1995 Volume 4 Issue 2 Pages 145-150
The hemodynamic reserve has been assessed in 14 patients with moyamoya disease by means of a 1-hexamethyl-propyleneamine oxide (HM-PAO) single photon emission computed tomography (SPECT) and an acetazolamide challenge prior to undergoing revascularization Surgery. Following acetazolamide loading, focal decreases in the regional cerebral blood flow (r-CBF) were noted in 5 of 9 tested children under 16 years of age (reverse steal phenomenon). As for the other 4 tested children, the reverse steal phenomenon did not occur, although their vasodilatory response was disturbed. Manifestation of the reverse steal phenomenon suggests that there may be risks associated with hypercapnic management during general anesthesia.
