Abstract #1003

Flow territory instability may provide a new measure of hemodynamic reserve capacity in patients with intracranial stenosis

Daniel Arteaga¹, Megan Strother¹, Taylor Davis¹, Carlos Faraco¹, Lori Jordan², Allison Scott¹, and Manus Donahue¹

¹Radiology, Vanderbilt University, Nashville, TN, United States, ²Neurology, Vanderbilt University, Nashville, TN, United States

Non-invasive, hemodynamic markers are needed to better characterize stroke risk in patients with symptomatic intracranial (IC) stenosis. We developed and applied a planning-free vessel-encoded pseudo-continuous arterial spin labeling sequence in IC stenosis patients during room air and hypercapnia to examine the extent of geometrical changes in cerebral blood flow territories. IC stenosis patients demonstrated increased shifting relative to healthy controls; among IC stenosis patients, shifting was higher in those who experienced non-cardioembolic stroke within two-years. Shifting of cerebral blood flow territories may provide a novel marker of hemodynamic impairment and stroke risk.

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