The clinical role of PET in cerebrovascular disease
| العنوان: | The clinical role of PET in cerebrovascular disease |
|---|---|
| المؤلفون: | David J. Brooks |
| المصدر: | Neurosurgical Review. 14:91-96 |
| بيانات النشر: | Springer Science and Business Media LLC, 1991. |
| سنة النشر: | 1991 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, Ischemia, Hemodynamics, Infarction, Blood volume, Cerebral Infarction, General Medicine, Blood flow, medicine.disease, Cerebral autoregulation, Brain Ischemia, Cerebrovascular Disorders, Cerebral blood flow, Internal medicine, medicine, Cardiology, Humans, Surgery, Neurology (clinical), Cerebral perfusion pressure, Nuclear medicine, business, Tomography, Emission-Computed |
| الوصف: | In normal subjects cerebral oxygen metabolism and blood flow are closely coupled, both grey and white matter extracting about 40% of their arterial oxygen supply. During acute ischaemia blood flow falls and oxygen extraction rises to 100% so that cerebral metabolism becomes totally blood flow dependent. Once acute infarction has occurred both cerebral oxygen metabolism and arterial oxygen extraction fall to low levels, while blood flow often paradoxically rises — the state of luxury perfusion. Once luxury perfusion becomes established the use of pharmacological or surgical methods to increase cerebral blood flow is inappropriate. PET will measure regional cerebral metabolism and blood flow non-invasively in man. Using PET ischaemic tissue can be distinguished from infarcted tissue, and the presence of luxury perfusion can be confirmed. In this way strokes in evolution can be detected, and the use of revascularisation procedures rationalised. Not only are regional cerebral metabolism and blood flow closely coupled, but blood volume is also coupled to blood flow. When >60% stenosis of extracranial arteries occurs, reactive vasodilatation of the distal circulation with an increase in rCBV results in order to reduce vascular resistance. By monitoring rCBV with PET, haemodynamically compromised regions of brain can be detected. It has been shown that patients with local areas of raised rCBV due to carotid artery stenosis are at a higher risk of infarction. PET will identify such patients and follow the haemodynamic effects of endarterectomy or EC-IC bypass. Finally PET can look at the distant functional effects of lacunar infarction. In this way more information about the functional anatomy of the brain can be obtained, and mechanisms of functional recovery from stroke can be monitored. |
| تدمد: | 1437-2320 0344-5607 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::208d327171aacc9677f28b51cd68456fTest https://doi.org/10.1007/bf00313030Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....208d327171aacc9677f28b51cd68456f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14372320 03445607 |
|---|