[A study of regional cerebral blood flow before and after superficial temporal artery-to-middle cerebral artery anastomosis].
Regional cerebral blood flow (rCBF), using a single photon emission CT with Xe-133 inhalation method, was measured before and after the operation in 30 patients who underwent a superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis. The purpose of this study is to assess the effect of STA-MCA anastomosis from the standpoint of hemodynamics and the results obtained were as follows: rCBF at rest increased after the operation, which was approximately 10% alterations and was localized in temporal region of operated hemisphere and frontal region of non-operated hemisphere respectively. rCBF during STA compression test after surgery decreased only in temporal region (anastomotic site) of operated hemisphere. This findings might indicate that blood flow via the bypass artery become to provide mainly to the confined area. CO2 reactivity was disturbed in 6 patients before operation, but it restored in 4 patients after operation. Autoregulation was also abolished in 8 patients before operation, but it restored in 6 patients after operation. In the group of severe degree of ischemia, however, autoregulation did not show the tendency to recover after the operation, whereas CO2 reactivity somewhat recovered. Angiographical retrograde filling which indicates collateral circulation reduced or disappeared in 12 out of 14 patients, in which postoperative rCBF in temporal region increased, in addition autoregulation and CO2 reactivity tended to recover after the bypass operation. These data mentioned above probably indicated the influences of CBF increase via the bypass artery. In summary, it might be concluded that the hemodynamic change such as disappearance of collateral circulation seen on angiography, additionally postoperative rCBF increase in anastomotic site seemed to be related to the restoration of these vascular responses such as CO2 reactivity and autoregulation in ischemic brain.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000503:physiopathology / Q000601:surgery*; D002245:Carbon Dioxide; D002533:Cerebral Angiography; D002540:Cerebral Cortex / Q000098:blood supply*; D002548:Cerebral Revascularization; D003097:Collateral Circulation; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006706:Homeostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow
D002245:Carbon Dioxide