Correlation of cerebral blood flow and MCA flow velocity measured in healthy volunteers during acetazolamide and CO2 stimulation

Ulrich, P.; Becker, Thomas E.; Kempski, Oliver

doi:10.1016/0022-510x(94)00252-j

Cited by 38 publications

(24 citation statements)

References 63 publications

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“…Similar results were reported with inhalation of CO 2 . 2,15,19 Comparative rCBF and TCD data are controversial, 24 since a slightly less pronounced increase of rCBF compared with intracranial flow velocity was observed. Sorteberg et al 8 reported a MCA flow velocity increase with acetazolamide of 36% to 42% versus a rCBF increase of only 24% to 26%; Dahl et al 9 found a MCA flow velocity increase of 35% with a corresponding rCBF increase of only 30%.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Acetazolamide and CO ₂ on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Eicke

Buss

Bahr

et al. 1999

Stroke

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Background and Purpose-The vasomotor response can be tested by means of transcranial Doppler sonography. If a constant vessel diameter is assumed, the flow velocity changes will reflect blood flow volume changes. This hypothesis is difficult to verify. Simultaneous assessment of intracranial flow velocity and extracranial flow volume changes may solve this problem. Methods-We tested vasomotor response in 32 volunteers (age, 42Ϯ18 years) with 5% CO 2 . Acetazolamide (1 g) was tested in 15 volunteers (age, 28Ϯ8 years). To evaluate drug-dependent flow changes in the external carotid artery territory, acetazolamide was administered in 7 patients with unilateral occlusion of the internal carotid artery without evidence of collateralization through the ophthalmic artery (age, 67Ϯ12 years). Simultaneous recording included measurements of flow volume in the common carotid arteries (M-mode color duplex system) and flow velocity in the middle cerebral arteries. Results-With CO 2 and acetazolamide, intracranial flow velocity increased by 31% and 39%, respectively, with a simultaneous increase of common carotid artery flow volume of 47% and 50%, respectively. No change in extracranial flow volume was observed in patients with an occluded internal carotid artery. Conclusions-These data show not only the expected increase of flow velocity in the middle cerebral artery but also suggest an increase in cross-sectional vessel diameter of 6% and 4% with CO 2 and acetazolamide, respectively. It remains unresolved whether this observation is due to a direct effect of the drug on the vessel walls or is simply pressure dependent. (Stroke. 1999;30:76-80.)

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Section: Discussionmentioning

confidence: 99%

“…2,8,9,18 -21 If a constant vessel diameter is assumed, relative flow velocity changes correlate directly with flow volume changes. 7 With acetazolamide (1 g IV), maximum flow velocity increases in the MCA of 34% to 60% 8,9,15,[21][22][23] are observed. Similar results were reported with inhalation of CO 2 .…”

Section: Discussionmentioning

confidence: 99%

Influence of Acetazolamide and CO ₂ on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Eicke

Buss

Bahr

et al. 1999

Stroke

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“…Since the introduction of TCD in 1982, 5 several studies have validated the technique as a measure of CBF and relative changes in CBF during different physiological conditions and for different diseases. 4,[6][7][8][9] The validity of TCD measurements requires that the diameter of the insonated vessel remains unchanged. Most clinical studies agree that the diameter of large arteries remains almost constant during arterial carbon dioxide (CO 2 ) tension changes.…”

mentioning

confidence: 99%

Transcranial doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure

et al. 2001

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“…5) Significant sex-or age-related differences in carbon dioxide-or acetazolamide-induced cerebral vasomotor reactivity are known: women and younger subjects have a stronger cerebral vasodilatory response to changes in arterial carbon dioxide pressure or administration of acetazolamide than men or elderly subjects, respectively. 9,10,18,21) Although the mechanisms of increased cerebral vasomotor reactivity in women or younger subjects are currently undefined, the vascular smooth muscle of women or younger subjects may be more sensitive to that stimulus than that of men or elderly subjects. 9) Therefore, the difference in the sensitivity of tissues to carbon dioxide retention increased by acetazolamide may also affect the incidence of the development of the adverse effects with acetazolamide challenge.…”

Section: Discussionmentioning

confidence: 99%

Adverse Effects of Intravenous Acetazolamide Administration for Evaluation of Cerebrovascular Reactivity Using Brain Perfusion Single-Photon Emission Computed Tomography in Patients With Major Cerebral Artery Steno-occlusive Diseases

Saitō

Ogasawara

Suzuki

et al. 2011

Neurol. Med. Chir.(Tokyo)

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Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography (SPECT) were prospectively investigated in 100 patients with major cerebral artery, atherosclerotic, and steno-occlusive diseases. All patients underwent two SPECT studies (with and without acetazolamide challenge) at an interval of 2 or 3 days, received a questionnaire immediately after each SPECT study, and returned the answered questionnaire within 7 days after the study. None of the 100 patients studied experienced any symptoms during the SPECT study without acetazolamide challenge. Sixty-three patients (63%) developed symptoms during the SPECT study with acetazolamide challenge, such as headache, nausea, dizziness, tinnitus, numbness of the extremities, motor weakness of the extremities, and general malaise 1-3 hours (mean 1.6 hours) after administration of acetazolamide, and these symptoms lasted for 0.5-72 hours (mean 7.9 hours). Multivariate statistical analysis revealed that younger age (95% confidence interval [CI] 0.896-0.980, p ＝ 0.0047) and female sex (95% CI 1.178-16.129, p ＝ 0.0274) were significantly associated with development of symptoms with acetazolamide challenge. The incidences of the development of symptoms with acetazolamide challenge were 91% (21/23) and 41% (12/29) in subgroups of women º70 years and men AE70 years, respectively. Patients should be informed of such adverse effects of intravenous acetazolamide administration prior to the acetazolamide challenge test for evaluation of cerebrovascular reactivity.

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Correlation of cerebral blood flow and MCA flow velocity measured in healthy volunteers during acetazolamide and CO2 stimulation

Cited by 38 publications

References 63 publications

Influence of Acetazolamide and CO ₂ on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Influence of Acetazolamide and CO ₂ on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Transcranial doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure

Adverse Effects of Intravenous Acetazolamide Administration for Evaluation of Cerebrovascular Reactivity Using Brain Perfusion Single-Photon Emission Computed Tomography in Patients With Major Cerebral Artery Steno-occlusive Diseases

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Correlation of cerebral blood flow and MCA flow velocity measured in healthy volunteers during acetazolamide and CO2 stimulation

Cited by 38 publications

References 63 publications

Influence of Acetazolamide and CO 2 on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Influence of Acetazolamide and CO 2 on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Transcranial doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure

Adverse Effects of Intravenous Acetazolamide Administration for Evaluation of Cerebrovascular Reactivity Using Brain Perfusion Single-Photon Emission Computed Tomography in Patients With Major Cerebral Artery Steno-occlusive Diseases

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Influence of Acetazolamide and CO ₂ on Extracranial Flow Volume and Intracranial Blood Flow Velocity

Influence of Acetazolamide and CO ₂ on Extracranial Flow Volume and Intracranial Blood Flow Velocity