Transient hyperperfusion after superficial temporal artery/middle cerebral artery bypass surgery as a possible cause of postoperative transient neurological deterioration

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Kim, Jeong Eun; Oh, Chang Wan; Kwon, O-Ki; Park, Sukh Que; Kim, Sang Eun; Kim, Yu Kyeong
Issue Date
Cerebrovasc Dis. 2008;25(6):580-586
AdultAgedAnastomosis, Surgical/adverse effectsAtaxia/*etiologyCerebral Revascularization/*adverse effectsCerebrovascular CirculationFemaleHumansMaleMiddle AgedMiddle Cerebral Artery/surgeryReperfusion Injury/*complicationsSpeech Disorders/*etiologyTemporal Arteries/surgeryTomography, Emission-Computed, Single-Photon
BACKGROUND: This study was designed to investigate the relationship between transient neurological deterioration and changes in cerebral perfusion after superficial temporal artery/middle cerebral artery (STA-MCA) bypass. METHODS: Clinical characteristics of the patients with postoperative transient neurological deterioration were analyzed in 120 STA-MCA bypass procedures for ischemic cerebral diseases, such as atherosclerotic disease and moyamoya disease. Serial brain single-photon emission computed tomography (SPECT) was performed on 25 patients before surgery and on the third and tenth postoperative days. The hemispheric perfusion on SPECT was calculated semi-quantitatively using statistical parametric mapping and a probabilistic brain atlas. RESULTS: Among 120 procedures, there were 4 permanent postoperative neurological deficits (3.3%) and 20 postoperative transient neurologic deteriorations with unknown etiology (17%). In 25 patients analyzed for postoperative perfusion changes, cerebral perfusion increased on the third postoperative day and the increased perfusion negatively correlated with preoperative perfusion (correlation coefficient = -0.77; p < 0.001). Temporal changes and the location of transient hyperperfusion on SPECT correlated with the time course and neurological deficits associated with postoperative transient neurological deterioration in 3 patients. CONCLUSIONS: Postoperative transient relative hyperperfusion is a common phenomenon and may be one of the causes of postoperative transient neurological deterioration after STA-MCA bypass surgery for ischemic cerebral diseases.
1421-9786 (Electronic)
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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