{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:45:55Z","timestamp":1776689155610,"version":"3.51.2"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,12,24]],"date-time":"2012-12-24T00:00:00Z","timestamp":1356307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>High\u2010grade cervical carotid stenosis (70\u201399%) or occlusion often accompanies reversed ophthalmic artery flow (<jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content>), but its potential clinical significances remain poor understood. This study assessed <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content> and the related variables caused by carotid hemodynamic compromise in patients with unilateral severe cervical carotid stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study consisted of 200 patients diagnosed as unilateral high\u2010grade cervical carotid stenosis\/occlusion using ultrasonography. The hemodynamic parameters of 152 patients, excluding 48 with cervical carotid occlusion, were compared based on the presence of <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content>. Out of 200 patients, 159 underwent brain magnetic resonance imaging and were analysed for risk factors impacting functional outcomes including <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patients (<jats:italic>n\u2005<\/jats:italic>=\u200548) with internal carotid artery occlusion had significantly higher incidence (62.5%) of <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content> compared with that of 25.0% in those patients (<jats:italic>n\u2005<\/jats:italic>=\u2005152) with unilateral high\u2010grade carotid stenosis (<jats:italic>P\u2005<\/jats:italic>&lt;\u20050.001). In <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content> patients (<jats:italic>n\u2005<\/jats:italic>=\u200538) with the unilateral high\u2010grade stenosis, a significant retrobulbar arteries hemodynamic difference was observed between the stenotic and non\u2010stenotic vessels. The patients (<jats:italic>n\u2005<\/jats:italic>=\u2005159) with history of stroke (<jats:italic>P\u2005<\/jats:italic>=\u20050.035), <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content> (<jats:italic>P\u2005<\/jats:italic>=\u20050.023) and intracranial stenosis (<jats:italic>P\u2005<\/jats:italic>&lt;\u20050.001) exhibited significantly higher incidence of poor functional outcome compared with the corresponding control groups. In the same patients (<jats:italic>n\u2005<\/jats:italic>=\u2005159), those with both cervical and intracranial stenosis showed sevenfold higher risk (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 7.60; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 3.44\u201316.81) for <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content> than those with only cervical stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ROAF may result from intracranial hemodynamic compromise. Patients with unilateral high\u2010grade cervical carotid stenosis\/occlusion in combination with intracranial stenosis appear to be a significant risk factor for poor functional outcome and increased incidence of <jats:styled-content style=\"fixed-case\">ROAF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12038","type":"journal-article","created":{"date-parts":[[2012,12,24]],"date-time":"2012-12-24T01:39:44Z","timestamp":1356313184000},"page":"564-570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Reversal of ophthalmic artery flow as a predictor of intracranial hemodynamic compromise: implication for prognosis of severe carotid stenosis"],"prefix":"10.1111","volume":"20","author":[{"given":"C.\u2010L.","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Neurology Tri\u2010Service General Hospital, National Defense Medical Center Taipei 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Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.\u2010H.","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurology Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.\u2010S.","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Neurology Tri\u2010Service General Hospital, National Defense Medical Center Taipei 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