Occlusion of Extracranial-Intracranial Bypass Anastomosis-Associated Aneurysms Following Contralateral High-Flow Extracranial-Intracranial Bypass in a Patient with Impaired Cerebrovascular Reserve

2019 ◽  
Author(s):  
Christopher J Stapleton ◽  
Peter Theiss ◽  
Gregory D Arnone ◽  
Sophia F Shakur ◽  
Fady T Charbel
Keyword(s):  
Blood Flow ◽  
Perfusion Imaging ◽  
Cerebral Hemisphere ◽  
High Flow ◽  
Collateral Blood Flow ◽  
Flow Measurements ◽  
Cerebrovascular Reserve ◽  
Left Cerebral Hemisphere ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE Extracranial-intracranial (EC-IC) bypass anastomosis-associated aneurysms are rare sequelae of cerebral revascularization surgery. Although treatment paradigms are not well defined, clipping, trapping with revision bypass, and donor vessel ligation represent the most common microsurgical approaches. CLINICAL PRESENTATION A 53-yr-old male presented with cognitive decline, left extremity weakness, and left visual field blurriness. Computed tomographic angiography of head/neck demonstrated bilateral cervical internal carotid artery occlusion and magnetic resonance imaging of brain showed a small right parieto-occipital lobe infarct. The patient's symptoms worsened despite aggressive medical management. Therefore, a right superficial temporal artery to middle cerebral artery (STA-MCA) bypass was performed for flow augmentation. Follow-up digital subtraction angiography (DSA) approximately 1 yr after surgery noted 2 new aneurysms adjacent to the patent STA-MCA anastomosis. Perfusion imaging at that time showed persistently reduced blood flow in the left cerebral hemisphere. A left STA-MCA bypass was performed, and intraoperative blood flow measurements showed this to be a high-flow bypass. Follow-up DSA 4 mo later demonstrated involution of the right STA-MCA bypass and occlusion of the anastomosis-associated aneurysms with increased perfusion of the right cerebral hemisphere via collateral blood flow from the patent high-flow left STA-MCA bypass. At 7 mo following left STA-MCA bypass, the patient's neurological examination remained stable and perfusion imaging showed improved blood flow in the left cerebral hemisphere. CONCLUSION We present a unique case in which a high-flow left EC-IC bypass with robust contralateral collateral blood flow was associated with subsequent occlusion of a right EC-IC bypass and 2 anastomosis-associated aneurysms in a patient with bilateral impaired cerebrovascular reserve.

Regional cerebral blood flow patterns of change following the own body image exposure in eating disorders: A longitudinal study

2009 ◽  
Vol 24 (5) ◽  
pp. 275-281 ◽  
Author(s):  
Teresa Rodriguez-Cano ◽  
Luis Beato-Fernandez ◽  
Inmaculada Garcia-Vilches ◽  
Ana Garcia-Vicente ◽  
Victor Poblete-Garcia ◽  
...  
Keyword(s):  
Body Image ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Body Dissatisfaction ◽  
Regional Cerebral Blood Flow ◽  
Whole Body ◽  
Regional Cerebral Blood ◽  
Temporal Area ◽  
The Right

AbstractObjectiveThe aim of the present study is to see if the changes in the regional cerebral blood flow (rCBF) experienced by restrictive anorexia nervosa (AR) and bulimia nervosa (BN) patients, following the exposure to their own body image, persist at follow-up.MethodsThree single photon emission computed tomography (SPECT) were performed on nine patients with a DSM-IV diagnosis of AR, 13 with BP, and 12 controls: at rest, following a neutral stimulus, and after exposure to their previously filmed whole body image. Body dissatisfaction was measured by means of the Body Dissatisfaction Questionnaire (BSQ). One year later the same assessment was repeated.ResultsFollowing the exposure to their own body image, BN showed an increase in body dissatisfaction, which was associated with the increase in the rCBF of the Right Temporal Area. Those changes persisted at follow-up.DiscussionMore specific long term therapies are needed for the treatment of the averse response showed by ED patients to their own body image exposure that is associated with the hyperactivation of the right temporal area when they are confronted with their whole body image.

scholarly journals The Role of Electrode Size on the Incidence of Spreading Depression and on Cortical Cerebral Blood Flow as Measured by H2 Clearance

1992 ◽  
Vol 12 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Marleen J. Verhaegen ◽  
Michael M. Todd ◽  
David S. Warner ◽  
Bruce James ◽  
Julie B. Weeks
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Spreading Depression ◽  
Insertion Depth ◽  
Flow Measurements ◽  
Electrode Size ◽  
Cortical Gray Matter ◽  
The Right

Cerebral blood flow was measured by the H2 clearance method 30 and 60 min after the implantation of 300, 250, 125, or 50 μm diameter platinum–iridium electrodes 2 mm deep into the right parietal cortex of normothermic, normocarbic halothane-anesthetized rats. Another group of animals had 50 μm electrodes inserted 1 mm. In all animals, the presence or absence of a wave of spreading depression (SD) was noted at the time of implantation, with recordings made with glass micropipettes. H2 flow values were compared with those measured in gray matter from the same anatomical region (but from different rats), using [3H]nicotine. The incidence of SD ranged from 60% following insertion of 300 μm electrodes to 0% with 50 μm electrodes. H2 clearance flows also varied with electrode size, from 77 ± 21 ml 100 g−1 min−1 (mean ± standard deviation) with 300 μm electrodes to 110 ± 31 and 111 ± 16 ml 100 g−1 min−1 with 125 and 50 μm electrodes, respectively (insertion depth of 2 mm). A CBF value of 155 ± 60 ml 100 g−1 min−1 was obtained with 50 μm electrodes inserted only 1 mm. Cortical gray matter blood flow measured with [3H]nicotine was 154 ± 35 ml 100 g−1 min−1. When the role of SD in subsequent flow measurements was examined, there was a gradual increase in CBF between 30 and 60 min after electrode insertion in those animals with SD, while no such change was seen in rats without SD. These results indicate that the choice of electrode size and implantation depth influences the measurement of CBF by H2 clearance. CBF values equivalent to those obtained with isotopic techniques can be acutely obtained with small (50 μm diameter) electrodes inserted 1 mm into the cortex. While the occurrence of SD does influence CBF in the period immediately after implantation, a relationship between electrode size and measured flow is present that is independent of SD.

Abstract 09: Ultra-Fast Hypothermia Inhibit Early Cerebral Consumption of Lactate After Experimental Cardiac Arrest in Rabbits : A Microdialysis Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Matthias Kohlhauer ◽  
Alexandra Demelos ◽  
Emilie Boissady ◽  
Bijan Ghaleh ◽  
Renaud Tissier
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Therapeutic Window ◽  
Ultra Fast Cooling ◽  
Extracellular Lactate ◽  
Microdialysis Study ◽  
The Right ◽  
And Control

Introduction: Ultra-fast hypothermia through total liquid ventilation (TLV) has been shown to be neuroprotective after cardiac arrest. Hypothesis: The mechanism could involve a modification in brain metabolic substrat. Method: Anesthetized rabbits were instrumented with a carotid flow probe as well as arterial and jugular venous catheters. A microdialysis catether was implanted in the right brain cortex. Animals were then submitted to 10 min of ventricular fibrillation and cardiopulmonary resuscitation. After resumption of spontaneous circulation (ROSC), they were randomly submitted to ultra-fast cooling to 32°C by TLV (TLV group) or normothermic follow-up (Control) during 4h. Cerebral consumption of lactate, glucose and O 2 was calculated using arteriovenous differences in their content times mean carotid blood flow. Results: In Control, cerebral blood flow was significantly and sustainly decreased after ROSC (61±6 vs 101±6 ml/min after 240 min vs baseline), with a further decrease with hypothermia in TLV group (23±2 ml/min after 240 min, p<0.05). As compared to Control, TLV reduced the cerebral consumption of glucose (-69% at 240 min) and O 2 (-73% at 240 min). Importantly, Control animals showed a dramatic but transient cerebral consumption of lactate during the first 120 min after cardiac arrest (e.g. 124±31 mmol/min at 60 min). Concomitantly, this was associated with an increase in pyruvate extracellular stocks in brain (e.g. 57±10 μmol/L at 30 min). In TLV group, hypothermia blunted this initial burst of lactate consumption (e.g. 41±12 mmol/min at 60 min, p<0,05) and led to an accumulation in extracellular lactate ( e.g. 2053±68 vs 1246±278 μmol/L at 60 min, in TLV and Control respectively). This early build-up of lactate was then progressively consumed after 120 min in TLV group, allowing a delayed accumulation in pyruvate extracellular stocks from 120 min until the end of follow-up (103±19 and 17±4 μmol/L of pyruvate at 240 min in TLV vs Control respectively). Conclusion: Ultra-fast hypothermia reduces the cerebral consumption of lactate during the first 120 min after ROSC, allowing a delayed renewal in pyruvate stocks. This could explain the potent benefit of hypothermia during this early therapeutic window of 120 min.

Relation between Hemispheric Specialization and Gross Motor Control in Normal Right-Handed Children

1986 ◽  
Vol 63 (3) ◽  
pp. 1227-1231 ◽  
Author(s):  
Harriet Williams ◽  
Peter Werner ◽  
George Purgavie
Keyword(s):  
Cerebral Hemisphere ◽  
Hemispheric Specialization ◽  
Gross Motor ◽  
Projection System ◽  
Control Center ◽  
Left Cerebral Hemisphere ◽  
Processing Information ◽  
Hand Coordination ◽  
The Right ◽  
Abstract Shapes

The purpose of the present study was to investigate the nature of the relationship between gross-motor, eye-hand coordination and hemispheric specialization in normal right-handed children. Participants were 30 children, 75–99 mo. 15 boys and 15 girls performed a gross-motor eye-hand coordination task (a controlled, continuous one-handed ball bounce) and a test of hemispheric specialization. A backscreen tachistoscopic projection system was used to present letters and abstract shapes to left and right visual hemifields. A multivariate analysis of variance yielded a significant main effect for eye-hand coordination but not for sex. Follow-up analyses indicated that speed and accuracy of responses to verbal and spatial stimuli presented to the left cerebral hemisphere were significantly related to proficiency of eye-hand coordination. Data suggest that certain aspects of hemispheric specialization may be important to gross-motor eye-hand coordination in young children. Since the left cerebral hemisphere is the major control center for movements of the right side, the hemisphere which controls movements of a particular side may also assume the major responsibility for processing information needed to regulate those movements.

scholarly journals Vein of Galen malformation treated with the Micro Vascular Plug system: case report

2017 ◽  
Vol 19 (6) ◽  
pp. 729-733 ◽  
Author(s):  
Woojin Joo ◽  
Philippe Mercier ◽  
Shiva Kheradmand ◽  
Peyman Shirani ◽  
Ahmed Sarhan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Case Report ◽  
High Flow ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Vascular Plug ◽  
Valuable Addition

This case report describes the use of the Micro Vascular Plug (MVP) system in a mural-type vein of Galen aneurysmal malformation, resulting in successful occlusion of the cerebrovascular fistula. This result was confirmed with immediate cessation in blood flow and 6-month follow-up angiography. The unique characteristics of the MVP provide potential advantages over current embolic techniques for occlusion of high-flow, fistulous, intracranial vessels such as those seen in the vein of Galen aneurysmal malformation, and may represent a valuable addition to the currently available options.

Effect of naloxone on regional cerebral blood flow during endotoxin shock in conscious rats

1987 ◽  
Vol 253 (3) ◽  
pp. R425-R433
Author(s):  
W. R. Law ◽  
J. L. Ferguson
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Endotoxin Shock ◽  
Sprague Dawley ◽  
Regional Cerebral Blood ◽  
Large Share ◽  
Flow Measurements ◽  
Sprague Dawley Rats ◽  
The Right

Maintenance of cerebral blood flow (CBF) is vital during cardiovascular shock. Since opioids have been implicated in the pathophysiology of endotoxin shock and have been shown to alter cerebral perfusion patterns, we determined whether opioids were responsible for any of the changes in regional CBF observed during endotoxin shock and whether the use of naloxone might impair or aid in the maintenance of CBF. When blood flow (BF) is studied with microspheres in rats, the left ventricle of the heart is often cannulated via the right carotid artery. Questions have arisen concerning the potential adverse effects of this method on CBF in the hemisphere ipsilateral to the ligated artery. We measured right and left regional CBF by use of this route of cannulation. Twenty-four hours after cannulations were performed, flow measurements were made using radiolabeled microspheres in conscious unrestrained male Sprague-Dawley rats (300-400 g) before and 10, 30 and 60 min after challenging with 10 mg/kg Escherichia coli endotoxin (etx) or saline. Naloxone (2 mg/kg) or saline was given as a treatment 25 min post-etx. We found no significant differences between right and left cortical, midbrain, or cerebellar BF at any time in any treatment group. After etx, the whole brain received a large share of the depressed cardiac output. Thus global CBF was not significantly reduced below its pre-etx value, an effect unaltered by naloxone. Regionally, BF was reduced to cerebellum and midbrain by 30 min post-etx. Naloxone prevented this depression. No region was affected to a greater or lesser degree than others.(ABSTRACT TRUNCATED AT 250 WORDS)

Quantitation of regional chondro-osseous circulation in canine tibia and femur

1982 ◽  
Vol 242 (3) ◽  
pp. H365-H375
Author(s):  
J. E. Schnitzer ◽  
P. McKinstry ◽  
T. R. Light ◽  
J. A. Ogden
Keyword(s):  
Blood Flow ◽  
Bone Formation ◽  
Regional Differences ◽  
Skeletal Maturity ◽  
High Flow ◽  
Skeletally Immature ◽  
Acute Hematogenous Osteomyelitis ◽  
Delayed Healing ◽  
The Right ◽  
Regional Comparisons

Regional osseous blood flow (OBF) to various regions of the femur and tibia was measured using radioactively labeled 15-micrometers microspheres injected into the right atrium of neonatal, skeletally immature, and skeletally mature canines. Each bone was divided into as many as 41 anatomically distinct sections to assess developmental and regional comparisons in OBF. A quantitative decrease in OBF with increasing chondro-osseous maturity was observed for both the whole bones as well as many regions within a given bone. This was particularly significant in the tibia in which OBF to the mature tibia was much lower than in the immature tibia or even the mature femur. In the immature and neonatal bones, the epiphyseal and metaphyseal regions nearest the physes had the highest flow. The physis had a statistically significant high flow rate. Furthermore, regional differences in OBF correlated well with known regional functions in both endochondral and membranous (periosteal) bone formation. OBF tended to be greater in regions of greater metabolic activity associated with hematopoiesis and endochondral osteogenesis. OBF values correlated well with regional predilections of various diseases such as acute hematogenous osteomyelitis prior to skeletal maturity and osseous metastases, and, by extrapolation, strongly support a physiological reason for delayed healing and nonunion in tibial fractures in the skeletally mature human.

Preliminary Report: Hemispheric Relationships in Composing

1980 ◽  
Vol 162 (2) ◽  
pp. 74-95 ◽  
Author(s):  
Benjamin M. Glassner
Keyword(s):  
Cerebral Hemisphere ◽  
Preliminary Report ◽  
Traditional Instruction ◽  
Amplitude Ratios ◽  
Left Cerebral Hemisphere ◽  
Right Cerebral Hemisphere ◽  
Left And Right ◽  
The Right

The purpose of the study reported here is to examine the right/left cerebral hemisphere relationships between writing in the extensive mode and writing in the reflexive mode. Preliminary findings suggest that writing which is focused on communicating information already familiar and formulated by the writer, characteristics of extensive composing, is accompanied by greater relative engagement of the left cerebral hemisphere as indicated by lower relative EEG amplitude ratios measured from electrodes placed symmetrically over the left and right temporal areas. Writing which is focused upon discovering meanings, which is tentative and exploratory - characteristics of reflexive composing - is accompanied by greater relative engagement of the right cerebral hemisphere. Traditional instruction has failed because it is “half-brained,” addressing only one of these modes of composing.

Improvement in Regional Cerebral Blood Flow and Cerebral Vasoreactivity after Extracranial-Intracranial Arterial Bypass

Neurosurgery ◽  
1988 ◽  
Vol 22 (5) ◽  
pp. 913-919 ◽  
Author(s):  
Hunt H. Batjer ◽  
Michael D. Devous ◽  
Phillip D. Purdy ◽  
Bruce Mickey ◽  
Frederick J. Bonte ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Regional Cerebral Blood ◽  
Flow Measurements ◽  
Cerebrovascular Reserve ◽  
Neurological Improvement

Abstract Regional cerebral blood flow was measured with xenon-133 inhalation single photon emission computed tomography in a patient who developed a neurological deficit after carotid ligation. Hemispheric hypoperfusion was noted in resting studies and impaired vasoreactivity was suggested by lack of symmetrical flow augmentation after acetazolamide administration. Because of progressive neurological deterioration, an extracranial-intracranial bypass was performed. After prompt neurological improvement, repeat cerebral blood flow measurements at 1 and 9 weeks postoperatively confirmed improvement in resting flow and vasoreactivity. It is possible that decreased cerebrovascular reserve implied by measurements of vasoreactivity can identify patients who will benefit from surgical revascularization.

Sign in / Sign up

Export Citation Format

Share Document