In 50 patients with internal carotid artery occlusion and 40 patients with internal carotid artery stenosis hemispheric and regional cerebral blood flow (rCBF) was measured by the 133Xenon clearance method, rCBF was evaluated according to the presence of ischemic or hyperemic foci and to the level of regional perfusion alteration. The degree of collateral circula tion and diameter of stenosis were determined from the angiograms. The clinical symptoms were expressed in a score of motor deficiencies. In internal carotid artery occlusion no correla tion of motor deficiency index with angiographically demonstrable collateral circulation was detectable, but there was good correlation with hemispheric CBF and an excellent correlation (P < 0.001) with the rCBF parameters. In internal carotid artery stenosis no correlation existed between motor deficiency and the degree of stenosis or hemispheric CBF, but good correlation was observed between motor deficiency and the rCBF parameters (P < 0.01). 

According to these findings, angiographical demonstration of collateral circulation and of stenosis does not provide as accurate information on impending or already developed tissue in farction as does rCBF measurement. Presence of hyperemic foci and lack of ischemic foci were related to lesser motor disturbances. Borderlines of 30 ml/100 gm per minute for threatening tissue ischemia and of 25 ml/100 gm per minute for present tissue ischemia are established. Some points favor the thromboembolic theory of infarction in internal carotid artery stenosis.

The Value of Regional Cerebral Blood Flow Measurements Compared to Angiography in the Assessment of Obstructive Neck Vessel Disease

Nine cases of Moya Moya disease collected since 1968 are presented. The absence of inflammatory signs and the high percentage of congenital malformations is emphasized. However, despite the post-mortem findings in one of the cases, no etiologic factor has been conclusively demonstrated.

Etiology of moya moya disease acquired or congenital.

Spontaneous Occlusions of Carotid and Middle Cerebral Arteries. pp 362–374

* Read at the 21st Annual Meeting of the American College of Angiology. San Juan (Puerto Rico) February 23-March 2, 1975. ‡ Service of Neurosurgery of the Ciudad Sanitaria Francisco Franco of the Social Security, Barcelona, Spain. Director: Prof. A. Ley. ‡‡ Service of Neuroradiology of the Ciudad Sanitaria Francisco Franco of the Social Security, Barcelona. Spain. It is a well known fact that the pattern and morphology of the cerebral vascular tree undergoes a number of changes in the course of life, as can be

Obliterating Vascular Lesions in the Cerebral Aging Process

* From the Neuroradiological Department, Neurosurgical Clinic (Dr. A. Ley), University of Barcelona School of Medicine, Barcelona, Spain. The variations in the degrees of gravity and the clinical course that are observed in patients with obstructive lesions of the carotid arteries or any of their intracranial branches are evidence for the wide range of efficiency of the mechanisms that compensate for such obstruction. The study presented here was undertaken in order to learn whether correlations exist between the type and place of such vascular obstructions on the one hand and the clinical and angiographic data on the other.

M Rovira

Papers

Clinical and angiographic correlations in collateral brain circulation.