Impaired cerebral vasoreactivity after embolization of arteriovenous malformations: assessment with serial acetazolamide challenge xenon CT

Journal Article · Wed May 01 04:00:00 EDT 1991 · AJNR, American Journal of Neuroradiology; (United States)

OSTI ID:5409743

Tarr, R W; Johnson, D W; Horton, J A; Yonas, H; Pentheny, S; Durham, S; Jungreis, C A; Hecht, S T ^[1]

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1. Presbyterian-Univ. Hospital, Pittsburgh, PA (USA)

Embolization of a portion of the nidus of an arteriovenous malformation not only may alter hemodynamics within the nidus, but also may change blood flow dynamics in adjacent normal vessels. Sequential acetazolamide-challenge xenon CT cerebral blood flow studies were performed in eight patients before and after embolization of arteriovenous malformations to assess the hemodynamic effects on the major vascular territories supplying the malformation. Acetazolamide is a potent cerebral vasodilator, and its administration combined with cerebral blood flow studies allows assessment of cerebral vasoreactivity. In seven of the eight patients, one or more parenchymal areas exhibited a normal cerebral blood flow augmentation response to acetazolamide before embolization, but diminished acetazolamide flow augmentation was seen after embolization, indicating abnormal vasoreactivity. We found that the decrease in vasoreactivity peaked 6-10 days after embolization. In one of the eight patients, a temporary delayed neurologic deficit developed during a period of impaired cerebral vasoreactivity following embolization. Our results suggest that embolization of an arteriovenous malformation can induce vasoreactivity changes in adjacent normal vessels. Because these changes appear to be somewhat time-dependent, an appropriate interval should be observed between embolization stages or before surgical resection of an arteriovenous malformation following embolization to allow hemodynamic equilibration to occur. Acetazolamide challenge combined with serial cerebral blood flow studies following embolization enables determination of this hemodynamic equilibration.

• OSTI ID: 5409743
• Journal Information: AJNR, American Journal of Neuroradiology; (United States), Journal Name: AJNR, American Journal of Neuroradiology; (United States) Vol. 12:3; ISSN 0195-6108; ISSN AAJND
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BLOOD FLOW
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
CEREBRAL CORTEX
CEREBRUM
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ISOTOPES
NERVOUS SYSTEM
ORGANS
PATIENTS
TOMOGRAPHY
VASCULAR DISEASES
XENON ISOTOPES