Related Experiment Video

Updated: May 13, 2026

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
09:11

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability

Published on: February 23, 2016

Chronic hemodynamic compromise and cerebral ischemic events in asymptomatic or remote symptomatic large-artery

H Yamauchi1, T Higashi, S Kagawa

  • 1Division of PET Imaging, Shiga Medical Center Research Institute, Shiga, Japan.

AJNR. American Journal of Neuroradiology
|March 9, 2013
PubMed

Insights

Patients with chronic hemodynamic compromise in intracranial artery disease face a higher risk of ischemic events. This condition may predict strokes and TIAs in both asymptomatic and symptomatic individuals.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Atherosclerotic disease of the intracranial internal carotid artery or middle cerebral artery (LAICOD) can lead to ischemic events.
  • While overall risk is low in asymptomatic or remote symptomatic LAICOD, a high-risk subgroup may exist.
  • Identifying predictors of ischemic events is crucial for targeted medical management.

Purpose of the Study:

  • To investigate whether chronic hemodynamic compromise predicts ischemic events in patients with asymptomatic or remote symptomatic LAICOD.
  • To assess the role of physiological parameters in determining stroke risk within this patient population.

Main Methods:

  • Prospective study of 89 patients with atherosclerotic LAICOD (51 asymptomatic, 19 coexistent asymptomatic, 19 remote symptomatic).
  • Utilized (15)O-PET to assess cerebral blood flow (CBF), oxygen extraction fraction (OEF), and CBF/CBV ratio.
  • Patients were followed for 2 years for ischemic events (stroke, TIA) or death.

Main Results:

  • Hemorrhagic transformation (MP) defined by decreased CBF, increased OEF, and decreased CBF/CBV ratio was assessed.
  • The incidence of ipsilateral ischemic events was significantly higher in patients with MP (2/5) compared to those without (1/84) (P < .0001).
  • A decreased CBF/CBV ratio also significantly predicted ischemic events (2/9 vs 1/80; P = .0001).

Conclusions:

  • Chronic hemodynamic compromise, indicated by specific PET findings, is a significant predictor of ischemic events.
  • This finding applies to both asymptomatic and remote symptomatic patients with LAICOD.
  • Aggressive medical management may be warranted for patients identified with hemodynamic compromise.
Abstract

More Related Videos

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection08:22

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Published on: July 21, 2013

Related Concept Videos

Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...