Carbonic anhydrase inhibition and cerebral venous blood gases and ions in man. Demonstration of increased oxygen availability to ischemic brain.

INCREASES of the carbon dioxide tension of brain tissue and cerebral blood flow (CBF) were found to follow administration of acetazolamide (Diamox) in the monkey.1,2Apparently acetazolamide interfered with carbon dioxide transport by cerebral venous blood with accumulation of carbon dioxide in brain tissue. Reports that CBF increased in man following acetazolamide have been reported by Posner and Plum,3and Ehrenreich et al.4Several important questions relevant to its therapeutic use in man remain unsettled. Does carbon dioxide accumulate in the human brain as it does in animals after acetazolamide administration? How rapidly does cerebral blood flow increase in man after acetazolamide administration and for how long? Is oxygen supply to the ischemic human brain affected by cerebral arteriosclerosis increased by acetazolamide? What are the mechanisms by which human cerebral blood flow becomes increased? Is there any relationship between increased CBF and the acidosis produced by acetazolamide?

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