Abstract
Previous studies on CO2 reactivity in cerebral low flow infarcts (LFIs) included patients with lesions in the frontoparasagittal area, supraganglionic white matter, and temporoparieto-occipital zone. Supraganglionic white matter LFIs are, however, difficult to separate from non-low flow induced infarcts of the lacunar type, and temporoparieto-occipital LFIs from infarcts in the territory of the inferior stem of the middle cerebral artery. The CO2 reactivity of the middle cerebral artery was studied in 56 patients with high grade stenoses and occlusions of the internal carotid artery and LFIs (n = 9) in the frontoparasagittal border zone, territorial infarcts (n = 26), no infarcts (n = 21), and normal subjects (n = 25) by means of transcranial Doppler sonography. The aim was to investigate whether patients with LFIs have significantly lower CO2 reactivity than patients with territorial infarcts, no infarcts, and normal subjects. Patients with LFIs had the most severely reduced CO2 reactivity on the symptomatic side and CO2 reactivity was significantly lower than on the asymptomatic side. It was also lower than in patients with unilateral and bilateral internal carotid artery obstructions and territorial infarcts, asymptomatic patients, and healthy volunteers. It is concluded that LFIs are associated with significantly reduced CO2 reactivity.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson D. E., McLane M. P., Reichman O. H., Origitano T. C. Improved cerebral blood flow and CO2 reactivity after microvascular anastomosis in patients at high risk for recurrent stroke. Neurosurgery. 1992 Jul;31(1):26–34. doi: 10.1227/00006123-199207000-00005. [DOI] [PubMed] [Google Scholar]
- Bogousslavsky J., Regli F. Unilateral watershed cerebral infarcts. Neurology. 1986 Mar;36(3):373–377. doi: 10.1212/wnl.36.3.373. [DOI] [PubMed] [Google Scholar]
- Donnan G. A., Bladin P. F., Berkovic S. F., Longley W. A., Saling M. M. The stroke syndrome of striatocapsular infarction. Brain. 1991 Feb;114(Pt 1A):51–70. [PubMed] [Google Scholar]
- Gibbs J. M., Wise R. J., Leenders K. L., Jones T. Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion. Lancet. 1984 Feb 11;1(8372):310–314. doi: 10.1016/s0140-6736(84)90361-1. [DOI] [PubMed] [Google Scholar]
- Leblanc R., Yamamoto Y. L., Tyler J. L., Diksic M., Hakim A. Borderzone ischemia. Ann Neurol. 1987 Dec;22(6):707–713. doi: 10.1002/ana.410220606. [DOI] [PubMed] [Google Scholar]
- MEYER J. E. Uber die Lokalisation frühkindlicher Hirnschäden in arteriellen Grenzgebieten. Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr. 1953;190(4):328–341. doi: 10.1007/BF01225301. [DOI] [PubMed] [Google Scholar]
- Ringelstein E. B., Sievers C., Ecker S., Schneider P. A., Otis S. M. Noninvasive assessment of CO2-induced cerebral vasomotor response in normal individuals and patients with internal carotid artery occlusions. Stroke. 1988 Aug;19(8):963–969. doi: 10.1161/01.str.19.8.963. [DOI] [PubMed] [Google Scholar]
- Ringelstein E. B., Zeumer H., Angelou D. The pathogenesis of strokes from internal carotid artery occlusion. Diagnostic and therapeutical implications. Stroke. 1983 Nov-Dec;14(6):867–875. doi: 10.1161/01.str.14.6.867. [DOI] [PubMed] [Google Scholar]
- Weiller C., Ringelstein E. B., Reiche W., Buell U. Clinical and hemodynamic aspects of low-flow infarcts. Stroke. 1991 Sep;22(9):1117–1123. doi: 10.1161/01.str.22.9.1117. [DOI] [PubMed] [Google Scholar]
- Weiller C., Ringelstein E. B., Reiche W., Thron A., Buell U. The large striatocapsular infarct. A clinical and pathophysiological entity. Arch Neurol. 1990 Oct;47(10):1085–1091. doi: 10.1001/archneur.1990.00530100051013. [DOI] [PubMed] [Google Scholar]
- Widder B., Paulat K., Hackspacher J., Mayr E. Transcranial Doppler CO2 test for the detection of hemodynamically critical carotid artery stenoses and occlusions. Eur Arch Psychiatry Neurol Sci. 1986;236(3):162–168. doi: 10.1007/BF00380944. [DOI] [PubMed] [Google Scholar]
- Wodarz R. Watershed infarctions and computed tomography. A topographical study in cases with stenosis or occlusion of the carotid artery. Neuroradiology. 1980;19(5):245–248. doi: 10.1007/BF00347803. [DOI] [PubMed] [Google Scholar]
- van der Zwan A., Hillen B. Review of the variability of the territories of the major cerebral arteries. Stroke. 1991 Aug;22(8):1078–1084. doi: 10.1161/01.str.22.8.1078. [DOI] [PubMed] [Google Scholar]
