Advanced

AJNR - American Journal of Neuroradiology

Publication Preview: Published July 24, 2008

American Journal of Neuroradiology 2008;29:1841.

This Article Full Text (PDF) All Versions of this Article: ajnr.A1234v1 29/10/1841    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Tanaka, M. Articles by Hatazawa, J. Search for Related Content PubMed PubMed Citation Articles by Tanaka, M. Articles by Hatazawa, J.

American Journal of Neuroradiology
DOI 10.3174/ajnr.A1234

BRAIN

Chronic Middle Cerebral Artery Occlusion: A Hemodynamic and Metabolic Study with Positron-Emission Tomography

M. Tanaka, E. Shimosegawa, K. Kajimoto, Y. Kimura, H. Kato, N. Oku, M. Hori, K. Kitagawa and J. Hatazawa

From the Departments of Nuclear Medicine and Tracer Kinetics (M.T., E.S., K.K., Y.K., H.K., N.O., J.H.), Cardiovascular Medicine (M.T., M.H.), and Neurology (K.K.), Osaka University Graduate School of Medicine, Osaka, Japan.

Please address correspondence to: Jun Hatazawa, MD, Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan; e-mail: hatazawa{at}tracer.med.osaka-u.ac.jp

BACKGROUND AND PURPOSE: Chronic middle cerebral artery (MCA) occlusion is more common than generally thought. It is important to assess the cerebral hemodynamic status in patients with this chronic condition. We investigated the cerebral hemodynamic and metabolic disturbances in these patients in relation to the development of the collateral vasculature.

MATERIALS AND METHODS: We studied 13 patients with chronic unilateral MCA occlusion who had a minor or no stroke by using positron-emission tomography (PET). PET was performed by the oxygen 15 (¹⁵O) gas steady-state inhalation method. The intracranial arteries were evaluated by digital subtraction angiography. We divided the patients into 2 subgroups according to whether they had a normal or increased oxygen extraction fraction (OEF) in the occluded MCA territory and compared the 2 groups.

RESULTS: Of the 13 patients, 9 were classified into the normal OEF and 4 were classified into the increased OEF group. In the increased OEF group, the mean OEF values were also increased in the territories of the ipsilateral anterior cerebral artery, ipsilateral posterior cerebral artery, and contralateral MCA. The patients in the increased OEF group had more than 1 steno-occlusive lesion in the major intracranial arteries (P = .008). Three of the 4 patients in the increased OEF group also had vascular lesions in the collateral pathways to the MCA territory.

CONCLUSION: Most patients with chronic MCA occlusion did not show severe hemodynamic impairment. Those with increased OEF tended to have other areas of severe hemodynamic impairment and other vascular lesions, especially in the collateral pathways.