Completed strokeに対する血行再建術の適応

概要

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The trial to establish the indication of the vascular reconstruction for the completed stroke was done by reviewing of 33 cases of completed stroke treated with STA-MCA anastomosis. 10 out of 33 cases made excellent and rapid recovery from severe neurological deficit immediate to four weeks after surgery. Preoperative studies of CT, cerebral angiogram, EEG, somatosensory evoked potentials (SEP) and timing of the surgery of these 10 cases were analyzed and the surgical indication was estimated through the results. The results and estimated criteria of the surgery are as follows; 1) The ratio of CT number of affected brain to its intact brain is over 50%, mean value is 68. 5%. 2) Anatomical nature of preexisting collateral circulation must be sufficient in the ischemic brain. 3) The reduction ratio of V1-amplitude of SEP in affected brain to intact brain is less than 53.4%. 4) Timing of the surgery is approximately four weeks after the onset. EEG is useful study in postoperative follow-up, but is not of great value to predict the surgical indication. If it is required to satisfy the above criteria, the indication of vascular reconstruction for the completed stroke will be subject to more restriction.
The Japanese Society on Surgery for Cerebral Strokeの論文