title: Factors associated with delayed intracerebral hemorrhage after superficial temporal artery-middle cerebral artery bypass in steno-occlusive cerebrovascular diseases.
abstract: BACKGROUND
  Intra-cerebral hemorrhage (ICH) is a devastating complication that can result from superficial temporal artery-middle cerebral artery (STA-MCA) bypass in patients undergoing treatment for steno-occlusive cerebrovascular disease (CVD). There is a clinical need to find the possible risk factors to prevent ICH, as it is a significant cause of mortality and morbidity. The aim of the study was to investigate the factors associated with delayed ICH after STA-MCA bypass in patients with steno-occlusive CVDs.
  
  
  METHODS
  We retrospectively analyzed the records of 163 patients seen from 2002 to 2011 with STA-MCA bypass for steno-occlusive cerebrovascular diseases at the Department of Neurosurgery, Xuan Wu Hospital, Beijing. Demographic and clinical data, including age, gender, vascular risk factors, preoperative syndrome, preoperative National Institutes of Health Stroke Scale (NIHSS), ipsilateral ischemic lesions, classification of steno-occlusive CVDs, donor branches of STA, graft patency, postoperative hypertension, and postoperative-increased MCA velocity were recorded and analyzed. Binary Logistic regression served to identify factors associated with delayed ICH after STA-MCA bypass.
  
  
  RESULTS
  We identified 8 (4.9%) patients with delayed ICH after STA-MCA bypass. Patients with hypertension, preoperative stroke, ipsilateral ischemic lesions, postoperative hypertension and postoperative-increased MCA velocity were significantly more prone to experiencing delayed ICH after STA-MCA bypass. Logistic regression analysis shows ipsilateral ischemic lesions, postoperative hypertension, and postoperative-increased MCA velocity remained independent predictors for delayed ICH after STA-MCA bypass.
  
  
  CONCLUSIONS
  Despite the varied associated factors in patients with steno-occlusive CVDs, ipsilateral ischemic lesions, postoperative hypertension, and postoperative-increased MCA velocity could be associated with delayed ICH after STAMCA bypass.
authors.affiliation: Department of Neurosurgery, General Hospital of People's Liberation Army, Medical School of Chinese People's Liberation Army, Beijing 100853, China.
authors.forename: Zhiqi
authors.initials: Z
authors.lastname: Mao
authors.affiliation: Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Wayne State University, School of Medicine, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, General Hospital of People's Liberation Army, Medical School of Chinese People's Liberation Army, Beijing 100853, China. Email xinguanyu@gmail.com.
authors.forename: Xinguang
authors.initials: X
authors.lastname: Yu
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002548:Cerebral Revascularization; D005260:Female; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013699:Temporal Arteries / Q000601:surgery*