Reversal of focal ''misery-perfusion syndrome'' by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography

Journal Article · · Stroke; (United States)

DOI:https://doi.org/10.1161/01.STR.12.4.454· OSTI ID:5346171

Baron, J C; Bousser, M G; Rey, A; Guillard, A; Comar, D; Castaigne, P

Tomographic images of cerebral blood flow (CBF) and oxygen extraction fraction (OEF) using the 15O continuous inhalation technique, and positron emission tomography, were obtained from a patient with cerebral ischemia distal to an occluded left internal carotid artery. There was a focal mismatch between CBF and oxygen metabolism in the brain supplied by the middle cerebral artery where CBF was decreased and OEF increased (''misery-perfusion syndrome'' as opposed to ''luxury-perfusion syndrome''). These abnormalities were most marked in the parieto-occipital watershed area. After left superficial temporal to middle cerebral artery anastomosis, the clinical attacks ceased and a repeat study did not demonstrate the previous CBF and OEF abnormalities. This suggests that this pattern of abnormalities indicates potential viable tissue. The concept of ''misery-perfusion'' may be of some importance in the pathophysiological mechanisms of hemodynamic cerebral ischemia and serve as a rational basis for revascularization procedures.

• Research Organization: Commissariat a l'Energie Atomique, Departement de Biologie, Orsay, France
• OSTI ID: 5346171
• Journal Information: Stroke; (United States), Journal Name: Stroke; (United States) Vol. 12:4; ISSN SJCCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
550900 -- Pathology
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BLOOD FLOW
BLOOD VESSELS
BODY
BRAIN
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CAROTID ARTERIES
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
ELEMENTS
EMISSION COMPUTED TOMOGRAPHY
INHALATION
INTAKE
ISCHEMIA
NERVOUS SYSTEM
NONMETALS
ORGANS
OXYGEN
PATHOLOGICAL CHANGES
POSITRON COMPUTED TOMOGRAPHY
TOMOGRAPHY
VASCULAR DISEASES