Detection of cerebral hypoperfusion during trial carotid occlusion with reversal following extracranial-intracranial bypass prior to permanent occlusion.
The authors describe a patient with a large intracavernous aneurysm of the right internal carotid artery and a marked decrease in focal brain blood flow induced by temporary carotid balloon occlusion. The patient subsequently underwent a superficial temporal to middle cerebral artery bypass followed by successful carotid occlusion using detachable balloons placed proximal to the aneurysm. Postoperative rCBF demonstrated normal perfusion in the region of the right internal carotid artery distribution as well as normalization of perfusion to a previous area of baseline perfusion abnormality. Cerebral brain blood flow imaging was useful in the initial evaluation as well as the management of this patient.
Walker
B S
BS
Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas.
Mathews
D
D
Batjer
H
H
Allen
B C
BC
Purdy
P D
PD
D000368:Aged; D000662:Amphetamines; D001921:Brain / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000502:physiology; D002404:Catheterization; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003097:Collateral Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D007457:Iodine Radioisotopes; D020367:Iofetamine; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D000662:Amphetamines; D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D020367:Iofetamine