Journal article
Cerebral hemodynamic impairment: Methods of measurement and association with stroke risk
Neurology, Vol.53(2), pp.251-259
1999
DOI: 10.1212/WNL.53.2.251
PMID: 10430410
Abstract
Stenosis or occlusion of the major arteries of the head and neck may cause hemodynamic impairment of the distal cerebral circulation. Hemodynamic factors may play an important role in the pathogenesis of ischemic stroke for patients with cerebrovascular disease. Several neuroimaging methods are currently available for the indirect assessment of the hemodynamic effect of atherosclerotic stenosis or occlusion on the distal cerebrovasculature. Because these methods rely on different underlying physiologic mechanisms, they are not interchangeable. Two basic categories of hemodynamic impairment can be assessed with these techniques: Stage 1, in which autoregulatory vasodilation secondary to reduced perfusion pressure is inferred by the measurement of either increased blood volume or an impaired blood flow response to a vasodilatory stimulus; and Stage 2, in which increased oxygen extraction fraction (OEF) is noninvasively but directly measured. The correlation of different Stage 1 methods with each other and with Stage 2 techniques is quite variable. Clinical studies associating different manifestations of hemodynamic impairment with stroke risk often suffer from methodologic problems. The best evidence to date for such an association is for increased OEF measured in patients with symptomatic carotid occlusion. In the absence of data demonstrating improvement in patient outcome, there is currently no role for the routine use of these tools to guide clinical management in patients with cerebrovascular disease.
Details
- Title: Subtitle
- Cerebral hemodynamic impairment: Methods of measurement and association with stroke risk
- Creators
- C. P DERDEYN - Section of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United StatesR. L GRUBB - Division of Radiological Sciences, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United StatesW. J POWERS - Division of Radiological Sciences, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.53(2), pp.251-259
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- DOI
- 10.1212/WNL.53.2.251
- PMID
- 10430410
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Language
- English
- Date published
- 1999
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020744102771
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