Document Detail

The clinical role of the cerebral collateral circulation in carotid occlusion.
MedLine Citation:
PMID:  2116535     Owner:  NLM     Status:  MEDLINE    
The occurrence and severity of ischemic cerebral symptoms after carotid occlusion depends on the interdependency of cerebral collateral blood supply. Only those with the "fittest" collateral capacity survive this process of natural selection. Using the transcranial Doppler method in 55 patients with unilateral carotid occlusion, we tested the dependency of each cerebral hemisphere on the remaining patent carotid artery by digital carotid compression, and in 41 of these patients we also tested the carbon dioxide reactivity in each hemisphere. Both hemispheric dependency and carbon dioxide reactivity were compared to 15 healthy controls. Mean blood flow velocities in the middle cerebral artery were lower on the occluded side than on the patent side (p less than 0.003). When the patent carotid artery was compressed middle cerebral artery blood flow velocities on the occluded side were mainly independent of the patent carotid artery, but on the patent side there was a high degree of dependency (p less than 0.0001). Carbon dioxide reactivity did not differ between the hemispheres, but in hemispheres with total dependency, carbon dioxide reactivity was inversely proportional to the severity of stenosis (r = -0.63). Tests of cerebral collateral reserve in patients with unilateral carotid occlusion evaluated by carotid compression and cerebral carbon dioxide reactivity may discriminate between survivors and potential nonsurvivors before the patent carotid artery occludes.
J W Norris; A Krajewski; N M Bornstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  12     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1990-09-13     Completed Date:  1990-09-13     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  113-8     Citation Subset:  IM    
Stroke Research Unit, Sunnybrook Medical Centre, Toronto, Ontario, Canada.
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MeSH Terms
Blood Flow Velocity / physiology
Carbon Dioxide / diagnostic use
Carotid Artery Diseases / physiopathology*
Cerebrovascular Circulation / physiology*
Collateral Circulation / physiology*
Constriction, Pathologic
Middle Aged
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comment In:
J Vasc Surg. 1991 Mar;13(3):459-60   [PMID:  1999869 ]

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

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