Perrine K, Devinsky O, Luciano D J, Choi I S, Nelson P K
Department of Neurology, Hospital for Joint Diseases, New York (NY) University School of Medicine, USA.
Arch Neurol. 1995 Jul;52(7):712-6. doi: 10.1001/archneur.1995.00540310086020.
To determine behavioral correlates of anterior cerebral artery (ACA) and posterior cerebral artery (PCA) perfusion patterns in the intracarotid amobarbital sodium procedure.
Multivariate analysis of covariance and partial correlations of behavioral measures to ACA crossflow and PCA filling.
Angiography and the intracarotid amobarbital procedure at a comprehensive epilepsy center.
Forty-two patients with intractable epilepsy (right-hemisphere seizure focus [n-23]; left-hemisphere seizure focus [n = 19]).
Internal carotid angiography was performed both at a standard injection rate (8 mL of contrast per second) and at 1 mL/s, which matched the rate of the subsequent amobarbital injection. The degree of ipsilateral PCA and contralateral ACA filling were graded on a seven-point scale and compared with postinjection behavior, language, and memory measures.
The ACA crossflow did not correlate significantly with that of any measure. The degree of PCA-filling pattern correlated significantly only with the level of consciousness (r = .31, P < .004), but it was not significant after accounting for the effects of seizure laterality, injection side, and amobarbital dosage. Neither ACA crossflow nor PCA filling correlated significantly with memory. The degree of ACA and PCA filling was overestimated at standard angiography (8 mL of contrast medium per second) injection rates.
Although the degree of PCA filling correlates mildly with the level of consciousness postinjection, possibly by perfusion of thalamic or mesencephalic branches, it is not reliably predictive and is less contributory than the injection side and seizure laterality. The PCA filling is not required to produce valid memory assessment in the intracarotid amobarbital procedure, and ACA crossflow is not predictive of behavioral responses.
确定颈动脉注射异戊巴比妥钠试验中大脑前动脉（ACA）和大脑后动脉（PCA）灌注模式与行为的相关性。
行为测量与ACA交叉血流及PCA充盈的多变量协方差分析和偏相关性分析。
在一家综合性癫痫中心进行血管造影和颈动脉注射异戊巴比妥试验。
42例难治性癫痫患者（右半球癫痫病灶[n = 23]；左半球癫痫病灶[n = 19]）。
分别以标准注射速率（每秒8毫升造影剂）和1毫升/秒的速率进行颈内动脉血管造影，后者与随后的异戊巴比妥注射速率相匹配。对同侧PCA和对侧ACA的充盈程度进行七点评分，并与注射后行为、语言和记忆测量结果进行比较。
ACA交叉血流与任何测量指标均无显著相关性。PCA充盈模式的程度仅与意识水平显著相关（r = 0.31，P < 0.004），但在考虑癫痫灶侧别、注射侧和异戊巴比妥剂量的影响后，该相关性不显著。ACA交叉血流和PCA充盈与记忆均无显著相关性。在标准血管造影（每秒8毫升造影剂）注射速率下，ACA和PCA的充盈程度被高估。
尽管PCA充盈程度与注射后意识水平有轻度相关性，可能是通过丘脑或中脑分支的灌注，但它并非可靠的预测指标，且相比注射侧和癫痫灶侧别，其作用较小。在颈动脉注射异戊巴比妥试验中，进行有效的记忆评估无需考虑PCA充盈情况，且ACA交叉血流不能预测行为反应。
