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Department of Neurology, William S. Middleton Memorial Veterans Administration Hospital and the University of Wisconsin Hospital and Clinics, Madison, WI (Drs. Levine, Lagreze, and Dobkin, and Ms. Hanson)
Department of Radiology, William S. Middleton Memorial Veterans Administration Hospital and the University of Wisconsin Hospital and Clinics, Madison, WI (Drs. Levine and Nickles)
Department of Medical Physics, William S. Middleton Memorial Veterans Administration Hospital and the University of Wisconsin Hospital and Clinics, Madison, WI(Dr. Nickles and Mr. Satter)
Department of Nuclear Medicine, William S. Middleton Memorial Veterans Administration Hospital and the University of Wisconsin Hospital and Clinics, Madison, WI. (Mr. Rowe)
We report the vasocapacitance of the cerebral circulation, as determined by cerebral blood flow reactivity to induced hypercapnia using fluoromethane positron emission tomography, in 32 patients with unilateral anterior circulation transient ischemic attacks. A hemodynamic subset of eight patients, defined based on exertional, positional, orthostatic, or cardiac dysrhythmic induction of symptomatology, is characterized by multiple (median, 4.5 attacks per patient), brief (median, 2.5 minutes per attack), continued episodes of hemispheric ischemia including focal limb shaking. Symptomatic middle cerebral artery flow territories show significantly lower (p < 0.04) and more asymmetric (p = 0.036) vasodilatory responses in the hemodynamic subset. Although ipsilateral internal carotid artery occlusion is more prevalent in the hemodynamic subset, the features of age, mean arterial blood pressure, carbon dioxide values, serum glucose, serum hematocrit, and number or type of risk factors do not differ significantly between groups. These studies of vasocapacitance help validate clinical criteria for cerebral hemodynamic events with an objective physiologic measurement.
Address correspondence and reprint requests to Dr. Levine, Neurology and Stroke Service/127, Middleton VA Hospital, 2500 Overlook Terrace, Madison, WI 53705.
Supported by Veterans Administration Research Grant 821-103.
Presented in part at the fortieth annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.
Received June 17, 1988. Accepted for publication in final form July 26, 1988.
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