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      The Acetazolamide Challenge: Techniques and Applications in the Evaluation of Chronic Cerebral Ischemia

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          Abstract

          SUMMARY: The acetazolamide (ACZ) challenge test is a useful clinical tool and a reliable predictor of critically reduced perfusion. In patients with chronic steno-occlusive disease, the ability to maintain normal cerebral blood flow by reducing vascular resistance secondary to autoregulatory vasodilation is compromised. Identification of the presence and degree of autoregulatory vasodilation (reflecting the cerebrovascular reserve) is a significant prognostic factor in patients with chronic cerebrovascular disease. The pharmacologic challenge of a vasodilatory stimulus such as ACZ can also be used to optimize the treatment strategies for these patients. The pathophysiology, methods, and clinical applications of the ACZ challenge test are discussed in this article.

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          Author and article information

          Journal
          AJNR Am J Neuroradiol
          AJNR Am J Neuroradiol
          ajnr
          AJNR: American Journal of Neuroradiology
          American Society of Neuroradiology
          0195-6108
          1936-959X
          May 2009
          : 30
          : 5
          : 876-884
          Affiliations
          [a ]Departments of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
          [b ]Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
          [c ]Department of Radiology, Cincinnati Children's Hospital Medical Center
          [d ]The Neuroscience Institute, Cincinnati, Ohio
          Author notes
          Please address correspondence to Achala S. Vagal, MD, Department of Radiology, Section of Neuroradiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH 45267-0762; e-mail: vagala@ 123456healthall.com
          Article
          PMC7051638 PMC7051638 7051638 09-00007
          10.3174/ajnr.A1538
          7051638
          19246526
          3220eeab-0e11-4099-aab9-6f4050e71e8d
          Copyright © American Society of Neuroradiology
          History
          : 5 January 2009
          : 4 January 2009
          Categories
          Review Articles
          Custom metadata
          876
          May 2009
          Review Article

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