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Titolo:
Lack of evidence for a poor haemodynamic or metabolic state of the brain in patients with haemodynamic clinical features associated with carotid artery occlusion
Autore:
Klijn, CJM; Kappelle, LJ; van der Grond, J; Visser, GH; Algra, A; Tulleken, CAF; van Gijn, J;
Indirizzi:
Univ Utrecht, Med Ctr, Dept Neurol, NL-3508 GA Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3508 GA 3508 GA Utrecht, Netherlands Univ Utrecht, Med Ctr, Dept Radiol, NL-3508 GA Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3508 GA 3508 GA Utrecht, Netherlands Univ Utrecht, Med Ctr, Dept Clin Neurophysiol, NL-3508 GA Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3508 GA 3508 GA Utrecht, Netherlands Univ Utrecht, Med Ctr, Dept Neurosurg, NL-3508 GA Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3508 GA 3508 GA Utrecht, Netherlands Univ Utrecht, Med Ctr, Julius Ctr Gen Practice & Patient Oriented Res, NL-3508 GA Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3508 GA 3508 GA Utrecht, Netherlands Rudolf Magnus Inst Neurosci, NL-3508 TA Utrecht, Netherlands Rudolf MagnusInst Neurosci Utrecht Netherlands NL-3508 TA , Netherlands
Titolo Testata:
CEREBROVASCULAR DISEASES
fascicolo: 2, volume: 12, anno: 2001,
pagine: 99 - 107
SICI:
1015-9770(2001)12:2<99:LOEFAP>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAGNETIC-RESONANCE SPECTROSCOPY; CEREBROVASCULAR REACTIVITY; CEREBRAL HEMODYNAMICS; ISCHEMIC STROKE; DISEASE; STENOSIS; PERFUSION; ENDARTERECTOMY; TERRITORIES; HYPOTENSION;
Keywords:
carotid artery occlusion; haemodynamics; cerebral metabolism; carbon dioxide; spectroscopy; nuclear magnetic resonance;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Klijn, CJM Univ Utrecht, Med Ctr, Dept Neurol, C03-236,POB 85500, NL-3508 GA Utrecht,Netherlands Univ Utrecht C03-236,POB 85500 Utrecht Netherlands NL-3508 GA
Citazione:
C.J.M. Klijn et al., "Lack of evidence for a poor haemodynamic or metabolic state of the brain in patients with haemodynamic clinical features associated with carotid artery occlusion", CEREB DIS, 12(2), 2001, pp. 99-107

Abstract

Objective:To assess whether patients with carotid artery occlusion (CAO) who have clinical features suggesting a haemodynamic origin have a poor haemodynamic or metabolic state of the brain. Methods: In 117 patients with ischaemic symptoms of the eye or brain that were transient or at most moderately disabling and associated with a CAO, we compared CO2 reactivity, quantitative flow measurement by magnetic resonance (MR) angiography, metabolic ratios measured by H-1-MR spectroscopy, collateral blood flow patterns and the presence of infarcts of the borderzone type between patients grouped by the following clinical features: (1) presence or absence of at least one of the 'classical' haemodynamic symptoms: limb shaking, retinal claudication, precipitation of symptoms by exercise, by rising from a sitting or lying position, by transition from a cold to a warm environment, or by documented hypotension, and (2) symptoms having occurred after demonstration of the CAOor only before the occlusion was documented. Results: Patients with (n = 16) and without (n = 101) one of the 'classical' haemodynamic symptoms did not differ in any of the measured indices. Patients with recurrent symptoms after documentation of the CAO (n = 56) had lower CO2 reactivity (difference 8.3%, 95% confidence interval 0.1-16.5) than those with symptoms only before documentation of the occlusion (n = 61), whereas no significant differences were found in any of the other measured indices. The difference in CO2reactivity was no longer significant after adjustment for the interval between the patients' last symptoms and the CO2 reactivity measurement. Conclusion: In patients with CAO we could not find an association between symptoms that have been associated with hypoperfusion and a poor haemodynamic or metabolic state of the brain. Copyright (C) 2001 S. Karger AG, Basel.

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Documento generato il 01/04/20 alle ore 00:50:34