Brain Stress Test for Assessing Risk for Hemodynamic Stroke.

Brain stress test CO2 Cerebrovascular reserve Hypercapnia MRI Stroke

Journal

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques
ISSN: 0317-1671
Titre abrégé: Can J Neurol Sci
Pays: England
ID NLM: 0415227

Informations de publication

Date de publication:
10 Jan 2023
Historique:
pubmed: 11 1 2023
medline: 11 1 2023
entrez: 10 1 2023
Statut: aheadofprint

Résumé

In patients with intracranial steno-occlusive disease (SOD), the risk of hemodynamic stroke depends on the poststenotic vasodilatory reserve. Cerebrovascular reactivity (CVR) is a test for vasodilatory reserve. We tested for vasodilatory reserve by using P In this retrospective study, 100 consecutive patients with symptomatic intracranial SOD that had undergone CVR testing were identified. CVR was measured as % BOLD MR signal intensity/mmHg P 83 patients were included in the study. CVR was normal in 14 patients and impaired in 69 patients ipsilateral to the lesion. Of these, 53 underwent surgical revascularization. CVR and symptoms improved in 86% of the latter. The overall incidence of stroke was 4.8 % (4/83). All strokes occurred in patients with impaired CVR (4/69; 2/53 in the surgical group, all in the nonrevascularized hemisphere), and none in patients with normal CVR (0/14). Our study confirms that CO

Sections du résumé

BACKGROUND BACKGROUND
In patients with intracranial steno-occlusive disease (SOD), the risk of hemodynamic stroke depends on the poststenotic vasodilatory reserve. Cerebrovascular reactivity (CVR) is a test for vasodilatory reserve. We tested for vasodilatory reserve by using P
METHODS METHODS
In this retrospective study, 100 consecutive patients with symptomatic intracranial SOD that had undergone CVR testing were identified. CVR was measured as % BOLD MR signal intensity/mmHg P
RESULTS RESULTS
83 patients were included in the study. CVR was normal in 14 patients and impaired in 69 patients ipsilateral to the lesion. Of these, 53 underwent surgical revascularization. CVR and symptoms improved in 86% of the latter. The overall incidence of stroke was 4.8 % (4/83). All strokes occurred in patients with impaired CVR (4/69; 2/53 in the surgical group, all in the nonrevascularized hemisphere), and none in patients with normal CVR (0/14).
CONCLUSION CONCLUSIONS
Our study confirms that CO

Identifiants

pubmed: 36624923
pii: S0317167123000033
doi: 10.1017/cjn.2023.3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-7

Auteurs

Lashmi Venkatraghavan (L)

Department of Anaesthesia, University Health Network, Toronto, ON, Canada.

Casey Rosen (C)

Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.

Larissa McKetton (L)

Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.

Julien Poublanc (J)

Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.

Olivia Sobczyk (O)

Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.

James Duffin (J)

Department of Physiology, The University of Toronto, Toronto, ON, Canada.

Michael Tymianski (M)

Division of Neurosurgery, University Health Network, University of Toronto, Toronto, ON, Canada.

Joseph A Fisher (JA)

Department of Anaesthesia, University Health Network, Toronto, ON, Canada.

David J Mikulis (DJ)

Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.

Classifications MeSH