Summary
A total of 106 patients with 112 internal carotid artery occlusions were investigated by cranial computed tomography and transcranial Doppler ultrasonography (CO2 test), giving a measure of the cerebrovascular reserve capacity. The morphological patterns of the ischaemic lesions were classified into three categories: lacunar, thromboembolic and haemodynamic infarctions. Of 29 patients with an exhausted CO2 reactivity, 19 showed a haemodynamic type of infarction, whereas of 45 cases with a normal CO2 reactivity only 2, and of 38 patients with a diminished CO2 reactivity only 3 had haemodynamically caused infarctions (P<0.001). The correlation between an exhausted CO2 reactivity and the presence of haemodynamic infarctions could be of value for therapy in patients with carotid artery occlusions.
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References
Bogousslavsky J, Regli F (1986) Watershed infarcts distal to carotid artery occlusion. Stroke 17:127–127
Fisher CM (1982) Lacunar strokes and infarcts: a review. Neurology 32:871–876
Kleiser B, Widder B, Hackspacher J, Schmid P (1990) Natural history of internal carotid artery occlusions with respect to CO2 reactivity. J Neurol 237:145
Ringelstein EB, Weiller C (1990) Hirninfarktmuster im Computertomogramm. Pathophysiologische Konzepte, Validierung und klinische Relevanz. Nervenarzt 61:462–471
Ringelstein EB, Zeumer H, Angelou D (1983) The pathogenesis of strokes from internal carotid artery occlusion. Diagnostic and therapeutical implications. Stroke 14:867–875
Ringelstein EB, Sievers C, Ecker S, Schneider PA, Otis SM (1988) Noninvasive assessment of CO2-induced cerebral vasomotor response in normal individuals and patients with internal carotid artery occlusions. Stroke 19:963–969
Schmidt-Kastner R, Grosse-Orphoff B, Hossmann KA (1986) Delayed recovery of CO2 reactivity after one hour's complete ischaemia of cat brain. J Neurol 233:367–369
Symon L, Branston NM, Strong AJ (1976) Autoregulation in acute focal ischaemia. An experimental study, Stroke 7:547–554
The EC/IC Bypass Study Group (1985) Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. Engl J Med 313:1191–1200
Widder B (1989) The Doppler CO2 test to exclude patients not in need of extracranial/intracranial bypass surgery. J Neurol Neurosurg Psychiatry 52:38–42
Widder B (1989) Doppler- und Duplex-Sonographie der hirnversorgenden Arterien. Springer, Berlin Heidelberg New York
Widder B, Paulat K, Hackspacher J, Mayr E (1986) Transcranial Doppler CO2-test for the detection of hemodynamically critical carotid artery stenoses and occlusions. Eur Arch Psychiatry Neurol Sci 236:162–168
Wodarz R (1980) Watershed infarctions and computed tomography. A topographical study in cases with stenosis or occlusions of the carotid artery. Neuroradiology 19:245–248
Zülch KJ (1981) Cerebrovascular pathology and pathogenesis as a basis of neuroradiological diagnosis. In: Diethelm L, Wende S (eds) Roentgen diagnosis of the central nervous system. (Encyclopedia of medical radiology), Springer, Berlin Heidelberg New York, pp 1–192
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Kleiser, B., Krapf, H. & Widder, B. Carbon dioxide reactivity and patterns of cerebral infarction in patients with carotid artery occlusion. J Neurol 238, 392–394 (1991). https://doi.org/10.1007/BF00319858
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DOI: https://doi.org/10.1007/BF00319858