AJDRAJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 2009;30:876.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1538

REVIEW ARTICLE

The Acetazolamide Challenge: Techniques and Applications in the Evaluation of Chronic Cerebral Ischemia

A.S. Vagal, J.L. Leach, M. Fernandez-Ulloa and M. Zuccarello

From the Departments of Radiology (A.S.V., J.L.L., M.F.-U.) and Neurosurgery (M.Z.), University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Radiology (J.L.L.), Cincinnati Children's Hospital Medical Center; and The Neuroscience Institute (A.S.V., J.L.L., M.Z.), Cincinnati, Ohio.

Please address correspondence to Achala S. Vagal, MD, Department of Radiology, Section of Neuroradiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH 45267-0762; e-mail: vagala{at}healthall.com

SUMMARY: The acetazolamide (ACZ) challenge test is a useful clinical tool and a reliable predictor of critically reduced perfusion. In patients with chronic steno-occlusive disease, the ability to maintain normal cerebral blood flow by reducing vascular resistance secondary to autoregulatory vasodilation is compromised. Identification of the presence and degree of autoregulatory vasodilation (reflecting the cerebrovascular reserve) is a significant prognostic factor in patients with chronic cerebrovascular disease. The pharmacologic challenge of a vasodilatory stimulus such as ACZ can also be used to optimize the treatment strategies for these patients. The pathophysiology, methods, and clinical applications of the ACZ challenge test are discussed in this article.






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