Cerebrovascular Reactivity Within Perfusion-Territories in Patients with an ICA Occlusion

Reinoud Pieter Harmen Bokkers¹, Matthias J. van Osch², C. J. Klijn³, L Jaap Kappelle³, Willem P. Mali¹, Jeroen Hendrikse¹

Patients with a symptomatic occlusion of the internal carotid artery (ICA) and hemodynamic compromise of the brain may benefit from bypass surgery. Our objective was to investigate cerebrovascular reactivity in the perfusion-territories of the cerebral arteries at brain tissue level in patients with an ICA occlusion using arterial spin labeling MRI, and determine whether cerebrovascular reactivity varies within the perfusion-territory of the remaining ICA. Our results show that ASL-MRI can visualize brain tissue with impaired cerebrovascular reactivity. The brain tissue on the side of the occlusion, supplied through collaterals originating from the unaffected ICA, was the most impaired.