Document Detail

An anatomic mathematical measurement to find an adequate recipient M4 branch for superficial temporal artery to middle cerebral artery bypass surgery.
MedLine Citation:
PMID:  17876234     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: With the recent interest in superficial temporal artery-middle cerebral artery (MCA) bypass for hemodynamic related ischemia, we performed an anatomic study to find the best possible craniotomy site that will allow finding a suitable recipient cortical artery without compromising the use of the best branch and/or segment of the donor's superficial temporal artery branches. METHODS: Anatomic dissection and measurements were performed in 15 injected cadaveric heads to verify the location of an adequate temporal recipient cortical branch of the MCA. The location of the branch was then correlated with surface anatomic landmarks. Mathematical measurements were then derived. RESULTS: A perpendicular line measuring 5 cm in length is drawn starting from a point two-thirds the distance from the lateral canthus to the tragus, and ending at the center of a circle measuring 3 cm in diameter, which is equivalent to the craniotomy size and site. This craniotomy will expose the posterior aspect of the sylvian fissure and exposes no less than two M4 temporal MCA branches. The diameter of at least one branch is larger than 1 mm in 93% of the specimens. These findings were later successfully applied to several bypass operations. CONCLUSION: This study provides an anatomic and patient-independent mathematical measurement as a way to predictably find an adequate recipient temporal M4 branch for superficial temporal artery-MCA bypass in the majority of patients.
Paulo A S Kadri; Ali F Krisht; Gautam K Gandhi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  61     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-18     Completed Date:  2007-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  74-8; discussion 78     Citation Subset:  IM    
Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
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MeSH Terms
Anastomosis, Surgical / methods*
Anthropometry / methods
Computer Simulation
Middle Cerebral Artery / anatomy & histology*,  surgery*
Models, Anatomic*
Neurosurgical Procedures / methods
Surgery, Computer-Assisted / methods*
Temporal Arteries / anatomy & histology*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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