title: Bilateral flow changes after extracranial-intracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies.
abstract: We report on a symptomatic case in which the whole intracranial blood supply was provided by a single vertebral artery as both internal carotid arteries were occluded and the contralateral vertebral artery was severely hypoplasic. The patient was treated by a flow-augmentation extracranial-intracranial bypass. Preoperative perfusion studies were essential in tailoring surgical strategy. Keypoints of the paper are contralateral perfusion changes after unilateral bypass surgery. The patient experienced a total recovery from symptoms and a bilateral improvement in brain perfusion, probably as consequence of post-operative hemodynamic rearrangement.
authors: a Department of Neurosurgery , University Hospital Zurich , Switzerland.
authors: Giuseppe
authors: G
authors: Esposito
authors: b Institute of Neurosurgery, Catholic University of Rome , Italy.
authors: Giuseppe Maria
authors: GM
authors: Della Pepa
authors: b Institute of Neurosurgery, Catholic University of Rome , Italy.
authors: Giovanni
authors: G
authors: Sabatino
authors: c Institute of Radiology, Catholic University of Rome , Italy.
authors: Simona
authors: S
authors: Gaudino
authors: b Institute of Neurosurgery, Catholic University of Rome , Italy.
authors: Alfredo
authors: A
authors: Puca
authors: b Institute of Neurosurgery, Catholic University of Rome , Italy.
authors: Giulio
authors: G
authors: Maira
authors: b Institute of Neurosurgery, Catholic University of Rome , Italy.
authors: Enrico
authors: E
authors: Marchese
authors: b Institute of Neurosurgery, Catholic University of Rome , Italy.
authors: Alessio
authors: A
authors: Albanese
mesh_terms: D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000503:physiopathology* / Q000601:surgery*; D002536:Cerebral Arteries / Q000503:physiopathology* / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation; D057510:Endovascular Procedures / Q000379:methods*; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome
keywords: DSCE MRI; EC–IC bypass; STA–MCA bypass; bilateral carotid occlusion; cerebral revascularization; stroke