title: Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report.
abstract: Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.
authors.affiliation: Serviço de Neurocirurgia, The Neurovascular Group, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. jmarcondes@hucff.ufrj.br
authors.forename: J
authors.initials: J
authors.lastname: Marcondes
authors.forename: A
authors.initials: A
authors.lastname: Aversa
authors.forename: M
authors.initials: M
authors.lastname: Peçanha
authors.forename: F
authors.initials: F
authors.lastname: Domingues
authors.forename: F
authors.initials: F
authors.lastname: Nascimento
authors.forename: C
authors.initials: C
authors.lastname: André
authors.forename: G
authors.initials: G
authors.lastname: Freitas
authors.forename: F
authors.initials: F
authors.lastname: Azevedo
authors.forename: M
authors.initials: M
authors.lastname: Exposito
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D002404:Catheterization; D002544:Cerebral Infarction / Q000517:prevention & control; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications; D015899:Tomography, Emission-Computed, Single-Photon