Hemodynamic stroke
คำสำคัญ:
hemodynamic, stroke, watershed infarction, cerebral hypoperfusion, systemic failureบทคัดย่อ
Hemodynamic stroke คือภาวะสมองขาดเลือดที่เกิดจากภาวะ hypoperfusion ซึ่งอาจเกิดได้จากสาเหตุทางระบบอื่นๆของร่างกายหรือความผิดปกติของหลอดเลือดสมองเองเช่นการมีหลอดเลือด ICA หรือ CCA หรือ VA ตีบรุนแรงจนมีให้แรงดันเลือดที่ไปเลี้ยงสมองลดลง อาการและอาการแสดงส่วนใหญ่ของ hemodynamic stroke ไม่แตกต่างจากสาเหตุอื่น แต่อาจมีลักษณะบางอย่างที่พบได้บ่อยกว่าเช่น limb shaking, fluctuation ของอาการ เป็นต้น การวินิจฉัยส่วนใหญ่ใช้เครื่องมือทางรังสีเพื่อดูตำแหน่งที่เกิดภาวะสมองขาดเลือด ดูลักษณะหลอดเลือด และวัดปริมาณ cerebral perfusion ซึ่งประกอบด้วยหลายวิธี เช่น CT/ MRI brain, CT angiogram, MR angioram, digital subtraction angiogram และ perfusion scan หลักการรักษาคือการแก้ไขสาเหตุของการเกิด hemodynamic failure และแก้ไขหลอดเลือดที่มีพยาธิสภาพที่อาจเป็นสาเหตุของการลดลงของ cerebral pressure หรือทำให้ collateral ที่สำคัญน้อยลง อย่างไรก็ตามยังต้องการข้อมูลทางการศึกษาที่มากขึ้น
เอกสารอ้างอิง
Adams JH, Brierley JB, Connor RCR,et al. The effects of systemic hypotension upon the human brain: clinical and neuropathological observations in 11
cases. Brain 1966;89:235-268.
Brierley JB, Prior PF, Calverley J,et al. The pathogenesis of ischaemic neuronal damage along the cerebral arterial boundary zones in Papio anubis. Brain
1980;103:929-965.
Baron JC, Bousser MG, Comar D,et al.Noninvasive tomographic study of cerebral blood flow and oxygenmetabolism in vivo. Potentials, limitations, and
clinical applicationsin cerebral ischemic disorders. Eur Neurol 1981; 20: 273-284.
Moustafa RR., Izquierdo-Garcia D, Jones PS,et al. Watershed Infarcts in Transient Ischemic Attack/Minor Stroke With 50% CarotidStenosis: Hemodynamic
or Embolic? Stroke. 2010;41:1410-1416.
Castaigne P, Lhermitte F, Gautier JC, et al.Internal carotid artery occlusion: a study of 61 instances in50 patients with post-mortem data. Brain 1970; 93: 231-
258.
Barnett HJM, Peerless SJ, Kaufmann JCE. “Stump” of internal carotid artery—a source for further cerebral embolic ischemia. Stroke 1978; 9: 448-456.
Georgiadis D, Grosset DG, Lees KR. Transhemispheric passage of microemboli in patients with unilateral internal carotid artery occlusion. Stroke 1993; 24:
1664-1666.
Grubb RL Jr, Derdeyn CP, Fritsch SM, et al. Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAMA 1998; 280: 1055-1060.
Yamauchi H, Fukuyama H, Nagahama Y, et al. Signifi cance of increased oxygen extraction fraction in fi ve-year prognosis of major cerebral arterial occlusive diseases. J Nucl Med 1999; 40: 1992-1998.
Hankey GJ, Gubbay SS. Focal cerebral ischaemia and infarction due to antihypertensive therapy. Med J Aust 1987; 146: 412-414.
Gottesman RF, Sherman PM, Grega MA, et al. Watershed strokes after cardiac surgery: diagnosis, etiology, and outcome. Stroke 2006;37: 2306-2311.
Shahar A, Sadeh M. Severe anemia associated with transient neurological deficits. Stroke 1991; 22: 1201-1202.
Kim JS, Kang SY. Bleeding and subsequent anemia: a precipitant for cerebral infarction. Eur Neurol 2000; 43: 201-208.
Bogousslavsky J, Regli F. Unilateral watershed cerebral infarcts. Neurology.1986;36:373-377.
Bladin CF, Chambers BR. Clinical features, pathogenesis, and computed tomographic characteristics of internal watershed infarction. Stroke.1993;24:1925-1932.
Brown MM, Wade JP, Bishop CC,et al. Reactivity of the cerebral circulation in patients with carotid occlusion. J Neurol NeurosurgPsychiatry. 1986;49:899–904.
Dobkin BH. Orthostatic hypotension as a risk factor for symptomatic occlusive cerebrovascular disease. Neurology 1989; 39: 30–34.
Ross RW, Page NGR. Critical perfusion of brain and retina. Brain 1983; 106: 419-434.
Niehaus L, Neuhauser H, Meyer BU. Transient visual blurring,retro-orbital pain and repetitive involuntary movements in unilateral carotid artery occlusion. Clin
Neurol Neurosurg 1998;100: 31–32.
Klijn CJM, Kappelle LJ, van Huff elen AC, et al. Recurrent ischemia in symptomatic carotid occlusion: prognostic value of hemodynamic factors. Neurology
2000; 56: 1806-1812.
Tatemichi TK, Desmond DW, Prohovnik I, et al. Dementia associated with bilateral carotid occlusions: neuropsychological and haemodynamic course after
extracranial to intracranial bypass surgery. J Neurol Neurosurg Psychiatry 1995; 58: 633-636.
Bakker FC, Klijn CJ, Jennekens-Schinkel A,et al. Cognitive impairment in patients with carotid artery occlusion and ipsilateral transient ischemic attacks. J
Neurol 2003; 250: 1340-1347.
Momjian MI, Baron JC. The pathophysiology of watershed infarction in internal carotid artery disease: review of cerebral perfusion studies. Stroke 2005; 36:
567-577.
Del Sette M, Eliasziw M, Streifl er JY, et al. Internal borderzone infarction: a marker for severe stenosis in patients with symptomatic internal carotid artery
disease. Stroke 2000; 31: 631-636.
Bladin CF, Chambers BR. Clinical features, pathogenesis, and computed tomographic characteristics of internal watershed infarction. Stroke 1993; 24: 1925-1932.
Mangla R, Kolar B, Almast J,et al.Border Zone Infarcts: Pathophysiologic and Imaging Characteristics. RadioGraphics 2011; 31:1201–1214
Nemoto EM, Yonas H, Kuwabara H, et al. Identification of hemodynamic compromise by cerebrovascular reserve and oxygen extraction fraction in occlusive
vascular disease J Cereb Blood Flow Metab 2004; 24: 1081-1089.
Smith LMcG, Elkins JS, Dillon WP,et al. Perfusion-CT assessment of the cerebrovascular reserve: a revisit tothe acetazolamide challenges. J Neuroradiol 2008; 35: 157-164.
Bokkers RP, Bremmer JP, van Berckel BN, et al. Arterial spin labeling perfusion MRI at multiple delay times: a correlative studywith H215O positron emission tomography in patients with symptomatic carotid artery occlusion.J Cereb Blood Flow Metab 2009; 30: 222-229.
Rutgers DR, Klijn CJM, Kappelle LJ,et al. Sustained bilateral hemodynamic benefi t of contralateral carotid endarterectomy in patients with symptomatic
internal carotid artery occlusion.Stroke 2001; 32: 727-734.
Yoshimoto T. Use of cerebrovascular reactivity in patients with symptomatic major cerebral artery occlusion to predict 5-year outcome: comparison of xenon-133 and iodine-123-IMP singlephoton emission computed tomography. J Cereb Blood Flow Metab 2002; 22: 1142-1148.
Smith LMcG, Elkins JS, Dillon WP, Schaeff er S,et al.Perfusion-CT assessment of the cerebrovascular reserve: a revisit tothe acetazolamide challenges. J Neuroradiol 2008; 35: 157-164.
Bokkers RP, Bremmer JP, van Berckel BN, et al. Arterial spinlabeling perfusion MRI at multiple delay times: a correlative studywith H215O positron emission tomography in patients with symptomatic carotid artery occlusion.J Cereb Blood Flow Metab 2009; 30: 222-229.
Tanya NT, George C, Michael JL,et al. Relationship Between Blood Pressure and Stroke Recurrence in Patients With Intracranial Arterial Stenosis. Circulation 2007;115:2969-2975.
Bruce O, Hans CD, Salim Y,et al.Level of Systolic Blood Pressure Within the Normal Range and Risk of Recurrent Stroke. JAMA 2011;306:2137-2144.
Rothwell PM, Howard SC, Spence JD. Relationship Between Blood Pressure and Stroke Risk in Patients With Symptomatic Carotid Occlusive Disease. Stroke 2003; 34:2583-2590.
EC/IC Bypass Study Group. Failure of extracranialintracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med 1985; 313: 1191–200.
Fluri F, Engelter S, Lyrer P. Extracranial-intracranial arterial bypass surgery for occlusive carotid artery disease. Cochrane Database Syst Rev 2010; 2: CD005953.
Rutgers DR, Klijn CJM, Kappelle LJ,et al. Sustained bilateral hemodynamic benefi t of contralateral carotid endarterectomy in patients with symptomatic
internal carotid artery occlusion. Stroke 2001; 32: 727-734.
cases. Brain 1966;89:235-268.
Brierley JB, Prior PF, Calverley J,et al. The pathogenesis of ischaemic neuronal damage along the cerebral arterial boundary zones in Papio anubis. Brain
1980;103:929-965.
Baron JC, Bousser MG, Comar D,et al.Noninvasive tomographic study of cerebral blood flow and oxygenmetabolism in vivo. Potentials, limitations, and
clinical applicationsin cerebral ischemic disorders. Eur Neurol 1981; 20: 273-284.
Moustafa RR., Izquierdo-Garcia D, Jones PS,et al. Watershed Infarcts in Transient Ischemic Attack/Minor Stroke With 50% CarotidStenosis: Hemodynamic
or Embolic? Stroke. 2010;41:1410-1416.
Castaigne P, Lhermitte F, Gautier JC, et al.Internal carotid artery occlusion: a study of 61 instances in50 patients with post-mortem data. Brain 1970; 93: 231-
258.
Barnett HJM, Peerless SJ, Kaufmann JCE. “Stump” of internal carotid artery—a source for further cerebral embolic ischemia. Stroke 1978; 9: 448-456.
Georgiadis D, Grosset DG, Lees KR. Transhemispheric passage of microemboli in patients with unilateral internal carotid artery occlusion. Stroke 1993; 24:
1664-1666.
Grubb RL Jr, Derdeyn CP, Fritsch SM, et al. Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAMA 1998; 280: 1055-1060.
Yamauchi H, Fukuyama H, Nagahama Y, et al. Signifi cance of increased oxygen extraction fraction in fi ve-year prognosis of major cerebral arterial occlusive diseases. J Nucl Med 1999; 40: 1992-1998.
Hankey GJ, Gubbay SS. Focal cerebral ischaemia and infarction due to antihypertensive therapy. Med J Aust 1987; 146: 412-414.
Gottesman RF, Sherman PM, Grega MA, et al. Watershed strokes after cardiac surgery: diagnosis, etiology, and outcome. Stroke 2006;37: 2306-2311.
Shahar A, Sadeh M. Severe anemia associated with transient neurological deficits. Stroke 1991; 22: 1201-1202.
Kim JS, Kang SY. Bleeding and subsequent anemia: a precipitant for cerebral infarction. Eur Neurol 2000; 43: 201-208.
Bogousslavsky J, Regli F. Unilateral watershed cerebral infarcts. Neurology.1986;36:373-377.
Bladin CF, Chambers BR. Clinical features, pathogenesis, and computed tomographic characteristics of internal watershed infarction. Stroke.1993;24:1925-1932.
Brown MM, Wade JP, Bishop CC,et al. Reactivity of the cerebral circulation in patients with carotid occlusion. J Neurol NeurosurgPsychiatry. 1986;49:899–904.
Dobkin BH. Orthostatic hypotension as a risk factor for symptomatic occlusive cerebrovascular disease. Neurology 1989; 39: 30–34.
Ross RW, Page NGR. Critical perfusion of brain and retina. Brain 1983; 106: 419-434.
Niehaus L, Neuhauser H, Meyer BU. Transient visual blurring,retro-orbital pain and repetitive involuntary movements in unilateral carotid artery occlusion. Clin
Neurol Neurosurg 1998;100: 31–32.
Klijn CJM, Kappelle LJ, van Huff elen AC, et al. Recurrent ischemia in symptomatic carotid occlusion: prognostic value of hemodynamic factors. Neurology
2000; 56: 1806-1812.
Tatemichi TK, Desmond DW, Prohovnik I, et al. Dementia associated with bilateral carotid occlusions: neuropsychological and haemodynamic course after
extracranial to intracranial bypass surgery. J Neurol Neurosurg Psychiatry 1995; 58: 633-636.
Bakker FC, Klijn CJ, Jennekens-Schinkel A,et al. Cognitive impairment in patients with carotid artery occlusion and ipsilateral transient ischemic attacks. J
Neurol 2003; 250: 1340-1347.
Momjian MI, Baron JC. The pathophysiology of watershed infarction in internal carotid artery disease: review of cerebral perfusion studies. Stroke 2005; 36:
567-577.
Del Sette M, Eliasziw M, Streifl er JY, et al. Internal borderzone infarction: a marker for severe stenosis in patients with symptomatic internal carotid artery
disease. Stroke 2000; 31: 631-636.
Bladin CF, Chambers BR. Clinical features, pathogenesis, and computed tomographic characteristics of internal watershed infarction. Stroke 1993; 24: 1925-1932.
Mangla R, Kolar B, Almast J,et al.Border Zone Infarcts: Pathophysiologic and Imaging Characteristics. RadioGraphics 2011; 31:1201–1214
Nemoto EM, Yonas H, Kuwabara H, et al. Identification of hemodynamic compromise by cerebrovascular reserve and oxygen extraction fraction in occlusive
vascular disease J Cereb Blood Flow Metab 2004; 24: 1081-1089.
Smith LMcG, Elkins JS, Dillon WP,et al. Perfusion-CT assessment of the cerebrovascular reserve: a revisit tothe acetazolamide challenges. J Neuroradiol 2008; 35: 157-164.
Bokkers RP, Bremmer JP, van Berckel BN, et al. Arterial spin labeling perfusion MRI at multiple delay times: a correlative studywith H215O positron emission tomography in patients with symptomatic carotid artery occlusion.J Cereb Blood Flow Metab 2009; 30: 222-229.
Rutgers DR, Klijn CJM, Kappelle LJ,et al. Sustained bilateral hemodynamic benefi t of contralateral carotid endarterectomy in patients with symptomatic
internal carotid artery occlusion.Stroke 2001; 32: 727-734.
Yoshimoto T. Use of cerebrovascular reactivity in patients with symptomatic major cerebral artery occlusion to predict 5-year outcome: comparison of xenon-133 and iodine-123-IMP singlephoton emission computed tomography. J Cereb Blood Flow Metab 2002; 22: 1142-1148.
Smith LMcG, Elkins JS, Dillon WP, Schaeff er S,et al.Perfusion-CT assessment of the cerebrovascular reserve: a revisit tothe acetazolamide challenges. J Neuroradiol 2008; 35: 157-164.
Bokkers RP, Bremmer JP, van Berckel BN, et al. Arterial spinlabeling perfusion MRI at multiple delay times: a correlative studywith H215O positron emission tomography in patients with symptomatic carotid artery occlusion.J Cereb Blood Flow Metab 2009; 30: 222-229.
Tanya NT, George C, Michael JL,et al. Relationship Between Blood Pressure and Stroke Recurrence in Patients With Intracranial Arterial Stenosis. Circulation 2007;115:2969-2975.
Bruce O, Hans CD, Salim Y,et al.Level of Systolic Blood Pressure Within the Normal Range and Risk of Recurrent Stroke. JAMA 2011;306:2137-2144.
Rothwell PM, Howard SC, Spence JD. Relationship Between Blood Pressure and Stroke Risk in Patients With Symptomatic Carotid Occlusive Disease. Stroke 2003; 34:2583-2590.
EC/IC Bypass Study Group. Failure of extracranialintracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med 1985; 313: 1191–200.
Fluri F, Engelter S, Lyrer P. Extracranial-intracranial arterial bypass surgery for occlusive carotid artery disease. Cochrane Database Syst Rev 2010; 2: CD005953.
Rutgers DR, Klijn CJM, Kappelle LJ,et al. Sustained bilateral hemodynamic benefi t of contralateral carotid endarterectomy in patients with symptomatic
internal carotid artery occlusion. Stroke 2001; 32: 727-734.
ดาวน์โหลด
เผยแพร่แล้ว
2019-02-14
รูปแบบการอ้างอิง
1.
พูลผล ส. Hemodynamic stroke. J Thai Stroke Soc [อินเทอร์เน็ต]. 14 กุมภาพันธ์ 2019 [อ้างถึง 31 ธันวาคม 2025];14(2):86-93. available at: https://he01.tci-thaijo.org/index.php/jtss/article/view/172296
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ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
