Abstract #4148
The vascular steal phenomenon is an incomplete contributor to negative cerebrovascular reactivity in patients with symptomatic intracranial stenosis
Daniel F. Arteaga 1 , Megan K. Strother 1 , Carlos C. Faraco 1 , Lori C. Jordan 2 , Travis R. Ladner 1 , Lindsey M. Dethrage 1 , Robert J. Singer 3 , J Mocco 4 , Paul F. Clemmons 5 , Michael J. Ayad 6 , and Manus J. Donahue 1,2
1
Department of Radiology, Vanderbilt
University, Nashville, Tennessee, United States,
2
Department
of Neurology, Vanderbilt University, Nashville,
Tennessee, United States,
3
Section
of Neurosurgery, Dartmouth Hitchcock Medical Center,
Lebanon, New Hampshire, United States,
4
Department
of Neurosurgery, Vanderbilt University, Nashville,
Tennessee, United States,
5
Department
of Radiology Nursing, Vanderbilt University, Nashville,
Tennessee, United States,
6
Department
of Neurosurgery, New York Methodist Hospital, Brooklyn,
New York, United States
Vascular steal has been proposed as a compensatory
mechanism in hemodynamically-compromised ischemic
parenchyma. Here, independent measures of changes in CBF
and BOLD MRI contrast in response to a vascular stimulus
in patients (n=40) with ischemic cerebrovascular disease
are recorded. 15/40 participants exhibited negative BOLD
reactivity. Of these, three participants exhibited
significant (P<0.01) reductions in CBF with hypercarbia;
eight exhibited increases (P<0.01) in CBF and the
remaining four participants exhibited no statistical
change in CBF. These findings suggest that the origins
of negative BOLD responses in stroke patients are most
frequently not due to vascular steal.
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