Related Experiment Video

Updated: Feb 3, 2026

Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice
08:41

Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice

Published on: October 27, 2014

23.9K

Intracerebral steal phenomenon in symptomatic carotid artery disease

Nolan S Hartkamp1, Jeroen Hendrikse1, Gert J de Borst2

  • 1Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

Journal of Neuroradiology = Journal De Neuroradiologie
|November 4, 2018
PubMed

Insights

Intracerebral steal, a reduction in brain blood flow, affects 21% of patients with internal carotid artery disease. This phenomenon is linked to impaired cerebrovascular reactivity and collateral blood flow via the circle of Willis.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Intracerebral steal is a paradoxical response where vasodilation in healthy brain areas reduces blood flow to compromised tissue.
  • Steno-occlusive internal carotid artery (ICA) disease can lead to hemodynamic compromise and intracerebral steal.

Purpose of the Study:

  • To investigate the presence and extent of intracerebral steal in patients with steno-occlusive ICA disease.
  • To assess the relationship between intracerebral steal and collateral blood flow through the circle of Willis (CoW).

Main Methods:

  • 38 patients with symptomatic steno-occlusive ICA disease underwent MRI with arterial spin labeling (ASL) perfusion imaging.
  • Intracerebral steal was identified as a decline in cerebral blood flow (CBF) after acetazolamide challenge.
  • Collateral flow via the CoW was evaluated using time-of-flight and 2D phase-contrast MR angiography (MRA).

Main Results:

  • Intracerebral steal was observed in 8 of 38 patients (21%).
  • Patients with steal showed lower cerebrovascular reactivity (CVR) in the affected hemisphere compared to those without.
  • Impaired collateral blood flow through the CoW was noted in 4 patients with steal, correlating with a larger steal volume.

Conclusions:

  • Intracerebral steal is detectable at the brain tissue level using ASL perfusion MRI in patients with obstructive ICA disease.
  • The presence of steal is associated with reduced CVR in adjacent brain tissue.
  • The volume of steal is linked to compromised collateral circulation through the CoW.
Abstract

Keywords:
Arterial spin labelingCarotid artery diseaseCerebral infarctionCerebrovascular reactivityIntracerebral vascular stealMagnetic resonance ImagingPerfusion imaging

More Related Videos

Mechanical Testing of Mouse Carotid Arteries: from Newborn to Adult10:32

Mechanical Testing of Mouse Carotid Arteries: from Newborn to Adult

Published on: February 23, 2012

13.2K
In Vivo Gene Transfer to the Rabbit Common Carotid Artery Endothelium10:18

In Vivo Gene Transfer to the Rabbit Common Carotid Artery Endothelium

Published on: May 6, 2018

9.7K

Related Concept Videos

Tip-of-the-Tongue Phenomenon01:10

Tip-of-the-Tongue Phenomenon

The tip-of-the-tongue (TOT) phenomenon is a cognitive experience characterized by a temporary inability to retrieve specific information from memory despite having a strong feeling of knowing the information. Although individuals cannot access the target word or detail, they frequently recall related elements, such as its initial letter, syllable count, or context. This partial retrieval often causes frustration, as one might recognize a familiar face or know that a name starts with a specific...
522
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
1.1K
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
378
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
451
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
269
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
384