The use of acetazolamide-enhanced regional cerebral blood flow measurement to predict risk to arteriovenous malformation patients

H. H. Batjer, M. D. Devous, J. A. Anson, R. F. Spetzler, W. S. Fisher

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

REGIONAL HEMODYNAMIC DISTURBANCES may complicate the treatment of certain cerebral arteriovenous malformations (AVM) and occasionally produce life- threatening situations. Acetazolamide-enhanced quantitative regional cerebral blood flow studies were performed preoperatively in 35 patients to determine if patterns of vasoreactivity could be identified that might be markers for postoperative morbidity. Ipsilateral and contralateral regions of hypoperfusion were identified on resting studies, and a steal index was calculated by dividing the regional cerebral blood flow in the steal region by the flow in a normal cerebellar region. Flow in these regions of interest was again quantitated after the administration of acetazolamide, a known cerebral vasodilator. A delta value was calculated by subtracting the resting index values from the acetazolamide indices. Abnormally enhanced vasoreactivity (vasodilation) to acetazolamide stimulation was noted in these threatened territories in AVM that had perforating vessel feeding and angiographic steal phenomena, that developed hyperemic disturbances, and that resulted in poor outcomes. These findings call into question traditional theories of AVM-related hemodynamic decompensation and suggest unique smooth muscle derangements in cerebral vasculature in some AVM patients.

Original languageEnglish (US)
Pages (from-to)213-218
Number of pages6
JournalNeurosurgery
Volume31
Issue number2
StatePublished - 1992

Fingerprint

Cerebrovascular Circulation
Acetazolamide
Arteriovenous Malformations
Regional Blood Flow
Hemodynamics
Intracranial Arteriovenous Malformations
Vasodilator Agents
Vasodilation
Smooth Muscle
Morbidity

Keywords

  • Arteriovenous malformation
  • Cerebral blood flow
  • Hyperemia
  • Therapeutic risk

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

The use of acetazolamide-enhanced regional cerebral blood flow measurement to predict risk to arteriovenous malformation patients. / Batjer, H. H.; Devous, M. D.; Anson, J. A.; Spetzler, R. F.; Fisher, W. S.

In: Neurosurgery, Vol. 31, No. 2, 1992, p. 213-218.

Research output: Contribution to journalArticle

Batjer, H. H. ; Devous, M. D. ; Anson, J. A. ; Spetzler, R. F. ; Fisher, W. S. / The use of acetazolamide-enhanced regional cerebral blood flow measurement to predict risk to arteriovenous malformation patients. In: Neurosurgery. 1992 ; Vol. 31, No. 2. pp. 213-218.
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