| Prevention of secondary ischemic events by superficial temporal artery-middle cerebral artery bypass surgery after tuberculosis-induced vasculopathy in a 5-year-old child. | |
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MedLine Citation:
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PMID: 20593990 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Tuberculosis-related vasculopathy and resulting ischemic events are a common finding after tuberculous meningitis (TBM) in children. The authors report on a case of recurring ischemic episodes that were refractory to repetitive endovascular procedures (transluminal angioplasty, stent insertion, in-stent vessel dilation). After failure of endovascular treatment, extracranial-intracranial (EC-IC) bypass surgery was performed to prevent further ischemia. This 5-year-old girl presented with a series of ischemic events in the left middle cerebral artery (MCA) territory 12 months after her presentation with TBM. Angiography studies showed a 50% lumen reduction of the left MCA. After failure of antithrombocyte aggregation and repeated endovascular procedures to prevent new ischemia, EC-IC bypass surgery was performed. The left superficial temporal artery-MCA bypass was found to be capable of preventing new ischemic events in the 21-month follow-up period, despite a near-total MCA occlusion on follow-up conventional and MR angiography studies. Bypass surgery seems to be a reliable tool to augment cerebral blood flow in tuberculosis-related stenoocclusive changes of cerebral vasculature after the failure of endovascular procedures. |
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Authors:
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Martin Misch; Ulrich-Wilhelm Thomale; Rolf Keitzer; Peter Vajkoczy |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of neurosurgery. Pediatrics Volume: 6 ISSN: 1933-0715 ISO Abbreviation: J Neurosurg Pediatr Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-02 Completed Date: 2010-07-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101463759 Medline TA: J Neurosurg Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 69-72 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Charité Campus Virchow, Medical University of Berlin, Berlin, Germany. martin.misch@charite.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Balloon Antitubercular Agents / therapeutic use* Brain Ischemia / diagnosis, etiology, prevention & control* Cerebral Angiography Cerebral Revascularization* Child, Preschool Combined Modality Therapy Cooperative Behavior Female Humans Infarction, Middle Cerebral Artery / diagnosis, prevention & control Interdisciplinary Communication Magnetic Resonance Angiography Magnetic Resonance Imaging Patient Care Team Platelet Aggregation Inhibitors / therapeutic use Postoperative Complications / diagnosis, etiology, prevention & control* Recurrence / prevention & control Stents Tuberculoma, Intracranial / drug therapy, surgery* Tuberculosis, Meningeal / surgery* Ventriculoperitoneal Shunt* |
| Chemical | |
Reg. No./Substance:
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0/Antitubercular Agents; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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