| Prediction of cerebral hyperperfusion after carotid endarterectomy using middle cerebral artery signal intensity in preoperative single-slab 3-dimensional time-of-flight magnetic resonance angiography. | |
| | |
MedLine Citation:
|
PMID: 19487885 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Cerebral hyperperfusion after carotid endarterectomy (CEA) occurs in patients with preoperative impairments in cerebral hemodynamics. Signal intensity of the middle cerebral artery (MCA) on single-slab 3-dimensional time-of-flight magnetic resonance angiography (MRA) can assess hemodynamic impairment in the cerebral hemisphere. The purpose of the present study was to determine whether the signal intensity of the MCA on preoperative MRA could identify patients at risk for cerebral hyperperfusion after CEA. METHODS: The signal intensity of the MCA ipsilateral to CEA on preoperative MRA was graded according to the ability to visualize the MCA in 81 patients with ipsilateral internal carotid artery stenosis (>or=70%). Cerebral blood flow was also quantified using single-photon emission computed tomography before and immediately after CEA and on the third postoperative day. RESULTS: Cerebral hyperperfusion immediately after CEA (cerebral blood flow increase >or=100% compared with preoperative values) was observed in 10 patients. Multivariate analysis revealed that only reduced signal intensity of the MCA was significantly associated with the development of postoperative cerebral hyperperfusion (95% confidence interval, 1.015-1.401; P = 0.0319). When the reduced signal intensity of the MCA on MRA was defined as an impairment in cerebral hemodynamics, MRA grading resulted in 100% sensitivity and 63% specificity, with a 28% positive predictive value and a 100% negative predictive value for the development of post-CEA hyperperfusion. Hyperperfusion syndrome developed on the fourth and sixth postoperative days in 2 of the 10 patients who exhibited hyperperfusion immediately after CEA. CONCLUSION: Signal intensity of the MCA, as assessed by this simple MRA method, may identify patients at risk for post-CEA cerebral hyperperfusion. |
| | |
Authors:
|
Hiroki Kuroda; Kuniaki Ogasawara; Ryonoshin Hirooka; Masakazu Kobayashi; Shunro Fujiwara; Kohei Chida; Daiya Ishigaki; Yasunari Otawara; Akira Ogawa |
Related Documents
:
|
1855 - The influence of arm ischaemia and arm hyperaemia on subclavian and vertebral artery bl... 11214015 - Middle cerebral artery circulation during carotid surgery. a transcranial doppler study. 495865 - Continuous oculoplethysmographic monitoring during carotid endarterectomy. 2967755 - Converting enzyme inhibition and the common carotid circulation in older patients with ... 911225 - Cerebral microembolization. i. pathophysiological studies. 19809155 - Three dimensional modelling of interaction between surface and darcy flow regimes throu... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Neurosurgery Volume: 64 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2009 Jun |
Date Detail:
|
Created Date: 2009-06-02 Completed Date: 2009-08-17 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
|
Languages: eng Pagination: 1065-71; discussion 1071-2 Citation Subset: IM |
Affiliation:
|
Department of Neurosurgery, Iwate Medical University, Morioka, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Carotid Stenosis / surgery Cerebrovascular Circulation* Disability Evaluation Endarterectomy, Carotid / adverse effects* Female Humans Inosine Monophosphate / diagnostic use Magnetic Resonance Angiography / methods* Male Middle Aged Middle Cerebral Artery / pathology*, physiopathology, radionuclide imaging* Predictive Value of Tests Preoperative Care Regional Blood Flow / physiology Retrospective Studies Risk Factors Tomography, Emission-Computed, Single-Photon / methods* |
| Chemical | |
Reg. No./Substance:
|
131-99-7/Inosine Monophosphate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Direct imaging of the distal dural ring and paraclinoid internal carotid artery aneurysms with high-...
Next Document: Impact of intraoperative high-field magnetic resonance imaging guidance on glioma surgery: a prospec...