title: Changes in computed tomography perfusion parameters after superficial temporal artery to middle cerebral artery bypass: an analysis of 29 cases.
abstract: Introduction Analysis of computed tomography perfusion (CTP) studies before and after superficial temporal artery to middle cerebral artery (STA-MCA) bypass is warranted to better understand cerebral steno-occlusive pathology. Methods Retrospective review was performed of STA-MCA bypass patients with steno-occlusive disease with CTP before and after surgery. CTP parameters were evaluated for change after STA-MCA bypass. Results A total of 29 hemispheres were bypassed in 23 patients. After STA-MCA bypass, mean transit time (MTT) and time to peak (TTP) improved. When analyzed as a ratio to the contralateral hemisphere, MTT, TTP, and cerebral blood flow (CBF) improved. There was no effect of gender, double vessel versus single vessel bypass, or time until postoperative CTP study to changes in CTP parameters after bypass. Conclusions Blood flow augmentation after STA-MCA bypass may best be assessed by CTP using baseline MTT or TTP and ratios of MTT, TTP, or CBF to the contralateral hemisphere. The failure of cerebrovascular reserve to improve after cerebral bypass may indicate irreversible loss of autoregulation with chronic cerebral vasodilation or the inability of CTP to detect these improvements.
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Serrone
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States.
authors.forename: Lincoln
authors.initials: L
authors.lastname: Jimenez
authors.affiliation: Department of Surgery, Division of Trauma/Critical Care, University of Cincinnati, Cincinnati, Ohio, United States.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Hanseman
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Carroll
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States ; Comprehensive Stroke Center at the UC Neuroscience Institute, Cincinnati, Ohio, United States.
authors.forename: Aaron W
authors.initials: AW
authors.lastname: Grossman
authors.affiliation: Department Radiology, University of Cincinnati, Ohio, United States.
authors.forename: Lily
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department Radiology, University of Cincinnati, Ohio, United States.
authors.forename: Achala
authors.initials: A
authors.lastname: Vagal
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Choutka
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States ; Comprehensive Stroke Center at the UC Neuroscience Institute, Cincinnati, Ohio, United States ; Mayfield Clinic, Cincinnati, Ohio, United States.
authors.forename: Norberto
authors.initials: N
authors.lastname: Andaluz
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States ; Comprehensive Stroke Center at the UC Neuroscience Institute, Cincinnati, Ohio, United States ; Mayfield Clinic, Cincinnati, Ohio, United States.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Ringer
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States ; Comprehensive Stroke Center at the UC Neuroscience Institute, Cincinnati, Ohio, United States ; Department Radiology, University of Cincinnati, Ohio, United States ; Mayfield Clinic, Cincinnati, Ohio, United States.
authors.forename: Todd
authors.initials: T
authors.lastname: Abruzzo
authors.affiliation: Departments of Neurosurgery, UC College of Medicine, Cincinnati, Ohio, United States ; Comprehensive Stroke Center at the UC Neuroscience Institute, Cincinnati, Ohio, United States ; Mayfield Clinic, Cincinnati, Ohio, United States.
authors.forename: Mario
authors.initials: M
authors.lastname: Zuccarello
keywords: Moyamoya; cerebral bypass; computed tomography; perfusion