Superficial temporal‐middle cerebral artery anastomosis

Abstract

In 44 patients, we studied the effects of superficial temporal-middle cerebral artery anastomosis on cerebral blood flow (CBF), neurologic examination, and cognitive functions. At 3 months, there was significant improvement in all variables. At 9 months, CBF was no longer significantly greater, but neurologic examination and cognitive functions had further improved. Patients with TIA had significant postoperative decreases in TIA frequency and did not progress to stroke, but had no significant changes in any variable. In stroke patients, we could not separate the effects of surgery from the natural evolution of changes in CBF and examination after stroke. None of the preoperative measurements predicted postoperative clinical improvement.

Cognitive disorders in patients with occlusive disease of the carotid artery: a systematic review of the literature

“…In one study ischemic episodes were labeled as TIAs, while neurological deficits were reported to continue for 4 weeks and longer [7]; in the present survey we considered these episodes as strokes. Five of the nine studies describing stroke patients included patients with minor strokes [8,9,19,28,29]. One study described both minor (25 %) and major (15 %) stroke patients [27], and three did not provide information on the severity of stroke [1,7,21].…”

“…One study described both minor (25 %) and major (15 %) stroke patients [27], and three did not provide information on the severity of stroke [1,7,21]. Two studies (11 %) included only patients with cerebral symptoms [19,29], four (22 %) included both patients with cerebral and ocular symptoms [1,7,10,28], and ten (56 %) presented no information regarding the location of symptoms [4, 8, 9, 11-13, 18, 21, 25, 27]. The number of ischemic episodes and the time interval between the latest ischemic episode and psychological assessment were mentioned in a minority of papers (22 % and 33 %, respectively); the number of episodes varied between 1 and at least 50 [9,10,18,29], and the interval varied between 3 days and at least 4 months [9,10,18,19,28,29].…”

“…Two studies (11 %) included only patients with cerebral symptoms [19,29], four (22 %) included both patients with cerebral and ocular symptoms [1,7,10,28], and ten (56 %) presented no information regarding the location of symptoms [4, 8, 9, 11-13, 18, 21, 25, 27]. The number of ischemic episodes and the time interval between the latest ischemic episode and psychological assessment were mentioned in a minority of papers (22 % and 33 %, respectively); the number of episodes varied between 1 and at least 50 [9,10,18,29], and the interval varied between 3 days and at least 4 months [9,10,18,19,28,29]. In one study the mean degree of stenosis was 59 % [3], in five the degree of stenosis was at least 70 % [1,11,12,17,28], in one at least 60 % [13], and in another at least 50 % [8].…”

“…In one study the mean degree of stenosis was 59 % [3], in five the degree of stenosis was at least 70 % [1,11,12,17,28], in one at least 60 % [13], and in another at least 50 % [8]. The remaining papers (56 %) did not mention the degree of stenosis [4,7,9,10,18,19,21,25,27,29]. Nine studies (50 %) included patients with bilateral carotid obstruction.…”

Rapid reversal of cognitive deficits with high-flow extracranial – Intracranial bypass in cerebral misery perfusion syndrome

“…Hence it was impossible to conduct subgroup analyses in patients with radiologically confirmed CMP [15,16]. Improvement in cognition after EC-IC bypass surgery has been reported by some [12] but not by others [17,18].…”