Hemodynamic Evaluation Before and After the STA-MCA Anastomosis : With Special Reference to Measurement of Regional Transit Time with Intra-arterial Digital Subtraction Angiography
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概要
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Twenty-seven patients with minor completed and major stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The regional cerebral blood flow (rCBF), using inhalation of stable xenon and computed tomographic scanning (Xe^s CT-CBF study), and the mode of transit time (MTT) in the MCA territory using intra-arterial digital aortography were measured. Activated rCBF and MTT was measured 20 minutes after the administration of acetazolamide (10 mg/kg) in 14 patients. Nineteen of the 23 patients with minor stroke (Group 1) showed immediate improvement in their neurological state within a few days of the operation, while four patients with minor stroke (Group 2) and four patients with major stroke (Group 3) showed no improvement. Based on the rCBF obtained with the Xe^s CT-CBF study, affected side rCBF/unaffected side rCBF and %f [(peak DSA number/affected side MTT)/(peak DSA number/unaffected side MTT)] were compared. There was a significant positive correlation. Affected side MTT in Group 1 was 6.41 ± 1.16 sec, preoperatively, and significantly decreased to 5.13 ± 0.91 sec after the operation. On the other hand, preoperative MTT in Group 2 was 4.40 ± 0.81 sec and 4.76 ± 0.89 sec, postoperatively. Preoperative %f in Group 1 was 0.514 ± 0.143 and significantly increased to 0.739 ± 0.154, postoperatively. Group 2 showed no change. Vasodilatory capacity with acetazolamide showed a marked improvement in Group 1, postoperatively. Our study indicated that if MTT is moderately lengthened, %f is moderately decreased, and vasodilatory capacity is impaired, in patients with minor ischemic stroke will benefit from STA-MCA anastomosis.
- 日本脳神経外科学会の論文
- 1990-09-15
著者
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Yamada Keisuke
Department Of Neurosurgery Of The Department Of Clinical Laboratory Osaka Neurological Institute
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TOUHO Hajime
Department of Neurosurgery, Osaka Neurological Institute
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KARASAWA Jun
Department of Neurosurgery, Osaka Neurological Institute
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SHISHIDO Hisashi
Department of Neurosurgery, Osaka Neurological Institute
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SHIBAMOTO Keiji
Department of Neurosurgery, Osaka Neurological Institute
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東保 肇
財団法人大阪脳神経外科病院
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唐澤 淳
財団法人大阪脳神経外科病院脳神経外科
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Shishido Hisashi
Department Of Neurosurgery Osaka Neurological Institute
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Shishido Hisashi
Department Of Neurosurgery Nojima Hospital
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Shibamoto Keiji
Department Of Neurosurgery Osaka Neurological Institute
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Karasawa Jun
Department Of Neurosurgery Osaka Neurological Institute
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Karasawa Jun
Department Of Neurological Surgery Kitano Hospital
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Touho Hajime
Departments Of Neurosurgery Osaka Neurological Institute
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Touho Hajime
Department Of Neurosurgery Osaka Neurological Institute Toyonaka
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Yamada Keisuke
Department Of Anesthesia Kanazawa University Hospital
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Touho Hajime
Department Of Neurosurgery Osaka Neurological Institute
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