Importance of ocular symptoms as an initial sign of the internal carotid artery occlusion: Evaluation of flow reserve by SPECT
- Osaka Univ. Medical School (Japan); and others
Retinopathy of internal carotid artery (ICA) occlusion is not a common clinical entity, but requires a prompt medical attention not only to save vision but also to prevent stroke, once it appears. The purpose of this study is to investigate the role of extracranial carotid artery disease as a source of ocular pathology and its relation to cerebral circulation. Nine male patients (65.6{plus_minus}7.2 years old) with severe stenosis (>90% ) or occlusion at the cervical segment of the ICA, suffering from ipsilateral amaurosis fugax (AF) or visual disturbance (VD) as their initial clinical symptoms took part in this study. Four patent had experienced AF, one had acute VD and four had chronic VD. In order to assess the cerebral circulation, all patents were examined by brain MRI, regional cerebral blood low (rCBF) and conventional cerebral angiography. Regional CBF and cerebral vasoreactivity were measured using I-123 IMP SPECT before and after the intravenous administration of 1 g acetazolamide. Brain MRI showed subcortical small infarctions in six patents, three of them had infarctions in the terminal area. No lesions could be detected in the remaining three. By clinical findings and SPECT study, we classified into following tour groups, i.e., group A (n=4): chronic VD and reduced cerebral vasoreactivity, group B (n=1): acute VD and normal cerebral vasoreactivity, group C (n=2): AF and reduced cerebral vasoreactivity, group D (n=2): AF and normal cerebral vasoreactivity. By angiography, ulcerated plaques were found in the ipsilateral ICA in group D patients. In conclusion, AF is caused by both hemodynamic and embolic factor, whereas VD is caused by mainly hemodynamic factor. Ocular symptoms In patients in the stroke-aged population should subsequently become a common indication for further investigation of cerebral circulation.
- OSTI ID:
- 198056
- Report Number(s):
- CONF-940605-; ISSN 0161-5505; TRN: 95:007029-0205
- Journal Information:
- Journal of Nuclear Medicine, Vol. 35, Issue Suppl.5; Conference: 41. annual meeting of the Society of Nuclear Medicine, Orlando, FL (United States), 5-8 Jun 1994; Other Information: PBD: May 1994
- Country of Publication:
- United States
- Language:
- English
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