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Abstract #1473

Narcosis depresses the BOLD-CVR response to acetazolamide in pediatric moyamoya vasculopathy

Pieter T Deckers1, Jeroen CW Siero2,3, Annick Kronenburg1, Kees PJ Braun4, Bart van der Zwan1, and Alex A Bhogal2
1Neurosurgery, UMC Utrecht, Utrecht, Netherlands, 2Imaging, UMC Utrecht, Utrecht, Netherlands, 3Spinoza Centre for Neuroimaging, Amsterdam, Netherlands, 4Pediatric Neurology, UMC Utrecht, Utrecht, Netherlands


Measuring cerebrovascular reactivity (CVR) under narcosis is underreported, while narcosis is often necessary for pediatric or cognitively impaired patients. When acetazolamide is used in awake patients, maximum CBF increase reaches a plateau after ~12min. Using ASL- and BOLD-MRI with acetazolamide we showed that for pediatric moyamoya patients the response is different. Patients under narcosis show lower CVR and reach peak CBF earlier (after around six minutes), after which CBF decreases again without the plateau-phase. This shows the response to acetazolamide is distinctively different between awake and narcosis patients and caution is warranted during interpretation of narcosis CVR images.

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