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Regional Cerebral Blood Flow After Acetazolamide Challenge in Patients with Dural Arteriovenous Fistula: Simple Way to Evaluate Intracranial Venous Hypertension

Jun Deguchia, Makoto Yamadaa, Hitoshi Kobataa and Toshihiko Kuroiwaa

a Department of Neurosurgery, Osaka Medical College, Japan



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  		FIG 1. Case 21. Right lateral internal carotid angiograms show a Cognard type IV lesion in an asymptomatic patient.

A, Preoperative image shows an anterior fossa DAVF with cortical venous reflux.

B, Postoperative image shows disappearance of the DAVF and venous reflux.



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  		FIG 2. Case 21. rCBF maps for a Cognard type IV lesion in an asymptomatic patient.

A and B, Before surgery, resting rCBF in the right frontal region (white outline) is low (A), and the response of rCBF to the acetazolamide challenge is limited (B).

C and D, At 6 months after surgery, resting rCBF (C) and the response of rCBF (D) to the acetazolamide challenge is increased.



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  		FIG 3. Differences in rCBF between groups according to Cognard angiographic classification.

A, Resting rCBF significantly differs between type I and types III and IV.

B, After acetazolamide challenge, rCBF significantly differs, even between type I and type II.

C, Increase in rCBF due to acetazolamide ({Delta}F, or acetazolamide value minus resting value) is significantly different between type I and the other types.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X