title: Urgent extracranial-intracranial bypass in the treatment of acute hemodynamic ischemic stroke: case report.
abstract: Extracranial-intracranial (EC-IC) bypass surgery is performed to allow flow augmentation in selected cases of occlusive cerebrovascular disease. The majority of EC-IC bypasses are described as an elective procedure in the prevention of hemodynamic ischemic stroke. There is only limited and controversial experience of superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis performed under urgent circumstances as a treatment of acute cerebral ischemia. We describe a unique case of a 75-year-old patient presenting with acute progressive hemodynamic ischemia after carotid endarterectomy (CEA), which developed contralaterally to the performed CEA in the region of chronic internal carotid artery (ICA) occlusion. Urgent performance of a standard STA-MCA bypass rapidly improved the cerebral hemodynamic and had an excellent therapeutic effect. The patient had recovered completely within 4 weeks of surgery. The role of urgent EC-IC bypass for stroke treatment is discussed.
authors: Department of Neurosurgery, University Hospital Pilsen, The Faculty of Medicine in Pilsen, Charles University in Prague, Czech Republic. mracek@fnplzen.cz
authors: Jan
authors: J
authors: Mracek
authors: Jan
authors: J
authors: Mork
authors: David
authors: D
authors: Stepanek
authors: Irena
authors: I
authors: Holeckova
authors: Jolana
authors: J
authors: Hommerova
authors: Jiri
authors: J
authors: Ferda
authors: Vladimir
authors: V
authors: Priban
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000628:therapy*; D016893:Carotid Stenosis / Q000601:surgery; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology; D004569:Electroencephalography; D016894:Endarterectomy, Carotid; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D020768:Middle Cerebral Artery / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D020521:Stroke / Q000628:therapy*; D013699:Temporal Arteries / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome