Cerebral Revascularization: Boom or Doom for Neurosurgeons

Abstract

Cerebral revascularization which was once commonly used technique became outdated and emerged in a new avatar. Fisher was the first person who promoted that most strokes were not due to vasospasm but due to CA disease. Improvement of various microsurgical methods and techniques are resulting in excellent outcomes. With the advent of modern techniques, cerebral revascularization has taken a back seat. However many diseases like moyamoya disease, complex intracranial aneurysms and skull based tumours, traditional cerebral revascularization methods play a very important role. Although an important method to treat strokes but is also associated with dreaded complication of intracranial haemorrhage. Cerebral collateral circulation channels are restored by cerebral revascularization. Although very commonly used treatment but underwent various modifications, implementations, expanding the horizons of diseases involved. All these innovations in the use of endovascular technique resulted in the decline of cerebral revascularization surgeries. New endovascular surgical approaches lead to shorter recovery times and the patients whose conditions are not indicated for the traditional cerebrovascular approaches can also be managed. One of the major and important drawback of Cerebral Revascularization is the intraoperative thrombosis which can result in severe motor and sensory disturbances. This article aims to weigh the pros and cons of cerebral revascularization.