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Neurosurgical Re-Engineering of the Damaged Brain and Spinal Cord pp 63–69Cite as

Acetazolamide vasoreactivity in persistent vegetative state and vascular dementia evaluated by transcranial harmonic perfusion imaging and Doppler sonography

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Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 87))

Summary

To clarify the pathophysiological differences of the cerebrovascular reserve capacity in relation to cerebral cognitive impairments between persistent vegetative state (PVS) and vascular dementia (VD), we evaluated acetazolamide (ACZ) vasoreactivity testing by transcranial harmonic perfusion imaging (HPI) and Doppler sonography (TCD).

Methods. The subjects were 11 adult patients with severe cognitive impairments (4 PVS, 7 VD). TCD mean velocity (Vm) in the middle and posterior cerebral artery (MCA, PCA) and peak intensity (PI), area under curve (AUC), and mean transit time (MTT) analyzed by HPI time-intensity curves in the bilateral temporal lobe (TL), basal ganglia (BG), and thalamus (Th) were evaluated before and after ACZ administration. Resting values and relative changes (%Δ) of TCD and HPI parameters were compared between PVS and VD.

Results a) resting values: There were no significant differences between the two groups, b) Vasoreactivity: 1) PVS: %Δ Vm. decreased in the left PCA and MCA. %Δ PI/AUC/MTT decreased in the left TL and bilateral BG. 2) VD: %Δ PI/AUC decreased in the right TL. %Δ MTT tended to decrease in the right side.

Conclusion. ACZ vasoreactivity tests by transcranial HPI and TCD allowed bedside, non-invasive, quantitative evaluation of the pathophysiology of cognitive function impairment and treatments, in relation to cerebrovascular reserve capacity in PVS and VD.

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Authors and Affiliations

  1. Department of Clinical Neurosciences, Kyoto Takeda Hospital, Kyoto, Japan

    Toshiyuki Shiogai M.D., Ph.D., M. Koshimura & C. Uebo

  2. Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    M. Makino, T. Mizuno & K. Nakajima

Authors
  1. Toshiyuki Shiogai M.D., Ph.D.
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  2. M. Koshimura
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  3. C. Uebo
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  4. M. Makino
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  5. T. Mizuno
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  6. K. Nakajima
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Corresponding author

Correspondence to Toshiyuki Shiogai M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Neurological Surgery, Nihon University, School of Medicine, Tokyo, Japan

    Y. Katayama

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© 2003 Springer-Verlag Wien

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Shiogai, T., Koshimura, M., Uebo, C., Makino, M., Mizuno, T., Nakajima, K. (2003). Acetazolamide vasoreactivity in persistent vegetative state and vascular dementia evaluated by transcranial harmonic perfusion imaging and Doppler sonography. In: Katayama, Y. (eds) Neurosurgical Re-Engineering of the Damaged Brain and Spinal Cord. Acta Neurochirurgica Supplements, vol 87. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6081-7_14

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  • DOI: https://doi.org/10.1007/978-3-7091-6081-7_14

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7223-0

  • Online ISBN: 978-3-7091-6081-7

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