Document Detail

Impaired vasoreactivity of the basilar artery system in patients with brainstem lacunar infarcts.
MedLine Citation:
PMID:  10393409     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Diminished vasoreactivity (VR) has been evidenced in patients with hemispheric small vessel disease, however, there is no data regarding vertebrobasilar (VB) territory VR changes in patients with subcortical vascular encephalopathy located in the brainstem. Therefore, we compared the cerebral blood flow velocity (CBFV) responses of the VB system during different vasoregulatory challenges in healthy volunteers to those in patients with brainstem lacunar infarcts. METHODS: In 20 patients with brainstem lacunar infarcts and in 10 healthy volunteers the VR of the VB system was measured by analyzing the CBFV changes during different stimulation paradigms (ventilation, tilting and acetazolamide tests). During transcranial Doppler registration the systemic blood pressure and the expiratory partial CO2 pressure were monitored. RESULTS: During hypercapnia the VR was significantly higher in the control group than in the patient group (10.1 +/- 4.9 vs. 3.4 +/- 5.0 cm/s/kPa, p = 0.0025). In a subgroup of patients with mean baseline CBFV <25 cm/s the VR was 1.5 +/- 2.4 cm/ s/kPa, while patients with mean baseline CBFV >25 cm/s showed a significantly higher value (7.8 +/- 6.9 cm/s/kPa). Furthermore, in patients with mean baseline CBFV <25 cm/s the pulsatility index was significantly higher than in patients with mean baseline CBFV >25 cm/s (1.11 +/- 0.26 vs. 0.86 +/- 0.19, p = 0.0325), reflecting significantly higher vascular resistance in the former group. Although CBFV measurements during tilting and acetazolamide tests tended to support these findings, they showed no significant differences between patients and controls. CONCLUSION: Patients with cerebral microangiopathy involving the brainstem showed impaired VR in the VB flow territory in association with baseline CBFV.
G Panczel; P Bönöczk; Z Voko; D Spiegel; Z Nagy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  9     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:    1999 Jul-Aug
Date Detail:
Created Date:  1999-09-27     Completed Date:  1999-09-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  218-23     Citation Subset:  IM    
National Stroke Center, Budapest, Hungary.
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MeSH Terms
Acetazolamide / pharmacology
Aged, 80 and over
Basilar Artery / physiopathology*,  ultrasonography
Blood Flow Velocity / drug effects
Blood Gas Analysis
Brain Stem / blood supply*,  physiopathology*
Cerebral Infarction / physiopathology*
Hypercapnia / physiopathology
Hypocapnia / physiopathology
Middle Aged
Tilt-Table Test
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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