2004 年 17 巻 1 号 p. 14-17
We attempted to evaluate the function of ophthalmic artery (OA) flow as the collateral pathway in cases of internal carotid artery occlusion (ICAO). Methods. We examined 18 patients having symptomatic ICAO who underwent OA color Doppler flow imaging (CDFI) and quantitative SPECT regional cerebral blood flow (rCBF)study. Results. (1) The OA CDFI findings were reversed OA flow in 10 patients and antegrade flow in 8. (2) The mean resting rCBF was 25.2ml/100 g/min in the patients with reversed OA flow, and 26.7 ml/100 g/min in the patients with antegrade OA flow. The mean cerebral blood flow reserve capacity with acetazolamide was 8.68% in the former and 28.3% in the latter. This difference was statistically significant (p<0.05). (3) In eight patients with severe hemodynamic compromise with a cerebral blood flow reserve capacity of less than 10% and a resting rCBF of less than 80%, the reversed OA flow was visualized significantly frequently (p<0.05). Conclusion. In ICAO patients, OA CDFI findings are well correlated with the hemodynamic stage and development of other collateral pathways. Reversed OA flow indicates severe intracranial hemodynamic compromise.