PT - JOURNAL ARTICLE AU - A.S. Vagal AU - J.L. Leach AU - M. Fernandez-Ulloa AU - M. Zuccarello TI - The Acetazolamide Challenge: Techniques and Applications in the Evaluation of Chronic Cerebral Ischemia AID - 10.3174/ajnr.A1538 DP - 2009 May 01 TA - American Journal of Neuroradiology PG - 876--884 VI - 30 IP - 5 4099 - http://www.ajnr.org/content/30/5/876.short 4100 - http://www.ajnr.org/content/30/5/876.full SO - Am. J. Neuroradiol.2009 May 01; 30 AB - 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.