Simultaneous bilateral cerebral blood flow and metabolism with arteriographic correlation in unilateral brain infarction or haemorrhage

Abstract

Cerebral blood flow and O2 consumption measurements were made on 12 subjects with predominantly unilateral cerebral vascular disease. Arteriography was performed for visualization of the entire extra[long dash]and intracranial cerebral circulation. In patients with cerebral infarction, cerebral blood flow and O2 consumption were greatly reduced on the side of the lesion in cases where arterial occlusion was complete and collateral circulation inadequate. Where circulation is adequate to prevent infarction, cerebral O2 consumption is maintained despite ar-terial stenosis, which greatly reduces homolateral blood flow. In cases of cerebral infarction without occlustve arterial disease, cerebral blood flow was not greatly reduced on the side of the lesion. The degree of reduction in cerebral O2 consumption was related to the size of the infarction. In 2 patients with intracerebral hematomas cerebral blood flow and O2 consumption were reduced from normal but the reduction was not greater on the side of the hematoma. Since unilateral brain disease may be reflected predominantly in homolateral jugular venous blood, cerebral blood flow measurements must be bilateral so as to ob-tain a reflection of mean values from the whole brain. Although severe occlusive cerebral vascular disease causes a marked reduction in cerebral blood flow and metabolism, this is not incompatible with sur-vival and considerable improvement.