Transient hyperperfusion after superficial temporal artery/middle cerebral artery bypass surgery as a possible cause of postoperative transient neurological deterioration
- Authors
- Kim, Jeong Eun; Oh, Chang Wan; Kwon, O-Ki; Park, Sukh Que; Kim, Sang Eun; Kim, Yu Kyeong
- Issue Date
- 2008-05-17
- Publisher
- Karger
- Citation
- Cerebrovasc Dis. 2008;25(6):580-586
- Keywords
- Adult; Aged; Anastomosis, Surgical/adverse effects; Ataxia/*etiology; Cerebral Revascularization/*adverse effects; Cerebrovascular Circulation; Female; Humans; Male; Middle Aged; Middle Cerebral Artery/surgery; Reperfusion Injury/*complications; Speech Disorders/*etiology; Temporal Arteries/surgery; Tomography, Emission-Computed, Single-Photon
- Abstract
- 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.
- ISSN
- 1421-9786 (Electronic)
- Language
- English
- URI
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18483458
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000132205&Ausgabe=237384&ProduktNr=224153&filename=000132205.pdf
http://hdl.handle.net/10371/68420
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