Abstract
Transcranial Doppler measurement (TCD) of cerebrovascular reserve (CVR) is usually performed by the CO2 test, the acetazolamide test, or the breath-holding test. Since these tests are time-consuming and labor-intensive, alternative methods such as the hand-gripping test are of interest. Twenty-one normal persons and 25 patients with unilateral carotid artery disease were studied. Flow velocity changes in both middle cerebral arteries (MCAs) during bilateral hand gripping were measured by TCD and compared with acetazolamide test results. The increase in MCA mean flow velocity (FVmean) during hand gripping was 18.0 +/- 6.3% in normal persons; the increases in the post-stenotic MCA were 15.8 +/- 9.7% in all patients and 9.4 +/- 5.4% in patients with impaired CVR as determined by the acetazolamide test. Only in the group with impaired acetazolamide reactivity was the increase in the poststenotic MCA significantly lower compared to that in controls (p < 0.01) and to the contralateral, nonstenotic side (p < 0.01). Nevertheless the FVmean increases in both tests showed a weak, but significant correlation (r = 0.59, p < 0.01). All FVmean increases during hand gripping were significantly (p < 0.01) lower than those during the acetazolam...Continue Reading
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