STA-MCA吻合術の適応と総合評価に関する補助検査法の選択と術後の評価時期

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The various examinations available should be used to estimate the surgical indication of STA-MCA anastomosis preoperatively, and also to evaluate its effect postoperatively. The data of cerebral angiography, CT scan, r-CBF, EEG and ophthalmodynamometry obtained from 18 cases treated by STA-MCA anastomosis in our clinic were analysed and discussed. 1) Four vessel angiography is essential not only to detect organic vascular lesions and also to evaluate the development of collateral circulation. Follow-up angiography in late postoperative period was documented interesting informations as to the changes of the collateral circulation. Mostly the donor artery via the shunt increased its diameter. 2) CT findings were usually unchanged after the surgery even if there were some clinical improvement through the operation. 3) In most of the cases, r-CBF showed improvement but not so remarkable. 4) EEG showed transient focal slow activity in the operated temporal region in the early postoperative period in half of the cases. Matas test during EEG examination might be useful to detect the surgical effect. The evidence obtained would indicate the evaluation of direct surgical effect by examinations at rest might be difficult. The most important effect of STA-MCA anastomosis would be to increase the cerebral vascular reserve in ischemic brain. So that, some tolerance test during examinations would be useful for real evaluation of the surgical effect.
The Japanese Society on Surgery for Cerebral Strokeの論文

STA-MCA吻合術の適応と総合評価に関する補助検査法の選択と術後の評価時期

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