Redistribution of cerebral blood flow following STA-MCA by-pass in patients with hemispheric ischemia

Journal Article · · Stroke; (United States)

DOI:https://doi.org/10.1161/01.STR.13.6.774· OSTI ID:6186122

Meyer, J S; Nakajima, S; Okabe, T; Amano, T; Centeno, R; Len, Y Y; Levine, J; Levinthal, R; Rose, J

Regional cerebral blood flow and vasomotor reactivity were measured in 33 patients with surgically remediable hemispheric ischemia by the /sup 133/Xe inhalation method prior to superficial temporal to middle cerebral artery (STA-MCA) by-pass. Thirteen patients also underwent LCBF and L lambda measurements by the stable xenon CT method for comparison. Twenty-four had proximal occlusion of one or both internal carotid arteries, 9 had intracranial occlusive disease. Measurements were repeated at intervals up to 30 months following surgery and compared to measurements in a similar group treated medically. In the surgically treated group 22 patients had recurrent TIAs, of whom 12 also had minor residual neurological deficits from recent small cerebral infarctions with potential for recovery while the remaining 11 had RINDs without TIAs. After surgery 28 improved with cessation of TIAs and/or neurological recovery, 3 remained unchanged, 2 cases worsened. Compared to age-matched normal hemispheric F1 values, pre-operative F1 values in the STA-MCA group were reduced in both ischemic and opposite hemispheres. Ischemic regions showed imparied vasomotor reactivity to 5% CO/sub 2/ or 100% O/sub 2/ inhalation. After surgery, mean hemispheric F1 values increased + 12.8% on the by-pass side and + 10.5% on the contralateral side. Mean F1 increases reached a maximum 3 months after by-pass, most evident in ipsilateral frontal region. Vasomotor reactivity did not significantly improve. Medically treated cases did not show similar F1 increases. Thirteen with carotid occlusive disease underwent CT LCBF and L lambda measurements before and after STA-MCA by-pass. Cases with recent infarcts showed reduced LCBF and L lambda values which increased significantly after STA-MCA by-pass, however the total group operated upon showed only trends for CBF increases, probably due to large standard deviations encountered in serial measurements.

• Research Organization: Cerebrovascular Research Laboratory, VA Medical Center, Houston
• OSTI ID: 6186122
• Journal Information: Stroke; (United States), Journal Name: Stroke; (United States) Vol. 13:6; ISSN SJCCA
• Country of Publication: United States
• Language: English

Related Subjects

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD FLOW
BLOOD VESSELS
BODY
BRAIN
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CAROTID ARTERIES
CENTRAL NERVOUS SYSTEM
CEREBRUM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISEASES
EVEN-ODD NUCLEI
INHALATION
INTAKE
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NERVOUS SYSTEM
NUCLEI
ORGANS
PATHOLOGY
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SURGERY
USES
VASCULAR DISEASES
XENON 133
XENON ISOTOPES