Author + information
- Horinek Daniel1,
- Malucelli Alberto2,
- Skoch Antonin3,
- Tomek Ales4,
- Buksakowska Irena5 and
- Benes Vladimir5
- 1Department of Neurosurgery, University Hospital Motol Prague, Czech Republic
- 2Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, Czech Republic
- 3Department of Experimental Radiology, Prague, Czech Republic
- 4Department of Neurology, University Hospital Motol, Prague, Czech Republic
- 5Department of Radiology, University Hospital Motol, Prague, Czech Republic
To evaluate cerebral hemodynamic, metabolic and anatomic changes occurring in patients with unilateral occlusion of internal carotid artery.
Twenty two patients with unilateral occlusion of ICA and twenty eight age and sex matched healthy subjects were included in the study. In both groups we performed proton magnetic resonance spectroscopy ( 1 H-MRS), semi-automated hippocampal volumetry in T1-weighted scans and transcranial Doppler examination (TCD) with calculation of Breath Holding Index (BHI). Metabolic, anatomic, and hemodynamic features were compared between the two groups.
The N-acetylaspartate(NAA)/choline(Cho) ratio was significantly lower in both hemispheres of enrolled patients compared with controls, while no statistically significant correlations were found for lactate (Lac), creatine (Cr) and Cho alone. The volume of hippocampus was significantly reduced on both sides in patients in comparison with healthy subjects. No statistically significant differences in NAA concentration and hippocampal volume were found between the two hemispheres of examined patients, thus suggesting a bilateral impairment.
Patients with unilateral ICA occlusion have reduced NAA/Cho ratio in the white matter of both hemispheres and have bilateral atrophy of hippocampus. The alteration of hemodynamics alone cannot explain these changes. Lac is not a reliable marker of metabolic impairment in the chronic stage of ICA occlusion. The work has been supported by AZV 16-30965A grant.