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[Cerebral hemodynamics in stenoses of the internal carotid artery]
Insights
Cerebral hemodynamics in internal carotid artery (ICA) stenosis patients show reduced cerebral blood flow (CBF) without asymmetry. CBF decreases significantly when total arterial stenosis exceeds 40%.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Context:
- Investigates cerebral hemodynamics in patients with internal carotid artery (ICA) stenosis.
- Examines 51 patients with varying degrees of ICA stenosis, experiencing transient cerebral blood flow disorders or ischemic strokes.
- Integrates clinical, angiographic, and CT findings with rheological blood parameters.
Purpose:
- To characterize cerebral blood flow (CBF) patterns in patients with internal carotid artery (ICA) stenosis.
- To explore the relationship between the degree of ICA stenosis and CBF parameters.
- To identify thresholds for significant CBF reduction in relation to arterial narrowing.
Summary:
- Cerebral hemodynamics in ICA stenosis patients exhibit moderate, diffuse CBF reduction across both hemispheres without significant interhemispheric asymmetry.
- Cerebral blood flow (CBF) does not directly correlate with the degree of individual ICA stenosis but shows an inverse correlation with overall narrowing of major head arteries.
- A notable decrease in CBF is observed when the total stenosis of the main head arteries surpasses 40%.
Impact:
- Provides insights into the pathogenesis of cerebral circulation impairments in ICA stenosis.
- Informs clinical decision-making regarding treatment strategies for patients with internal carotid artery stenosis.
- Highlights the importance of assessing total arterial stenosis for predicting cerebral blood flow reduction.
Abstract:
The cerebral hemodynamics was studied in 51 patients with varying severity of stenoses of the internal carotid artery (ICA) expressed in transient disorders of the cerebral blood flow or ischemic strokes. To study the cerebral blood flow (CBF), the authors used the 133Xe-inhalational method; in their analysis they also considered the findings of clinical, angiographic and computer-aided tomographic examinations, as well as the rheological parameters of the blood. It has been established that the main characteristics of the cerebral hemodynamics in patients with ICA stenoses are a moderate diffuse reduction of the CBF in both hemispheres of the brain without a clear-cut interhemispherical asymmetry, the absence of the dependence of the CBF on the degree of ICA stenoses, inverse correlation between the degree of the total narrowing of the lumen of all main arteries of the head and parameters of the CBF, as well as a sharper decrease in the CBF in cases where the total stenosis of the main arteries of the head exceeds 40%. The article deals with the pathogenesis of cerebral circulation impairments in ICA stenoses and the selection of the tactics of treating patients.