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Assessment of Transient Cerebral Hemodynamic Disturbance via Whole-Brain Computed Tomography Perfusion After Extracranial-Intracranial Bypass in Ischemic Moyamoya Disease.
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- Additional Information
- Source:
Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
- Publication Information:
Original Publication: New York : Elsevier
- Subject Terms:
- Abstract:
Objective: To assess the cerebral hemodynamic data associated with transient cerebral hemodynamic disturbance (TCHD), including cerebral hyperperfusion syndrome (CHS) and watershed shift ischemia (WSI), by whole-brain (WB) computed tomography perfusion (CTP) before and after revascularization for ischemic moyamoya disease.
Methods: A total of 115 consecutive patients with ischemic moyamoya disease underwent revascularization. All patients underwent WB-CTP 24 hours before operation and on the day of onset of TCHD and 6 months after revascularization. The volumes of delay time (DT) >3 seconds and mismatch and relative cerebral blood flow <30% were calculated in 3 time points.
Results: Of the 115 patients, 18 115 had TCHD, comprising 10 with CHS and 8 with WSI. Compared with the brain volume of DT >3 seconds before revascularization, the volume decreased significantly (P < 0.05) on the day of CHS. The volume of mismatch in 3 time points indicated no significant differences (P > 0.05). The volume of relative cerebral blood flow <30% showed obvious differences of significance among 10 patients with CHS (P < 0.05) at 3 time points. In the WSI group, the volume of DT >3 seconds, mismatch, and DT >3 seconds showed significant differences, relatively (P < 0.05), at 3 time points. At the time of onset of TCHD, DT >3 seconds and mismatch in the CHS group were dramatically lower than those in the WSI group (P < 0.05). DT >3 seconds in the no-TCHD group showed significant differences (P < 0.05) at 3 time points.
Conclusions: WB-CTP could be used to assess the cerebral hemodynamic characteristics before and after revascularization. DT >3 seconds and mismatch played important roles in evaluating distinct features of TCHD.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
- Contributed Indexing:
Keywords: Cerebral hyperperfusion syndrome; Extracranial-intracranial bypass; Ischemic moyamoya disease; Watershed shift; Whole-brain CT perfusion
- Publication Date:
Date Created: 20201018 Date Completed: 20210629 Latest Revision: 20210629
- Publication Date:
20221213
- Accession Number:
10.1016/j.wneu.2020.10.046
- Accession Number:
33069937
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