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Role of collateral flow on cerebral hemodynamics in patients with unilateral internal carotid artery occlusion
Author(s) -
van Everdinge K. J.,
Visser G. H.,
Klijn C. J. M.,
Kappelle L. J.,
van Der Grond J.
Publication year - 1998
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410440206
Subject(s) - medicine , hemodynamics , posterior communicating artery , collateral circulation , internal carotid artery , cardiology , cerebral arteries , anterior cerebral artery , middle cerebral artery , ophthalmic artery , anterior communicating artery , blood flow , ischemia , subarachnoid hemorrhage
Abstract The objective of this study was to evaluate the role of collateral blood flow via the anterior and posterior communicating arteries (ACoA and PCoA) and via the ophthalmic artery (OphA) on cerebral hemodynamics, metabolism, and border zone infarcts in 57 patients with unilateral symptomatic occlusions of the internal carotid artery. Collateral flow via the ACoA and PCoA was determined with magnetic resonance angiography (MRA) and collateral flow via the OphA with transcranial Doppler (TCD). Volume flow was studied with MRA, metabolism with 1 H MR spectroscopy, CO 2 reactivity with TCD, and the incidence of border zone infarcts with MRI. Compared with controls, patients had deteriorated volume flow, metabolism, and CO 2 reactivity. No differences were found between patients with and patients without collateral flow through the ACoA and/or PCoA, or between patients with or without collateral flow via the OphA. Patients without collateral flow via any of these collaterals had decreased volume flow in the middle cerebral artery, decreased N ‐acetylaspartate/choline, and increased lactate/ N ‐acetylaspartate, compared with the other patients. Patients with symptomatic internal carotid artery occlusion have deteriorated cerebral hemodynamics and metabolism. Different collateral flow patterns via the ACoA, PCoA, or OphA have no effect on the hemodynamic and metabolic parameters, as long as one of these pathways is present.