbon Dioxide inVarious TypesofIschemic Cerebrovascular Disease: Evaluation bythe Transcranial Doppler Method   (Citations: 8)
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Background andPurpose: Theresponseofcerebral bloodflowtochanges inthearterial carbon dioxide partial pressure(i.e., carbon dioxide reactivity) hasbeenevaluated as a parameter ofcerebral perfusion reserveinpatients withcerebrovascular disease. Inthisstudy, variations inthisreactivity invarious ischemic cerebrovascular diseases wereevaluated byanewly established method, a transcranial Doppler technique. Methods: Thirty-three patients withsymptomatic cerebrovascular disease, 13patients withasymptom- atic cerebral infarction, and25age-matched normalcontrol subjects wereinvestigated. Thesymptomatic patients were divided intothree groups;thosewithunilateral carotid artery obstruction, thosewith cortical infarction, andthose withlacunar infarction. Thecarbon dioxide reactivity ofeachsubject was determined bysimultaneously measuring themean spatial Doppler frequency inthemiddlecerebral artery andtheend-tidal carbon dioxide partial pressureundernormocapnic, hypercapnic, andhypocap- nicconditions. Results: Inthepatients withcarotid obstruction, thecarbondioxide reactivity ofthehemisphere ipsilateral totheobstruction was more impaired thanthereactivity ofthesymptomatic hemispheres in anyother group,andwas significantly less thaninthecontralateral asymptomatic hemisphere (p<0.01). Inpatients withcortical infarction, thecarbondioxide reactivity ofthesymptomatic hemisphere was significantly less thaninnormalcontrol subjects (p<0.05) andwas also less thanthatofthecontralateral asymptomatic hemisphere (p<0.05). Inpatients withlacunar infarction, thecarbondioxide reactivity of bothhemispheres was significantly lessthanthatinnormalcontrols (p<0.01), although there was no difference between thesymptomatic andasymptomatic hemispheres. Inpatients withasymptomatic infarction, thecarbon dioxide reactivity was alsoless thanthatinnormalcontrols (p<0.01). Conclusions: Thecarbon dioxide reactivity ofcerebral blood flowmeasured bythis transcranial Doppler technique may beuseful forcharacterizing thehemodynamic changes thatoccurinvarious typesof ischemic cerebrovascular disease. (Stroke 1993;24:670-675)
Published in 2010.
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