過去5年間における頭蓋内外血管吻合術の手術成績

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Clinical results of 68 cases with ischemic brain undergoing extra-intracranial arterial bypass (EIAB) between September 1973 and August 1978 are analyzed. The vascular pathology shows internal carotid artery (IC) occlusions in 23 cases, middle cerebral artery (MC) occlusions or stenoses in 83, Moya-moya diseases in 5 and vertebral artery (VA) occlusions and stenoses in 2. They are classified to 58 completed strokes, one TIA and 9 rapidly progressive strokes in an acute stage. In 58 cases with completed stroke, 14 were improved, 10 slightly improved and 34 unchanged by the EIAB. In 9 cases with the emergency bypass within three days from onset, 5 cases were improved but one case, in which severe brain edema had already revealed preoperatively, died from postoperative hemorrhagic infarction. One case with TIA continued to be asymptomatic postoperatively. There are two cases with occipital-posterior inferior cerebellar arterial (OA-PICA) anastomosis. But both of them are completed strokes, who have been unchanged postoperatively. The authors proposed in this paper that a new method select the appropriate candidates for the emergency EIAB from severe ischemic stroke patients by a combination test of the agent-induced EEG or evoked potential, furthermore, by this new method, it is considered that the emergency EIAB should be performed for the appropriate candidates of rapid progressive strokes in acute stage to prevent severe neurological dificits for them.
The Japanese Society on Surgery for Cerebral Strokeの論文

過去5年間における頭蓋内外血管吻合術の手術成績

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