Hemodynamic and Metabolic Effects of Extracranial Carotid Disease

  title={Hemodynamic and Metabolic Effects of Extracranial Carotid Disease},
  author={Richard Leblanc and Y. Lucas Yamamoto and Jane L. Tyler and Antoine M. Hakim},
  journal={Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques},
  pages={51 - 57}
  • R. Leblanc, Y. Yamamoto, A. Hakim
  • Published 1 February 1989
  • Medicine
  • Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
ABSTRACT: Cerebral blood flow (CBF), cerebral blood volume (CBV), the CBF/CBV ratio – an index of the hemodynamic reserve capacity – the rate of oxygen metabolism (CMRO2), and the fractional extraction of oxygen by the brain (OEF) were studied by positron emission tomography (PET) in the cortical territory of both internal carotid arteries in 15 cases of transiently symptomatic or progressive extracranial atherosclerotic carotid disease. None of the patients had a major stroke or had a… 
Heterogeneity of cerebral hemodynamics and metabolism in carotid artery disease.
Visual inspection is important in the evaluation of pathophysiological changes caused by unilateral carotid stenosis, and clinical decisions in patients withCarotid artery disease should be based on careful visual examinations and statistical analyses of appropriately selected regions.
Borderzone hemodynamics in cerebrovascular disease
There was no evidence for selective borderzone hemodynamic impairment in this group of patients with severe carotid artery disease and ratios of each borderzone to the ipsilateral MCA territory for both I% and rOEF.
Cerebral ischaemic changes in association with the severity of ICA lesions and cerebropetal flow.
Border-zone infarctions and ischaemic metabolic changes are not directly the result of cerebral hypoperfusion caused by severe ICA lesions.
Hemodynamic aspect of cerebral watershed infarction: assessment of perfusion reserve using iodine-123-iodoamphetamine SPECT.
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Clinical features associated with internal carotid artery occlusion do not correlate with MRA cerebropetal flow measurements
OBJECTIVES The aetiology of clinical symptoms in patients with severe internal carotid artery (ICA) lesions may be thromboembolic or haemodynamic. The purpose was to assess whether changes in
MEG Frequency Analysis Depicts the Impaired Neurophysiological Condition of Ischemic Brain
Quantitatively imaged spontaneous neuromagnetic fields using the automated ROI setting enabled clear depiction of cerebral ischemic areas and may reveal unique neural activity that is distributed in the impaired vascular metabolic territory, in which the cerebral infarction has not yet been completed.
Effects of anterior communicating artery diameter on cerebral hemodynamics in internal carotid artery disease. A model study.
ACoA diameter strongly modulates the effects of ICaA lesions on cerebral hemodynamics, and some proposals for endarterectomy indications can be derived from this study.
The Pathophysiology of Watershed Infarction: A Three-Dimensional Time-of-Flight Magnetic Resonance Angiography Study.
The Pathophysiology of Watershed Infarction in Internal Carotid Artery Disease: Review of Cerebral Perfusion Studies
The evidence strongly favors a hemodynamic mechanism for internal WS infarction, especially regarding the so-called rosary-like pattern in the centrum semiovale, and the relationships between corticalWS infarcts and hemodynamic compromise appear more complicated.


Borderzone ischemia
Data indicate that the anterior borderzone may be selectively vulnerable to severe carotid stenosis, which produces, in this region, diminished perfusion, lowered hemodynamic reserve, and a tendency towards a rising fractional extraction of oxygen.
Effects of extra-intracranial arterial bypass on cerebral blood flow and oxygen metabolism in humans.
The study of patients with a successful unilateral extra-intracranial arterial by-pass suggests that long-standing hemodynamic failure may induce a metabolic depression that is still potentially reversible by surgical revascularization.
The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation.
A significant relationship was found between the PET measurements of cerebral hemodynamics and the arteriographic circulation pattern and the role of hemodynamic factors in the pathogenesis and treatment of cerebrovascular disease cannot be determined from the severity of carotid artery disease alone.
Cerebral haemodynamic changes after extracranial-intracranial bypass surgery.
Post-operative findings were consistent with an increase of regional cerebral perfusion pressure as a result of the bypass procedure, although this effect is potentially of value, those patients with most to gain from bypass surgery may also run the highest risk of peri-operative cerebral ischaemia.
Hemodynamic and metabolic effects of cerebral revascularization.
It is concluded that symptomatic carotid occlusion is associated with altered hemodynamic function and oxygen hypometabolism, and cerebral revascularization results in decreased CBV, indicating improved hemodynamic reserve, but does not consistently improve oxygen metabolism.
Physiological responses to focal cerebral ischemia in humans
Findings indicate that cerebral oxygen metabolism was maintained in the face of decreased blood flow by local compensatory mechanisms that included dilation of intraparenchymal blood vessels and increased transfer of oxygen from blood to tissue.
Extracranial‐intracranial bypass surgery
After superficial temporal artery-middle cerebral artery bypass, cerebral blood flow to the operated hemisphere increased, and with th postoperative increase in hemispheric CBF, there was a decrease in oxygen extraction, but no change in blood volume o oxygen metabolism.
Unilateral watershed cerebral infarcts
Patients with symptomatic unilateral watershed cerebral infarct had internal carotid artery occlusion or tight stenosis associated with a hemodynamically significant cardiopathy, increased hematocrit, or acute hypotension, and each type had a characteristic neurologic picture.
Focal Flow Disturbances in Acute Strokes: Effects on Regional Metabolism and Tissue pH
In acute stroke, the reduction of blood flow causes tissue damage and sets of a complex escalating chain reaction from acid metabolites and also from products of disturbed intracellular ionic