TY - JOUR T1 - The Acetazolamide Challenge: Techniques and Applications in the Evaluation of Chronic Cerebral Ischemia JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 876 LP - 884 DO - 10.3174/ajnr.A1538 VL - 30 IS - 5 AU - A.S. Vagal AU - J.L. Leach AU - M. Fernandez-Ulloa AU - M. Zuccarello Y1 - 2009/05/01 UR - http://www.ajnr.org/content/30/5/876.abstract N2 - 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. ER -