Cerebral blood flow and histopathological changes after bilateral carotid artery ligation (BCAL) in Wistar rats were studied. Eight of the 38 rats (21%) died within one week. In the 30 survivors, the incidence of histopathological change was 90% in the caudate nucleus, 23% in the cortex, 30% in the hippocampus, and 0% in the other structures. Local cerebral blood flow (LCBF) was measured using the quantitative autoradiographic 14C-iodoantipyrine technique in 24 anatomically discrete regions of the brain. BCAL induced ischemia in the entire forebrain. The percent reduction of LCBF was between 25-94% of the control at 2.5 h after BCAL. LCBF tended to recover 1 week after BCAL except for the regions of neuronal damage. These results suggest that neuronal damage does not correlate with the flow rate. In the present study, selective neuronal damage was also observed in rats with chronic cerebral ischemia.

The effects on local cerebral blood flow (LCBF) and glucose utilisation (LCGU) of permanent, bilateral carotid artery ligation (BCAL) were studied in conscious Wistar rats. LCBF and LCGU were measured using quantitative autoradiographic 14C-iodoantipyrine and the 14C-2-deoxyglucose (14C-DG) techniques in 24 anatomically discrete regions of the brain. LCBF in the cerebral hemispheres 2.5 h (acute) after BCAL significantly decreased to 25-87% of the sham control, with the exception of the mammillary body. After acute BCAL, there was a heterogeneous accumulation of 14C-DG in the caudate nucleus and cerebral cortices. Only in the lateral geniculate body did LCGU significantly decrease after BCAL. One week (chronic) later, LCBF was significantly decreased in 15 (containing the caudate nucleus and all the cerebral cortices) of 24 structures. LCGU in ten (containing the caudate nucleus and all the cerebral cortices) of 24 structures after chronic BCAL significantly decreased to 66-77% of the sham control, except for regions with neuronal damage in which there was a heterogeneous uptake of 14C-DG. The ratio of LCBF/LCGU in chronic BCAL was unchanged in comparison with values in the corresponding sham-operated group. This model of acute and chronic cerebral ischaemia, with impairment in cerebral circulation and/or glucose metabolism, is expected to become a pertinent tool for the neurophysiologist.

A 63-year-old woman demonstrated subclavian steal syndrome. She had been diagnosed with radio-cephalic AVF(RCAVF)13 years earlier. MRA and cerebral angiogram demonstrated retro-grade filling of the left vertebral artery. SPECT demonstrated lowered blood supply of the left cereberal area that disappeared following administration of Diamox. Doppler examination demonstrated retrograde flow of the left vertebral artery. With simple manual compression of the AVF anastomosis of the left wrist, Doppler wave form changed from a retrograde to a normal antegrade form. Estimation of the left brachial arterial flow by Doppler examination was 3.5 ／ L／min. We concluded that SSS of this case caused by lowered subclavian arterial pressure and high blood flow speed derived from high flow RCAVF. Vertibrobasilar insufficiency symptoms disappeared after closure of RCAVF.

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