[Extra-intracranial arterial bypass for treatment of patient with clinical refractory cerebral ischemia].
The extra-intracranial bypass may be used in selected cases of brain vascular insufficiency refractory to clinical treatment. We report a case of encephalic ischemia in the territory of the right middle cerebral artery due to occlusion of the ipsilateral internal carotid artery, with consequent reduction of the perfusion and vascular reserve in the parietal and frontal regions. Despite the clinical treatment, motor deficit improvement was directly related to the maintenance of high systemic arterial tension levels due to the use of vasopressor agent. After lateral-terminal extra-intracranial bypass between the superficial temporal and right middle cerebral artery, there was significant improvement of cerebral perfusion with remission of the motor deficit.
Falavigna
Asdrubal
A
Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil. asdrubal@doctor.com
Ferraz
Fernando Antonio Patriani
FA
Breunig
Juliano de Avelar
Jde A
Michelin
Marja Mandelli
MM
D000714:Anastomosis, Surgical; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal; D002533:Cerebral Angiography / Q000379:methods; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed