| Clinical implications of intraoperative infrared brain surface monitoring during superficial temporal artery-middle cerebral artery anastomosis in patients with moyamoya disease. | |
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MedLine Citation:
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PMID: 19425891 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: Surgical revascularization for moyamoya disease prevents cerebral ischemic attacks by improving cerebral blood flow (CBF). Symptomatic cerebral hyperperfusion is a potential complication of this procedure, but its treatment is contradictory to that for ischemia. Because intraoperative techniques to detect hyperperfusion are still lacking, the authors performed intraoperative infrared monitoring in moyamoya disease using a novel infrared imaging system. METHODS: During superficial temporal artery-middle cerebral artery anastomosis in 25 patients (26 hemispheres) with moyamoya disease, the authors monitored the brain surface temperature intraoperatively with the IRIS-V infrared imaging system. The average gradation value change (indicating temperature change) was calculated using commercial software. Magnetic resonance imaging, MR angiography, and N-isopropyl-p-[(123)I]iodoamphetamine SPECT studies were performed routinely before and within 10 days after surgery. RESULTS: Patency of bypass, detailed local hemodynamics, and changes in cortical surface temperature around the anastomosis site were well recognized by the IRIS-V infrared imaging system in all cases. In the present study, 10 patients suffered transient neurological symptoms accompanied by an increase in CBF around the anastomosis site, recognized as symptomatic hyperperfusion. The increase in temperature was significantly higher in these patients. Intensive blood pressure control was undertaken, and free-radical scavengers were administered. No patient in the present study suffered a permanent neurological deficit. CONCLUSIONS: Although the present method does not directly monitor surface CBF, temperature rise around the anastomosis site during surgery might be an indicator of postoperative hyperperfusion. Prospective evaluation with a larger number of patients is necessary to validate this technique. |
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Authors:
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Atsuhiro Nakagawa; Miki Fujimura; Tatsuhiko Arafune; Ichiro Sakuma; Teiji Tominaga |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 111 ISSN: 1933-0693 ISO Abbreviation: J. Neurosurg. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-02 Completed Date: 2010-01-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 1158-64 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi; and. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anastomosis, Surgical / methods Body Temperature Brain / physiopathology*, radionuclide imaging, surgery* Child Female Humans Infrared Rays / diagnostic use* Male Middle Aged Middle Cerebral Artery / surgery Monitoring, Intraoperative / methods* Moyamoya Disease / diagnosis, physiopathology, surgery* Neurosurgical Procedures / methods Temporal Arteries / surgery Thermography / methods* Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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