Progressive Cortical Neuronal Damage and Extracranial-Intracranial Bypass Surgery in Patients with Misery Perfusion
| Autor: | Hiroshi Yamauchi, Shinya Kagawa, Tatsuya Higashi, Masaaki Takahashi, Yoshihiko Kishibe |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty medicine.drug_class 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Distribution (pharmacology) Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Cerebral Cortex Benzodiazepine medicine.diagnostic_test Cerebral Revascularization business.industry Adult Brain Retrospective cohort study Middle Aged Receptors GABA-A Surgery medicine.anatomical_structure Bypass surgery Flumazenil Cerebral cortex Positron emission tomography Misery perfusion Anesthesia Positron-Emission Tomography Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X |
| Popis: | BACKGROUND AND PURPOSE: Misery perfusion may cause selective neuronal damage in atherosclerotic ICA or MCA disease. Bypass surgery can improve misery perfusion and may prevent neuronal damage. On the other hand, surgery conveys a risk for neuronal damage. The purpose of this retrospective study was to determine whether progression of cortical neuronal damage in surgically treated patients with misery perfusion is larger than that in surgically treated patients without misery perfusion or medically treated patients with misery perfusion. MATERIALS AND METHODS: We evaluated the distribution of benzodiazepine receptors twice by using PET and (11)C-labeled flumazenil in 18 surgically treated patients with atherosclerotic ICA or MCA disease (9 with misery perfusion and 9 without) and no perioperative stroke before and after bypass surgery; in 8 medically treated patients with misery perfusion and no intervening ischemic event; and in 7 healthy controls. We quantified abnormal decreases in the benzodiazepine receptors of the cerebral cortex within the MCA distribution and compared changes in the benzodiazepine receptor index among the 3 groups. RESULTS: The change in the benzodiazepine receptor index in surgically treated patients with misery perfusion (27.5 ± 15.6) during 7 ± 5 months was significantly larger than that in surgically treated patients without misery perfusion (−5.2 ± 9.4) during 6 ± 4 months (P < .001) and in medically treated patients with misery perfusion (3.2 ± 15.4) during 16 ± 6 months (P < .01). CONCLUSIONS: Progression of cortical neuronal damage in surgically treated patients with misery perfusion and no perioperative stroke may occur and may be larger than that in medically treated patients with misery perfusion and no intervening ischemic event. |
| Databáze: | OpenAIRE |
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