scholarly journals Effect of Age and Vascular Anatomy on Blood Flow in Major Cerebral Vessels

2014 ◽  
Vol 35 (2) ◽  
pp. 312-318 ◽  
Author(s):  
Sepideh Amin-Hanjani ◽  
Xinjian Du ◽  
Dilip K Pandey ◽  
Keith R Thulborn ◽  
Fady T Charbel
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Vascular Anatomy ◽  
Cerebral Vessels ◽  
Cerebral Vessel ◽  
Flow Rates ◽  
Adult Volunteers

Measurement of volume flow rates in major cerebral vessels can be used to evaluate the hemodynamic effects of cerebrovascular disease. However, both age and vascular anatomy can affect flow rates independent of disease. We prospectively evaluated 325 healthy adult volunteers using phase contrast quantitative magnetic resonance angiography to characterize these effects on cerebral vessel flow rates and establish clinically useful normative reference values. Flows were measured in the major intracranial and extracranial vessels. The cohort ranged from 18 to 84 years old, with 157 (48%) females. All individual vessel flows and total cerebral blood flow (TCBF) declined with age, at 2.6 mL/minute per year for TCBF. Basilar artery (BA) flow was significantly decreased in individuals with one or both fetal posterior cerebral arteries (PCAs). Internal carotid artery flows were significantly higher with a fetal PCA and decreased with a hypoplastic anterior cerebral artery. Indexing vessel flows to TCBF neutralized the age effect, but anatomic variations continued to impact indexed flow in the BA and internal carotid artery. Variability in normative flow ranges were reduced in distal vessels and by examining regional flows. Cerebral vessel flows are affected by age and cerebrovascular anatomy, which has important implications for interpretation of flows in the disease state.

Measuring Cerebral Blood Flow in Moyamoya Angiopathy by Quantitative Magnetic Resonance Angiography Noninvasive Optimal Vessel Analysis

Neurosurgery ◽  
2017 ◽  
Vol 81 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Nadia Khan ◽  
Robert M Lober ◽  
Lauren Ostergren ◽  
Jacob Petralia ◽  
Teresa Bell-Stephens ◽  
...  
Keyword(s):  
Blood Flow ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Posterior Circulation ◽  
Flow Rates ◽  
Revascularization Surgery ◽  
Artery Flow

Abstract BACKGROUND Moyamoya disease causes progressive occlusion of the supraclinoidal internal carotid artery, and middle, anterior, and less frequently the posterior cerebral arteries, carrying the risk of stroke. Blood flow is often partially reconstituted by compensatory moyamoya collaterals and sometimes the posterior circulation. Cerebral revascularization can further augment blood flow. These changes to blood flow within the cerebral vessels, however, are not well characterized. OBJECTIVE To evaluate blood flow changes resulting from the disease process and revascularization surgery using quantitative magnetic resonance angiography with noninvasive optimal vessel analysis (NOVA). METHODS We retrospectively analyzed 190 preoperative and postoperative imaging scans in 66 moyamoya patients after revascularization surgery. Images were analyzed for blood flow using NOVA and compared with preoperative angiographic staging and postoperative blood flow. Blood flow rates within superficial temporal artery grafts were compared based on angiographic evidence of patency. RESULTS Diseased vessels had lower blood flow, correlating with angiographic staging. Flow in posterior cererbal and basilar arteries increased with disease severity, particularly when both the anterior and middle cerebral arteries were occluded. Basilar artery flow and ipsilateral internal carotid artery flow decreased after surgery. Flow rates were different between angiographically robust and poor direct bypass grafts, as well as between robust and patent grafts. CONCLUSION Preoperative changes in cerebral vessel flow as measured by NOVA correlated with angiographic disease progression. NOVA demonstrated that preoperative augmentation of the posterior circulation decreased after surgery. This report is the first to quantify the shift in collateral supply from the posterior circulation to the bypass graft.

Impact of transient hypotension on regional cerebral blood flow in humans

2015 ◽  
Vol 129 (2) ◽  
pp. 169-178 ◽  
Author(s):  
Nia C.S. Lewis ◽  
Kurt J. Smith ◽  
Anthony R. Bain ◽  
Kevin W. Wildfong ◽  
Tianne Numan ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
Regional Cerebral Blood Flow ◽  
Internal Carotid ◽  
Regional Cerebral Blood

Diameter reductions in the internal carotid artery (ICA) and vertebral artery (VA) contribute to the decline in brain blood with hypotension. The decline in vertebral blood flow with hypotension was greater when carbon dioxide was low; this was not apparent in the ICA.

Clinical Utility of Quantitative Cerebral Blood Flow Measurements during Internal Carotid Artery Test Occlusions

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 996-1005 ◽  
Author(s):  
Randolph S. Marshall ◽  
Ronald M. Lazar ◽  
William L. Young ◽  
Robert A. Solomon ◽  
Shailendra Joshi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Clinical Utility ◽  
Internal Carotid ◽  
Flow Measurements ◽  
Blood Flow Measurements

Retinal macroaneurysm after carotid endarterectomy in patient with chronic ischemic retinopathy associated with hemodynamically significant stenosis of the internal carotid artery (clinical case)

2021 ◽  
pp. 274-277
Author(s):  
V.V. Tuzlaev ◽  
◽  
O.V. Kolenko ◽  
V.V. Egorov ◽  
I.Z. Kravchenko ◽  
...  
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Clinical Case ◽  
Internal Carotid ◽  
Significant Stenosis ◽  
Ischemic Retinopathy ◽  
Retinal Macroaneurysm ◽  
Intraretinal Hemorrhages

Purpose. To present a clinical case of development of retinal macroaneurysm after carotid endarterectomy (CE) in patient with chronic ischemic retinopathy (CIR) associated with hemodynamically significant stenosis of the internal carotid artery (ICA). Material and methods. Patient R., 74 years old, diagnosed with CIR of the 1st degree of severity of the right eye. In addition to standard ophthalmic examination methods, Doppler ultrasound with registration of blood flow in the orbital artery and spiral computed tomography of the ICA were performed. Results. Panretinal photocoagulation (PRP) of the retina led to obliteration of the retinal macroaneurysm, resorption of intraretinal hemorrhages, and stabilization of the course of CIR after CE of the ICA. Conclusion. The appearance of retinal macroaneurysm and intraretinal hemorrhages after CE in patient with CIR associated with hemodynamically significant ICA stenosis can be regarded as reperfusion complications after restoration of blood flow in the orbital artery, which requires timely retinal PRP of the retina. Key words: chronic ischemic retinopathy, retinal macroaneurysm, internal carotid artery, carotid endarterectomy.

Dynamic Computed Tomography Angiography in Suspected Brain Death: A Noninvasive Biomarker

2014 ◽  
Vol 65 (4) ◽  
pp. 352-359 ◽  
Author(s):  
Santanu Chakraborty ◽  
Reem A. Adas
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Brain Death ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Ancillary Test ◽  
Organ Harvesting

Purpose Neurologic determination of death or brain death is primarily a clinical diagnosis. This must respect all guarantees required by law and should be determined early to avoid unnecessary treatment and allow organ harvesting for transplantation. Ancillary testing is used in situations in which clinical assessment is impossible or confounded by other factors. Our purpose is to determine the utility of dynamic computed tomographic angiography (dCTA) as an ancillary test for diagnosis of brain death. Materials and Methods We retrospectively reviewed 13 consecutive patients with suspected brain death in the intensive care unit who had dCTA. Contrast appearance timings recorded from the dCTA data were compared to findings from 15 controls selected from patients who presented with symptoms of acute stroke but showed no stroke in follow-up imaging. Results The dCTA allows us to reliably assess cerebral blood flow and to record time of individual cerebral vessels opacification. It also helps us to assess the intracranial flow qualitatively against the flow in extracranial vessels as a reference. We compared the time difference between enhancement of the external and internal carotid arteries and branches. In all patients who were brain dead, internal carotid artery enhancement was delayed, which occurred after external carotid artery branches were opacified. Conclusion In patients with suspected brain death, dCTA reliably demonstrated the lack of cerebral blood flow, with extracranial circulation as an internal reference. Our initial results suggest that inversion of time of contrast appearance between internal carotid artery and external carotid artery branches at the skull base could predict a lack of distal intracranial flow.

scholarly journals Internal carotid artery blood flow response to cognitive task is similar between young and older adults

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Ryota Asahara ◽  
Kei Ishii ◽  
Tsubasa Izaki ◽  
Sunao Iwaki ◽  
Hidehiko Komine
Keyword(s):  
Older Adults ◽  
Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cognitive Task ◽  
Artery Blood Flow ◽  
Blood Flow Response ◽  
Flow Response

scholarly journals The combined use of proximal and distal protection devices uring carotid stenting: A case report

2019 ◽  
Vol 23 (2) ◽  
pp. 73
Author(s):  
D. U. Malaev ◽  
D. A. Redkin ◽  
V. I. Baystrukov ◽  
A. A. Prokhorikhin ◽  
A. A. Boykov ◽  
...  
Keyword(s):  
Blood Flow ◽  
Informed Consent ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Conflict Of Interest ◽  
Internal Carotid ◽  
Carotid Stenting ◽  
Protection System ◽  
Combined Use ◽  
Proximal Protection

<p>Despite the development of modern medical technologies, cerebrovascular disease remains a major health and social issue. Among all the cases of ischemic stroke, approximately 20% are attributable to stenotic lesions in the carotid artery. The main drawback of carotid stenting is the risk of embolic complications during the procedure. To resolve this problem, various devices that protect against embolism have been developed. In this clinical case, we describe the ability to minimize the risk of operative stroke through a combined application of the distal and proximal protection systems in carotid stenting.</p><p>In our patient, a 65-year-old woman, angiography of the carotid arteries revealed an ulcerated atherosclerotic plaque of the right internal carotid artery, with stenosis of the lumen of up to 95%. Considering the high risk of distal embolism, the Mo MaUltra (Italy) proximal protection system was used. When evaluating the installation of the Mo MaUltra system, the preserved blood flow through the superior thyroid artery and, therefore, the antegrade blood flow in the internal carotid artery was revealed. Considering the identified risk and the anatomy of the plaque surface, we decided on the additional use of the distal SpiderFX (USA) protection device.</p><p>The combined use of proximal protection system and distal protective device for carotid stenting is technically possible and may reduce the risk of embolic complications.</p><p>Received 23 January 2019. Revised 18 March 2019. Published 23 April 2019.</p><p><strong>Informed consent:</strong> The patient’s informed consent to use the records for medical purposes is obtained.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

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