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https://www.readbyqxmd.com/read/29449517/-a-case-of-moyamoya-disease-with-postoperative-cerebral-hyperperfusion-syndrome-followed-by-cerebral-infarction-due-to-watershed-shift
#1
Kimitoshi Sato, Shun Tsudaka, Takanori Miki, Norikata Kobayashi, Taro Yamashita, Kiyoharu Imataka, Takashi Yoshida, Fuminori Shimizu
The concept of "watershed shift"(WS)has been proposed as a cause of the ischemic complications following a superficial temporal artery-middle cerebral artery(STA-MCA)bypass operation performed for the management of moyamoya disease. Previous reports have observed that only 1.2-5.7% of the patients who underwent a bypass operation for the management of moyamoya disease developed cerebral infarction secondary to the WS phenomenon. To date, the WS phenomenon has not been objectively proven on imaging studies...
February 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29449516/-a-case-of-a-ruptured-cerebral-aneurysm-associated-with-microscopic-polyangiitis
#2
Toshihide Takahashi, Wataru Katayama, Yuji Kujiraoka, Tetsuya Yamamoto, Akira Matsumura
CASE: A 71-year-old woman was receiving dialysis for microscopic polyangiitis(MPA). She was transported to the emergency room after developing a headache and losing consciousness. She was in a coma and had dense left paralysis. Head computed tomography(CT)showed a subarachnoid hemorrhage. Head three-dimensional CT angiography showed an aneurysm proximal to the right M2(inferior trunk), which was considered as the source of bleeding. We performed an emergency aneurysm clipping surgery...
February 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29444270/a2-anterior-cerebral-artery-to-a3-anterior-cerebral-artery-interpositional-bypass-with-radial-artery-graft-for-a-ruptured-mycotic-fusiform-aneurysm-2-dimensional-operative-video
#3
Jan-Karl Burkhardt, Ethan Winkler, Halima Tabani, Sirin Gandhi, Arnau Benet, Michael T Lawton
No abstract text is available yet for this article.
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29435269/current-understanding-of-chronic-total-occlusion-of-the-internal-carotid-artery
#4
Baofeng Xu, Chao Li, Yunbao Guo, Kan Xu, Yi Yang, Jinlu Yu
At present, there is limited understanding of chronic total occlusion (CTO) of the internal carotid artery (ICA). Therefore, the present report collected related cases from PubMed and reviewed the literature. Cerebral vessels may form collateral circulation immediately or gradually following CTO of the ICA. The natural history of CTO of the ICA includes a variety of outcomes, all of which are biased toward a non-benign progressive process and are characterized by insufficient cerebral perfusion, embolus detachment and cognitive dysfunction...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29434769/protective-effect-of-n-acetylcysteine-activated-carbon-release-microcapsule-on-myocardial-ischemia-reperfusion-injury-in-rats
#5
Zhaobin Cai, Tingting Shi, Rangxiao Zhuang, Hongying Fang, Xiaojie Jiang, Yidan Shao, Hongping Zhou
With the development of science and technology, and development of artery bypass, methods such as cardiopulmonary cerebral resuscitation have been practiced in recent years. Despite this, some methods fail to promote or recover the function of tissues and organs, and in some cases, may aggravate dysfunction and structural damage to tissues. The latter is typical of ischemia-reperfusion (IR) injury. Lipid peroxidation mediated by free radicals is an important process of myocardial IR injury. Myocardial IR has been demonstrated to induce the formation of large numbers of free radicals in rats, which promotes the peroxidation of lipids within unsaturated fatty acids in the myocardial cell membrane...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29432378/low-perfusion-pressure-is-associated-with-renal-tubular-injury-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-secondary-analysis-of-an-observational-study
#6
Mirela Bojan, Maria C Basto Duarte, Vanessa Lopez, Laurent Tourneur, Stephanie Vicca, Marc Froissart
BACKGROUND: Earlier work on adults undergoing surgery with cardiopulmonary bypass suggests that there is a close relationship between the lower limit of the cerebral and renal autoregulation pressures. Although cerebral autoregulation during bypass in infants has been extensively investigated, the impact of bypass on kidney function is not well known. It is, nevertheless, acknowledged that the main pathophysiological process involved in cardiac surgery-related kidney damage is tubular injury, and that urine neutrophil gelatinase-associated lipocaline (uNGAL) is a reliable biomarker of injury...
February 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29431856/cerebral-embolization-silent-cerebral-infarction-and-neurocognitive-decline-after-thoracic-endovascular-aortic-repair
#7
A H Perera, N Rudarakanchana, L Monzon, C D Bicknell, B Modarai, O Kirmi, T Athanasiou, M Hamady, R G Gibbs
BACKGROUND: Silent cerebral infarction is brain injury detected incidentally on imaging; it can be associated with cognitive decline and future stroke. This study investigated cerebral embolization, silent cerebral infarction and neurocognitive decline following thoracic endovascular aortic repair (TEVAR). METHODS: Patients undergoing elective or emergency TEVAR at Imperial College Healthcare NHS Trust and Guy's and St Thomas' NHS Foundation Trust between January 2012 and April 2015 were recruited...
February 12, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29425519/an-adverse-event-analysis-inadvertent-exsanguination-following-left-ventricular-assist-device-implantation-in-a-child
#8
REVIEW
Alex Robertson, Tain-Yen Hsia
Neurologic deficit subsequent to cardiac surgery remains a cause of postoperative morbidity and mortality. Although myriad risk factors for postoperative cognitive decline have been identified, their individual influence remains undefined. Although less emphasis is now placed on the heart lung machine as the major source of postoperative cognitive decline, the conduct of cardiopulmonary bypass and, in particular, the management of the bypass circuit remain key to patient safety. We present a case of inadvertent intraoperative exsanguination of a patient following open heart surgery for implantation of a left ventricular assist device...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29415505/in-vivo-evaluation-of-cerebral-hemodynamics-and-tissue-morphology-in-rats-during-changing-fraction-of-inspired-oxygen-based-on-spectrocolorimetric-imaging-technique
#9
Afrina Mustari, Takuya Kanie, Satoko Kawauchi, Shunichi Sato, Manabu Sato, Yasuaki Kokubo, Izumi Nishidate
During surgical treatment for cerebrovascular diseases, cortical hemodynamics are often controlled by bypass graft surgery, temporary occlusion of arteries, and surgical removal of veins. Since the brain is vulnerable to hypoxemia and ischemia, interruption of cerebral blood flow reduces the oxygen supply to tissues and induces irreversible damage to cells and tissues. Monitoring of cerebral hemodynamics and alteration of cellular structure during neurosurgery is thus crucial. Sequential recordings of red-green-blue (RGB) images of in vivo exposed rat brains were made during hyperoxia, normoxia, hypoxia, and anoxia...
February 6, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29415372/one-stage-replacement-of-the-aorta-from-arch-to-thoracoabdominal-region
#10
Takashi Matsueda, Yuki Ikeno, Koki Yokawa, Yojiro Koda, Soichiro Henmi, Takeshi Inoue, Hiroshi Tanaka, Yutaka Okita
OBJECTIVES: We present our experience with one-stage replacement of thoracic aneurysm from the ascending aorta to the thoracoabdominal aorta. PATIENTS AND METHODS: Fourteen patients (10 male and 4 female; mean age 53.6 ± 12.4 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was chronic aortic dissection in 13 patients and intraoperative retrograde aortic dissection in 1 patient. Five patients had Marfan syndrome...
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29398374/association-between-optic-nerve-head-blood-flow-measured-using-laser-speckle-flowgraphy-and-radial-arterial-pressure-during-aortic-arch-surgery
#11
Hironobu Hayashi, Masahiro Okamoto, Hideaki Kawanishi, Nobuoki Tabayashi, Toyoaki Matsuura, Shigeki Taniguchi, Masahiko Kawaguchi
OBJECTIVE: This study was designed to investigate the association between ocular blood flow measured using laser speckle flowgraphy (LSFG) and radial arterial pressure during aortic arch surgery. DESIGN: A prospective study. SETTING: A single university hospital. PARTICIPANTS: This study included 24 patients undergoing aortic arch surgery with cardiopulmonary bypass (CPB) using antegrade selective cerebral perfusion (SCP)...
August 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29397930/fontan-failure-and-death-in-contemporary-fontan-circulation-analysis-from-the-last-two-decades
#12
Yasuhiro Kotani, Devin Chetan, Jiaquan Zhu, Arezou Saedi, Lisa Zhao, Luc Mertens, Andrew N Redington, John Coles, Christopher A Caldarone, Glen S Van Arsdell, Osami Honjo
BACKGROUND: We sought to evaluate the incidence of Fontan failure or complication and its relation to death in patients having contemporary Fontan strategies over 2 decades. METHODS: Five hundred patients who underwent Fontan completion (extracardiac, n = 326; lateral tunnel, n = 174) from 1985 to 2012 were reviewed. Patient characteristics, modes of Fontan failure/complication and death, and predictors for Fontan failure/complication and death were analyzed. RESULTS: There were 23 early deaths (4...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29383984/preoperatively-reduced-cerebrovascular-contractile-reactivity-to-hypocapnia-by-hyperventilation-is-associated-with-cerebral-hyperperfusion-syndrome-after-arterial-bypass-surgery-for-adult-patients-with-cerebral-misery-perfusion-due-to-ischemic-moyamoya-disease
#13
Shinpei Sato, Daigo Kojima, Yasuyoshi Shimada, Jun Yoshida, Kentaro Fujimato, Shunrou Fujiwara, Masakazu Kobayashi, Yoshitaka Kubo, Kenji Yoshida, Kazunori Terasaki, Shouta Tsutsui, Kenya Miyoshi, Kuniaki Ogasawara
The present study examined whether preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with development of cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease. Among 65 adult patients with ischemic moyamoya disease, 19 had misery perfusion in the precentral region on preoperative 15O positron emission tomography and underwent arterial bypass surgery for that region...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29380669/cerebral-blood-flow-measured-by-positron-emission-tomography-during-normothermic-cardiopulmonary-bypass-an-experimental-porcine-study
#14
Sisse Anette Thomassen, Benedict Kjærgaard, Aage Kristian Olsen Alstrup, Ole Lajord Munk, Jørgen Frøkiær, Anders Larsson, Bodil Steen Rasmussen
BACKGROUND: Mean arterial blood pressure (MAP) and/or pump flow during normothermic cardiopulmonary bypass (CPB) are the most important factors of cerebral perfusion. The aim of this study was to explore the influence of CPB blood flow on cerebral blood flow (CBF) measured by dynamic positron emission tomography (PET) using 15O-labelled water with no pharmacological interventions to maintain the MAP. METHODS: Eight pigs (69-71 kg) were connected to normothermic CPB...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29380063/intraoperative-monitoring-of-cerebral-cortical-blood-flow-and-middle-cerebral-artery-pressure-as-a-substitute-for-preoperative-balloon-test-occlusion-in-patients-with-internal-carotid-artery-aneurysms
#15
Yoshitaka Kubo, Takahiro Koji, Ryushi Kondo, Kenji Yoshida, Kuniaki Ogasawara
BACKGROUND: Balloon test occlusion (BTO) is a useful examination to evaluate the indications and methods for revascularization when treating unclippable internal carotid artery (ICA) aneurysms by parent artery occlusion. The purpose of the present study was to investigate the relationship between intraoperative monitoring of cerebral cortical blood flow (CoBF) and middle cerebral artery (MCA) pressure during surgical parent artery occlusion and the findings of BTO. METHODS: Eleven patients with an ICA aneurysm in the cavernous portion underwent preoperative BTO with brain perfusion single-photon emission tomography...
January 29, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29376064/evaluation-of-revascularization-after-total-arch-replacement-in-common-carotid-artery-occlusion
#16
Yasuhiro Matsuda, Tadaaki Koyama
Occlusion of the common carotid artery (CCA) is rare. CCA occlusion (CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography (SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow...
January 16, 2018: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29371165/occipital-artery-to-middle-cerebral-artery-bypass-in-cases-of-unavailable-superficial-temporal-artery
#17
Tsukasa Hirano, Takeshi Mikami, Hime Suzuki, Toru Hirano, Yusuke Kimura, Katusya Komatsu, Yukinori Akiyama, Masahiko Wanibuchi, Nobuhiro Mikuni
In neurosurgery, extracranial-to-intracranial (EC-IC) bypass surgery is necessary for patients who have undergone surgery in which the superficial temporal artery (STA) was already used for a different bypass procedure or was damaged. Here, we report our experience with EC-IC bypass using the occipital artery (OA) in cases in which the STA is unavailable, and discuss the technical considerations and pitfalls. Five patients with ischemic-onset moyamoya disease and atherosclerotic disease were included. Two patterns of skin incisions were planned according to the OA pathway and recipient artery location...
January 22, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29366994/coloring-technique-of-magnetic-resonance-angiography-for-superficial-temporal-artery-to-middle-cerebral-artery-bypass-surgery
#18
Toshiyuki Okazaki, Shinsuke Irie, Toru Inagaki, Osamu Saito, Motoshige Yamashina, Hitoshi Hyase, Hiroshi Nakagawa, Shinji Nagahiro, Koji Saito
Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass is an established surgical technique for achieving revascularization. It is important to select the proper recipient artery of MCA. 3D-CTA and conventional angiography are useful in the selection process but need contrast agents. The authors designed the coloring MRA technique that needed no agents to visualize the recipient artery. Retrospective evaluation of the efficacy and limitation for selection of the recipient artery and decision of the place and size of the craniotomy were carried out...
January 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29366619/encephaloduroateriosynangiosis-versus-conservative-treatment-for-patients-with-moyamoya-disease-at-late-suzuki-stage
#19
Peicong Ge, Xun Ye, Qian Zhang, Dong Zhang, Shuo Wang, Jizong Zhao
The purpose of this study is to investigate the long-term outcomes after conservative and encephaloduroateriosynangiosis procedures for patients with moyamoya disease at late Suzuki stage. We retrospectively reviewed 64 patients (128 hemispheres) with moyamoya disease at late Suzuki Stage at Beijing Tiantan Hospital. Clinical features, radiologic findings, and outcomes were analyzed. The mean age at diagnosis was 29.0 ± 14.9 years. The distribution of the initial Suzuki stage of MMD was as follows: stage 4, n = 75; stage 5, n = 46; stage 6, n = 7, PCA involvement was observed in 4 (37...
January 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29362282/-a-ruptured-middle-cerebral-artery-dissecting-aneurysm-operation-in-a-2-year-old-boy
#20
Shigeru Oya, Issei Kiko, Kenichiro Suyama, Takanori Suzuki, Kuniatsu Yamamoto, Hidetoshi Mochida, Saburo Watanabe, Hideharu Karasawa
We report the case of a ruptured dissecting aneurysm in an infant. A 2-year-old boy suffered sudden headache and nausea. CT scan revealed a subarachnoid hemorrhage, and digital subtraction angiography(DSA)revealed a dissecting aneurysm(3.9mm)at a branch of the right middle cerebral artery(MCA). Eight days after onset, carotid angiography revealed enlargement of the aneurysm(up to 6.8 mm). Right frontotemporal craniotomy and aneurysm trapping with STA-MCA bypass was performed. Two years and two months later, the aneurysm recurred as assessed by magnetic resonance angiography(MRA)...
January 2018: No Shinkei Geka. Neurological Surgery
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