Neurological improvement in chronic ischemic stroke following surgical brain revascularization.
50 patients suffering from completed ischemic stroke in the carotid territory for at least two months (17 mild, 31 moderate, 2 severe strokes) underwent extra-intracranial arterial bypass surgery. Neurological improvement was obtained in 43 cases; it persisted in time in 40 cases. Quantitative evaluation of motor performance in 21 patients showed that the degree of improvement was highly significant. Several factors strongly indicate a causal relation between surgical revascularization and neurological restoration. The positive surgical result is strictly dependent on correct patient selection and, in particular: i) on the documentation of local hemodynamic insufficiency; ii) on the occurrence of transient neurological (and to a certain extent EEG) improvement following hyperbaric oxygenation. The latter can also provide reliable information on the minimum degree of improvement to be expected from surgery.
Rossi
G F
GF
Istituto di Neurochirurgia, Università Cattolica, Roma.
Maira
G
G
Vignati
A
A
Puca
A
A
D000293:Adolescent; D000328:Adult; D002548:Cerebral Revascularization; D002561:Cerebrovascular Disorders / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000628:therapy