Does internal carotid blood flow correlate with cerebral blood flow in neurologically normal elderly patients with severe white matter lesions?
In neurologically normal elderly patients with severe white matter lesions, cerebral blood flow correlates with carotid blood flow independently of internal carotid artery stenosis, suggesting proportional atherosclerotic changes in cerebrovascular and carotid resistance.
Previous studies of white matter signal hyperintensity (WMSH) on T2-weighted MRI (magnetic resonance imaging) have shown it to be related to decreased cerebral blood flow (CBF). However, there have been few studies on the relationship of WMSH and the internal carotid blood flow (CaBF). Doppler ultrasound sonography is widely used for evaluation of CaBF. We analyzed the relationship between CBF, CaBF, and WMSH. The subjects had not suffered cerebral ischemic episodes although they had some risk factors for stroke. They received MRI and were classified into three groups, i.e. mild, moderate, and severe WMSH. The % stenosis of the internal carotid artery (ICA) was measured with angiography. Doppler sonography was used to measure the mean bilateral CaBF. The oxygen-15 steady-state technique and PET (positron emission tomography) were used to measure CBF. There were significant correlations between the % stenosis of ICA and the ipsilateral CaBF and between the % stenosis of ICA and hemispheric CBF. There was a significant relationship between CBF and CaBF in the severe WMSH group, remaining significant after partialling out of the effects of the % stenosis. This indicated that an atherosclerotic change of the cerebral artery occurred in a way that carotid vascular resistence and cerebrovascular resistence were 'proportional'. Copyright Rapid Science Ltd
Meguro et al. (Sun,) studied this question.