Cerebral hyperperfusion syndrome after extra-intracranial microanastomosis in patients with chronic occlusion of the internal carotid artery of atherosclerotic genesis
Abstract
INTRODUCTION. Cerebral hyperperfusion syndrome (CHS) is considered to be a complication of neurosurgical brain revascularization and reconstruction procedures on extracerebral arteries, resulting from increase in blood inflow to the brain exceeding metabolic demands.
OBJECTIVE: Evaluate incidence and describe clinical manifestations of the cerebral hyperperfusion syndrome following extra-intracranial bypass (ECIC bypass) surgery in patients with atherosclerotic occlusion of internal carotid artery, identify probable contributory factors for development of CHS.
RESULTS: In the studied cohort CHS was observed in 32 (23.36%) cases. The most frequent CHS symptoms observed were mental disorders and focal neurological deficitis (according to 19 records, accounting to 59.38% of CHS cases).
Statistically significant differences were demonstrated in patients with cerebral hyperperfusion syndrome concerning absolute mean transit time (MTT) value on the side of occlusion as well as its interhemispheric asymmetry, according to preoperative CT perfusion, in comparison with patients without CHS.
Based on obtained data mathematical model for calculation the probability of development of CHS was established.
About the Authors
A. V. Kokshin
Kazan Stae Medical University
Russian Federation
Russian Federation
Kazan
A. M. Nemirovskiy
Kazan Stae Medical University ; Interregional Clinical Diagnostic Center (ICDC)
Russian Federation
Russian Federation
Kazan
G. V. Danilov
N. N. Burdenko National Medical Research Center for Neurosurgery of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Moscow
V. I. Danilov
Kazan Stae Medical University ; Interregional Clinical Diagnostic Center (ICDC)
Russian Federation
Russian Federation
Kazan
Т. A. Nemirovskaya
Interregional Clinical Diagnostic Center (ICDC)
Russian Federation
Russian Federation
Kazan
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For citations:
Kokshin A.V., Nemirovskiy A.M., Danilov G.V., Danilov V.I., Nemirovskaya Т.A. Cerebral hyperperfusion syndrome after extra-intracranial microanastomosis in patients with chronic occlusion of the internal carotid artery of atherosclerotic genesis. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2019;11(1):35-41. (In Russ.)
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