scholarly journals Significance of Cerebral Blood Flow Analysis in the Acute Stage after Revascularization Surgery for Moyamoya Disease

2015 ◽  
Vol 55 (10) ◽  
pp. 775-781 ◽  
Author(s):  
Miki FUJIMURA ◽  
Teiji TOMINAGA
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Moyamoya Disease ◽  
Flow Analysis ◽  
Acute Stage ◽  
Blood Flow Analysis ◽  
Revascularization Surgery

Pitfalls of Regional Cerebral Blood Flow Analysis in Cerebrovascular Disease

1988 ◽  
Vol 13 (3) ◽  
pp. 197-201 ◽  
Author(s):  
HANS L. LAGREZE ◽  
ROSS L. LEVINE ◽  
JOHN S. SUNDERLAND ◽  
ROBERT J. NICKLES
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cerebrovascular Disease ◽  
Regional Cerebral Blood Flow ◽  
Flow Analysis ◽  
Regional Cerebral Blood ◽  
Blood Flow Analysis

Significance of Quantitative Cerebral Blood Flow Measurement in the Acute Stage after Revascularization Surgery for Adult Moyamoya Disease: Implication for the Pathological Threshold of Local Cerebral Hyperperfusion

2019 ◽  
Vol 48 (3-6) ◽  
pp. 217-225 ◽  
Author(s):  
Masayuki Kameyama ◽  
Miki Fujimura ◽  
Ryosuke Tashiro ◽  
Kenichi Sato ◽  
Hidenori Endo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Intracerebral Hemorrhage ◽  
Perioperative Management ◽  
Pressure Control ◽  
Acute Stage ◽  
Cerebral Hyperperfusion ◽  
Auc Value ◽  
Revascularization Surgery

Objective: Superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis is a standard surgical procedure for adult patients with moyamoya disease (MMD) and plays a role in preventing ischemic and/or hemorrhagic stroke. Cerebral hyperperfusion (CHP) syndrome is a potential complication of this procedure that can result in deleterious outcomes, such as delayed intracerebral hemorrhage, but the exact threshold of the pathological increase in postoperative cerebral blood flow (CBF) is unclear. Thus, we analyzed local CBF in the acute stage after revascularization surgery for adult MMD to predict CHP syndrome under modern perioperative management. Materials and Methods: Fifty-nine consecutive adult MMD patients, aged 17–66 years old (mean 43.1), underwent STA-MCA anastomosis with indirect pial synangiosis for 65 affected hemispheres. All patients were perioperatively managed by strict blood pressure control (systolic pressure of 110–130 mm Hg) to prevent CHP syndrome. Local CBF at the site of anastomosis was quantitatively measured using the autoradiographic method by N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography 1 and 7 days after surgery, in addition to the preoperative CBF value at the corresponding area. We defined CHP phenomenon as a local CBF increase over 150% compared to the preoperative value. Then, we investigated the correlation between local hemodynamic change and the development of CHP syndrome. Results: After 65 surgeries, 5 patients developed CHP syndrome, including 2 patients with delayed intracerebral hemorrhage (3.0%), 1 with symptomatic subarachnoid hemorrhage (1.5%), and 2 with focal neurological deterioration without hemorrhage. The CBF increase ratio was significantly higher in patients with CHP syndrome (270.7%) than in patients without CHP syndrome (135.2%, p = 0.003). Based on receiver operating characteristic analysis, the cutoff value for the pathological postoperative CBF increase ratio was 184.5% for CHP syndrome (sensitivity = 83.3%, specificity =  94.2%, area under the curve [AUC] value  =  0.825) and 241.3% for hemorrhagic CHP syndrome (sensitivity =  75.0%, specificity =  97.2%, AUC value  =  0.742). Conclusion: Quantitative measurement of the local CBF value in the early postoperative period provides essential information to predict CHP syndrome after STA-MCA anastomosis in patients with adult MMD. The pathological threshold of hemorrhagic CHP syndrome was as high as 241.3% by the local CBF increase ratio, but 2 patients (3.0%) developed delayed intracerebral hemorrhage in this series that were managed following the intensive perioperative management protocol. Thus, we recommend routine CBF measurement in the acute stage after direct revascularization surgery for adult MMD and satisfactory blood pressure control to avoid the deleterious effects of CHP.

Regional cerebral blood flow analysis of vascular dementia by the 133Xe inhalation method

Nosotchu ◽  
1987 ◽  
Vol 9 (2) ◽  
pp. 107-111
Author(s):  
Sho Watanabe ◽  
Koichi Miyakawa ◽  
Michiyuki Maruyama ◽  
Gonbei Kamijima ◽  
Yasuto Sasaki
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Vascular Dementia ◽  
Regional Cerebral Blood Flow ◽  
Flow Analysis ◽  
Regional Cerebral Blood ◽  
Blood Flow Analysis

scholarly journals Intraoperative Blood Flow Analysis of Direct Revascularization Procedures in Patients with Moyamoya Disease

2010 ◽  
Vol 31 (1) ◽  
pp. 262-274 ◽  
Author(s):  
Marco Lee ◽  
Raphael Guzman ◽  
Teresa Bell-Stephens ◽  
Gary K Steinberg
Keyword(s):  
Blood Flow ◽  
Moyamoya Disease ◽  
Superficial Temporal Artery ◽  
Flow Analysis ◽  
Temporal Artery ◽  
Local Flow ◽  
Blood Flow Analysis ◽  
Revascularization Procedures ◽  
Internal Carotid Arteries ◽  
Very High

Moyamoya disease is characterized by the progressive stenosis and often occlusion of the terminal internal carotid arteries, which leads to ischemic and hemorrhagic injuries. The etiology is unknown and surgical revascularization remains the mainstay treatment. We analyzed various hemodynamic factors in 292 patients with moyamoya disease, representing 496 revascularization procedures, including vessel dimension and intraoperative blood flow, using a perivascular ultrasonic flowprobe. Mean middle cerebral artery (MCA) flow rate was 4.4±0.26 mL/min. After superficial temporal artery (STA)–MCA bypass surgery, flows at the microanastomosis were increased fivefold to a mean of 22.2±0.8 mL/min. The MCA flows were significantly lower in the pediatric (16.2±1.3 mL/min) compared with the adult (23.9±1.0 mL/min; P<0.0001) population. Increased local flow rates were associated with clinical improvement. Permanent postoperative complications were low (<5%), but very high postanastomosis MCA flow was associated with postoperative stroke (31.2±6.8 mL/min; P=0.045), hemorrhage (32.1±10.2 mL/min; P=0.045), and transient neurologic deficits (28.6±5.6 mL/min; P=0.047) compared with controls. Other flow and vessel dimension data are presented to elucidate the hemodynamic changes related to the vasculopathy and subsequent to surgical intervention.

scholarly journals Diagnosis and Management of Moyamoya Disease

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 137-142
Author(s):  
Shinichiro Uchiyama ◽  
Masako Yamazaki ◽  
Tatsuya Ishikawa ◽  
Koji Yamaguchi ◽  
Takakazu Kawamata
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ischemic Stroke ◽  
Moyamoya Disease ◽  
Bypass Surgery ◽  
Diagnosis And Management ◽  
The World ◽  
Children And Young Adults ◽  
Ischemic Attack ◽  
Revascularization Surgery

Moyamoya disease is an uncommon vascular disease, which causes obstruction and stenosis of arteries of the circle of Willis, and preferentially affects children and young adults. This disease is seen across the world, but is more common in East Asia. It may cause hemorrhagic or ischemic stroke, or transient ischemic attack. If symptoms or cerebral blood flow become worse, revascularization surgery is recommended. We present 2 cases of moyamoya disease who underwent bypass surgery. We also discuss the epidemiology, pathology, genomics, and symptomatology as well as diagnosis, and management of moyamoya disease.

33. Quantitative cerebral blood flow analysis in predicting radiosurgical outcome in cerebral AVM

1996 ◽  
Vol 17 (4) ◽  
pp. 299 ◽  
Author(s):  
R. Kashyap ◽  
M. J. Carroll ◽  
A. H.S. Huneidi ◽  
C. Nimmon ◽  
P. N. Plowman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Analysis ◽  
Blood Flow Analysis
Sign in / Sign up

Export Citation Format

Share Document