Carbonic Anhydrase Inhibition and Cerebral Venous Blood Gases and Ions in Man

Gotoh, Fumio; Meyer, John Stirling; Tomita, Minoru

doi:10.1001/archinte.1966.03870070053007

Cited by 54 publications

(13 citation statements)

References 18 publications

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“…We have reexamined the effect of acetazolamide on CBF and although we observed an increase, it was consistently less than the large increases in CBF others have reported (1)(2)(3)(4)(5)(6)(7). This apparent discrepancy prompted us to measure the effect of acetazolamide on the CMRO2 because the reported CBF changes after intravenous acetazolamide (Table I) are based, in large measure, on the use of the brain arteriovenous oxygen difference as an index of CBF.…”

Section: Introductionmentioning

confidence: 64%

“…DISCUSSION Our data show that the intravenous administration of acetazolamide sufficient to acutely inhibit all circulat- 4 The effect of intravenous administration acetazolamide on CMRO2. The mean control CMRO2 was 4.16 ml/min per 100 g. FIGURE 5 The effect of hemolysis of the oxygen-15-labelecl blood used to measure the CMRO2 before (control) and after the intravenous administration of acetazolamide to rhesus monkeys. The mean control CMRO2 obtained with nonhemolyzed blood was 4.14 ml/min per 100 g.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Acetazolamide on Cerebral Blood Flow and Oxygen Utilization in the Rhesus Monkey

Laux¹,

Raichle²

1978

J. Clin. Invest.

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Section: Introductionmentioning

confidence: 64%

Section: Resultsmentioning

confidence: 99%

The Effect of Acetazolamide on Cerebral Blood Flow and Oxygen Utilization in the Rhesus Monkey

Laux¹,

Raichle²

1978

J. Clin. Invest.

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“…7,8 In this study, we injected a relatively low dose of acetazolamide (10 mg/kg) to assess rCVR because it is known that intravenous injection of 500 mg or 10 mg/kg acetazolamide is sufficient to increase rCBF. 7,8,19 Normal control values of rCBF (43.1Ϯ3.0 mL · 100 g Ϫ1 · min Ϫ1 , meanϮSD) and rCVR (20.3Ϯ5.3%) were obtained from 8 volunteers free of cerebrovascular disease who were from 34 to 74 years of age (mean, 50.4 years). 7,8 The values were rated as reduced when any was less than the mean minus 2 SD of the control values.…”

Section: Spect Measurementsmentioning

confidence: 99%

Long-Term Prognosis of Medically Treated Patients With Internal Carotid or Middle Cerebral Artery Occlusion

Kuroda

Houkin

Kamiyama

et al. 2001

Stroke

289

177

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Background and Purpose-The importance of hemodynamic parameters for predicting outcome in patients with occlusive carotid disease remains controversial. The present study was aimed at testing the hypothesis that regional cerebrovascular reactivity (rCVR) to acetazolamide can be a reliable predictor of subsequent ischemic stroke in medically treated patients with internal carotid artery or middle cerebral artery occlusion. Methods-Seventy-seven symptomatic patients were enrolled in this prospective, longitudinal cohort study. All patients met inclusion criteria of cerebral angiography, no or localized cerebral infarction on MRI or CT, and no or minimal neurological deficit. Regional cerebral blood flow (rCBF) and rCVR to acetazolamide were quantitatively determined by 133 Xe SEPCT. All patients were categorized into 4 types on the basis of SPECT studies. Results-During an average follow-up period of 42.7 months, 16 total and 7 ipsilateral ischemic strokes occurred. The annual risks of total and ipsilateral stroke in patients with decreased rCBF and rCVR were 35.6% and 23.7%, respectively, risks that are higher than those in other types of patients. When strokes were categorized into patients with and without decreased rCBF and rCVR, Kaplan-Meier analysis revealed that the risks of total and ipsilateral stroke in patients with decreased rCBF and rCVR were significantly higher than in those without (PϽ0.0001 and Pϭ0.0001, respectively, log-rank test). Relative risk conferred by decreased rCBF and rCVR was 8.0 (95% CI, 1.9 to 34.4) for ipsilateral stroke and 3.6 (95% CI, 1.4 to 9.3) for total stroke. Conclusions-Decreased

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“…11 How acetazolamide produces this vasodilation is still in doubt. Three concurrent actions 21 have been proposed: induced cerebral acidosis by carbonic anhydrase inhibition in the erythrocytes, 22 direct action on the carbonic anhydrase within the media of cerebral arteries, 23 and a direct action on the vascular smooth muscle cell, independent of carbonic anhydrase inhibition. 24 With such a sensitive drug challenge, any regional impairment of vasoreactivity preventing maximum vasodilation could be revealed and quantified by 133 Xe SPECT.…”

Section: H+7chmentioning

confidence: 99%

Vertebrobasilar insufficiency revealed by xenon-133 inhalation SPECT.

Delecluse

Voordecker

Raftopoulos

1989

Stroke

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A study of cerebral and cerebellar blood flow reactivity to acetazolamide by xenon-133-inhalation single photon emission computed tomography ( 133 Xe SPECT) was carried out in a patient with bouts of transient basilar ischemia, whose neurological examination, computed tomographic scan, and auditory evoked potentials were normal. Though the patient was symptom-free at the time of the study, 133Xe SPECT demonstrated vertebrobasilar insufficiency by snowing an impaired vasodilatory response in both the occipital lobes and the right cerebellar hemisphere. Three weeks later, the patient suffered an extensive stroke in these same areas. We therefore suggest that this method could be of great value in the assessment of vertebrobasilar insufficiency. Received May 10, 1988; accepted December 16, 1988. both the occipital lobes and the right cerebellar hemisphere of a patient who later suffered an extensive stroke in these same anatomic regions.Case Report A 60-year-old chronically hypertensive man was admitted for blood pressure stabilization. He reported a 2-month history of weekly attacks of vertigo, nausea, blurred vision, bifacial numbness, and lingual paresthesias of a few seconds' duration. These attacks were unrelated to postural changes, extreme head movement, or modifications in drug therapy. Blood pressure on admission was 180/90 mm Hg; the general physical and neurologic examination was otherwise normal, including the optic fundi and the visual fields. The electrocardiogram (EKG) was normal, while bidimensional cardiac echography showed only a slight left ventricular hypertrophy. EEG, electronystagmography, and brainstem AEPs were normal, as was cerebral CT scan. SPECT imaging of cerebral blood flow (CBF) distribution by means of the diffusible technetium99m-labeled tracer hexa-methyl propylethanol amine oxime (HMPAO) was normal. Digitized angiography showed a large, mildly atheromatous left vertebral artery; the right vertebral artery was not clearly seen (Figure 1). Digitized angiography also incidentally revealed a small asymptomatic aneurysm of the anterior communicating artery, later confirmed by conventional carotid angiography.A dynamic cerebral and cerebellar perfusion study was performed on admission by the xenon-133-inhalation method and a dedicated single photon emission computed tomograph (Tomomatic 564 SPECT, Medimatic, Copenhagen, Denmark) described in detail elsewhere.

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Carbonic Anhydrase Inhibition and Cerebral Venous Blood Gases and Ions in Man

Cited by 54 publications

References 18 publications

The Effect of Acetazolamide on Cerebral Blood Flow and Oxygen Utilization in the Rhesus Monkey

The Effect of Acetazolamide on Cerebral Blood Flow and Oxygen Utilization in the Rhesus Monkey

Long-Term Prognosis of Medically Treated Patients With Internal Carotid or Middle Cerebral Artery Occlusion

Vertebrobasilar insufficiency revealed by xenon-133 inhalation SPECT.

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