Correlation of Cerebral Blood Flow and Electroencephalographic Changes during Carotid Endarterectomy, with Results of Surgery and Hemodynamics of Cerebral Ischemia

Cerebral Blood Flow and Metabolism of Hyperperfusion after Cerebral Revascularization in Patients with Moyamoya Disease

“…The main neurologic deficits corresponding to dysfunctions around the bypass site at the perisylvian area include dysarthria, hand motor dysfunction, and motor or sensory dysphasia. Unlike the classical triad of symptoms such as severe unilateral headache, face and eye pain, and seizures and established criteria of CBF after CEA (Piepgras et al, 1988;Sundt et al, 1981;van Mook et al, 2005), a critical definition of CBF using PET, a gold standard, for the diagnosis of hyperperfusion after bypass surgery for MMD remains unestablished.…”

“…Despite favorable long-term outcomes after successful bypass surgery for MMD, increasing evidence suggests that this may be complicated with temporary neurologic deterioration during the postoperative acute stage owing to focal cerebral hyperperfusion around the site of the anastomosis (Fujimura et al, 2007(Fujimura et al, , 2009(Fujimura et al, , 2011Furuya et al, 2004;Kim et al, 2008;Ogasawara et al, 2005). Postoperative cerebral hyperperfusion is defined as a major increase in ipsilateral cerebral blood flow (CBF) well above the metabolic demands of brain tissue (Piepgras et al, 1988;Sundt et al, 1981), and is well characterized in patients after carotid endarterectomy (CEA). Although a similar cerebral hyperperfusion phenomenon was reported in patients with MMD using single-photon emission computed tomography (SPECT) or xenon-enhanced computed tomography (Fujimura et al, 2007(Fujimura et al, , 2009(Fujimura et al, , 2011Furuya et al, 2004;Kim et al, 2008;Ogasawara et al, 2005), no previous study has quantitatively analyzed CBF and metabolism of postoperative hyperperfusion in MMD.…”

Rapid Monitoring of Intraoperative Cerebral Blood Flow Using 133Xe

“…There were 13 men and 13 women under going 16 left and 10 right carotid endarterectomies. Ac cording to the risk classification by Sundt et al (1981), 10 patients were grade 1, one patient was grade 2, 13 pa tients were grade 3, and two patients were grade 4. Anes thesia was induced with thiopental (4 mg/kg) and tracheal intubation facilitated by vecuronium (0.1 mg/kg).…”

Perioperative stroke Part I: General surgery, carotid artery disease, and carotid endarterectomy

“…The results based on an analysis of 1104 procedures showed that the combined morbidity and mortality in grades 1 to 4 were I, 2, 4 and 9% respectively, and the incidence of neurological deficits were 1, 2, 2.6 and 4.5%. 95 In an analysis of 282 consecutive carotid endarterectomies done in the same institution from 1982 to 1984, it was shown that the risk of complications in grade I and 2 patients was 0%. The single nonfatal cardiac complication occurred in a patient with a grade 3 risk.…”