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[Status of cerebral and central hemodynamics in patients with ischemic stroke]
Insights
Radiocerebrography (RC) and radiocardiography (RCG) revealed reduced cerebral blood flow in ischemic brain stroke patients with poor outcomes. Hemodynamic assessment identified significant carotid artery stenosis, even without angiogram changes, and showed potential for improvement with medication.
Area of Science:
- Neurology
- Nuclear Medicine
- Radiology
Context:
- Ischemic brain stroke significantly impacts cerebral and central hemodynamics.
- Accurate assessment of cerebral blood flow is crucial for stroke patient management.
- Non-invasive imaging techniques offer valuable insights into cerebrovascular health.
Purpose:
- To evaluate cerebral and central hemodynamics in ischemic brain stroke patients using radiocerebrography (RC) and radiocardiography (RCG).
- To correlate hemodynamic findings with stroke outcomes and identify potential markers for significant stenosis.
- To explore the impact of therapeutic interventions on cerebral blood flow.
Summary:
- 30 ischemic brain stroke patients underwent simultaneous RC, RCG, CT, angiography, and rheoencephalography.
- Patients with favorable outcomes showed normal RC and RCG readings compared to controls (18 peripheral nervous disease patients).
- 19 disabled patients exhibited decelerated cerebral blood flow, particularly on the infarction side, indicating hemodynamically significant internal carotid artery stenosis, even when angiograms were normal. A correlation between central hemodynamics and cerebral blood flow was observed, with potential for improvement via medication.
Impact:
- RC and RCG can detect hemodynamically significant internal carotid artery stenosis not evident on conventional angiography.
- Findings suggest a link between central hemodynamics and cerebral blood flow, offering therapeutic targets.
- This study highlights the utility of nuclear medicine techniques in stroke assessment and management.
Abstract:
Overall 30 patients who suffered ischemic brain stroke were examined for cerebral and central hemodynamics by radiocerebrography (RC) with the aid of the radiopharmaceutical preparation Tx-99 and by radiocardiography (RCG) using 131I. These methods were employed simultaneously with computer-aided tomography, cerebral angiography, rheoencephalography. The control group was made up of 18 patients suffering from peripheral nervous diseases. In 11 patients with a favourable outcome of ischemic brain stroke and the recovery of work fitness, the RC and RCG readings did not practically differ from those in the controls. The remaining 19 patients with disability due to brain stroke demonstrated deceleration of the cerebral blood flow, most pronounced on the side of brain infarction. Asymmetry of the cerebral blood flow and deceleration of blood supply in the main and intracerebral vessels as shown by the RC readings turned out the signs of the hemodynamically significant stenosis of one of the internal carotid arteries, even in lack of the changes on the angiogram. A correlation was established between deterioration of central hemodynamics and deceleration of the cerebral blood flow, as was a possibility of an increase of the blood inflow to the brain after administering drugs that make the RCG readings return to normal.