Cerebral Revascularization: Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.Moyamoya Disease: A noninflammatory, progressive occlusion of the intracranial CAROTID ARTERIES and the formation of netlike collateral arteries arising from the CIRCLE OF WILLIS. Cerebral angiogram shows the puff-of-smoke (moyamoya) collaterals at the base of the brain. It is characterized by endothelial HYPERPLASIA and FIBROSIS with thickening of arterial walls. This disease primarily affects children but can also occur in adults.Myocardial Revascularization: The restoration of blood supply to the myocardium. (From Dorland, 28th ed)Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.Angioplasty, Balloon, Coronary: Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Cerebral Infarction: The formation of an area of NECROSIS in the CEREBRUM caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., INFARCTION, ANTERIOR CEREBRAL ARTERY), and etiology (e.g., embolic infarction).Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Cerebral Arteries: The arterial blood vessels supplying the CEREBRUM.Iofetamine: An amphetamine analog that is rapidly taken up by the lungs and from there redistributed primarily to the brain and liver. It is used in brain radionuclide scanning with I-123.Sarcoma, YoshidaCerebrovascular Circulation: The circulation of blood through the BLOOD VESSELS of the BRAIN.Carotid Artery, Internal: Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.Cerebellum: The part of brain that lies behind the BRAIN STEM in the posterior base of skull (CRANIAL FOSSA, POSTERIOR). It is also known as the "little brain" with convolutions similar to those of CEREBRAL CORTEX, inner white matter, and deep cerebellar nuclei. Its function is to coordinate voluntary movements, maintain balance, and learn motor skills.AustriaMicrosurgery: The performance of surgical procedures with the aid of a microscope.Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system.Medical Indigency: The condition in which individuals are financially unable to access adequate medical care without depriving themselves and their dependents of food, clothing, shelter, and other essentials of living.Proctoscopy: Endoscopic examination, therapy or surgery of the rectum.Intracranial Hemorrhage, Hypertensive: Bleeding within the SKULL that is caused by systemic HYPERTENSION, usually in association with INTRACRANIAL ARTERIOSCLEROSIS. Hypertensive hemorrhages are most frequent in the BASAL GANGLIA; CEREBELLUM; PONS; and THALAMUS; but may also involve the CEREBRAL CORTEX, subcortical white matter, and other brain structures.Endarterectomy, Carotid: The excision of the thickened, atheromatous tunica intima of a carotid artery.Angioplasty, Balloon: Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.Angioplasty: Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.Carotid Stenosis: Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.Brain: The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.Leukoencephalopathies: Any of various diseases affecting the white matter of the central nervous system.Nerve Fibers, Myelinated: A class of nerve fibers as defined by their structure, specifically the nerve sheath arrangement. The AXONS of the myelinated nerve fibers are completely encased in a MYELIN SHEATH. They are fibers of relatively large and varied diameters. Their NEURAL CONDUCTION rates are faster than those of the unmyelinated nerve fibers (NERVE FIBERS, UNMYELINATED). Myelinated nerve fibers are present in somatic and autonomic nerves.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Research: Critical and exhaustive investigation or experimentation, having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusions, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories, or laws. (Webster, 3d ed)Pedigree: The record of descent or ancestry, particularly of a particular condition or trait, indicating individual family members, their relationships, and their status with respect to the trait or condition.Thyroiditis, Subacute: Spontaneously remitting inflammatory condition of the THYROID GLAND, characterized by FEVER; MUSCLE WEAKNESS; SORE THROAT; severe thyroid PAIN; and an enlarged damaged gland containing GIANT CELLS. The disease frequently follows a viral infection.Research Personnel: Those individuals engaged in research.Research Support as Topic: Financial support of research activities.Biomedical Research: Research that involves the application of the natural sciences, especially biology and physiology, to medicine.Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called ATHERECTOMY.Stroke: A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery.Carotid Artery Diseases: Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology.Nerve Sheath Neoplasms: Neoplasms which arise from nerve sheaths formed by SCHWANN CELLS in the PERIPHERAL NERVOUS SYSTEM or by OLIGODENDROCYTES in the CENTRAL NERVOUS SYSTEM. Malignant peripheral nerve sheath tumors, NEUROFIBROMA, and NEURILEMMOMA are relatively common tumors in this category.Peripheral Nervous System Neoplasms: Neoplasms which arise from peripheral nerve tissue. This includes NEUROFIBROMAS; SCHWANNOMAS; GRANULAR CELL TUMORS; and malignant peripheral NERVE SHEATH NEOPLASMS. (From DeVita Jr et al., Cancer: Principles and Practice of Oncology, 5th ed, pp1750-1)Neurofibroma: A moderately firm, benign, encapsulated tumor resulting from proliferation of SCHWANN CELLS and FIBROBLASTS that includes portions of nerve fibers. The tumors usually develop along peripheral or cranial nerves and are a central feature of NEUROFIBROMATOSIS 1, where they may occur intracranially or involve spinal roots. Pathologic features include fusiform enlargement of the involved nerve. Microscopic examination reveals a disorganized and loose cellular pattern with elongated nuclei intermixed with fibrous strands. (From Adams et al., Principles of Neurology, 6th ed, p1016)Neurofibromatosis 1: An autosomal dominant inherited disorder (with a high frequency of spontaneous mutations) that features developmental changes in the nervous system, muscles, bones, and skin, most notably in tissue derived from the embryonic NEURAL CREST. Multiple hyperpigmented skin lesions and subcutaneous tumors are the hallmark of this disease. Peripheral and central nervous system neoplasms occur frequently, especially OPTIC NERVE GLIOMA and NEUROFIBROSARCOMA. NF1 is caused by mutations which inactivate the NF1 gene (GENES, NEUROFIBROMATOSIS 1) on chromosome 17q. The incidence of learning disabilities is also elevated in this condition. (From Adams et al., Principles of Neurology, 6th ed, pp1014-18) There is overlap of clinical features with NOONAN SYNDROME in a syndrome called neurofibromatosis-Noonan syndrome. Both the PTPN11 and NF1 gene products are involved in the SIGNAL TRANSDUCTION pathway of Ras (RAS PROTEINS).Neurilemmoma: A neoplasm that arises from SCHWANN CELLS of the cranial, peripheral, and autonomic nerves. Clinically, these tumors may present as a cranial neuropathy, abdominal or soft tissue mass, intracranial lesion, or with spinal cord compression. Histologically, these tumors are encapsulated, highly vascular, and composed of a homogenous pattern of biphasic fusiform-shaped cells that may have a palisaded appearance. (From DeVita Jr et al., Cancer: Principles and Practice of Oncology, 5th ed, pp964-5)Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Dissection: The separation and isolation of tissues for surgical purposes, or for the analysis or study of their structures.Authorship: The profession of writing. Also the identity of the writer as the creator of a literary production.Motor Cortex: Area of the FRONTAL LOBE concerned with primary motor control located in the dorsal PRECENTRAL GYRUS immediately anterior to the central sulcus. It is comprised of three areas: the primary motor cortex located on the anterior paracentral lobule on the medial surface of the brain; the premotor cortex located anterior to the primary motor cortex; and the supplementary motor area located on the midline surface of the hemisphere anterior to the primary motor cortex.Movement: The act, process, or result of passing from one place or position to another. It differs from LOCOMOTION in that locomotion is restricted to the passing of the whole body from one place to another, while movement encompasses both locomotion but also a change of the position of the whole body or any of its parts. Movement may be used with reference to humans, vertebrate and invertebrate animals, and microorganisms. Differentiate also from MOTOR ACTIVITY, movement associated with behavior.Brain Mapping: Imaging techniques used to colocalize sites of brain functions or physiological activity with brain structures.Psychomotor Performance: The coordination of a sensory or ideational (cognitive) process and a motor activity.

Giant basilar artery aneurysms encorporating the posterior cerebral artery: bypass surgery and coil occlusion--two case reports. (1/349)

Giant aneurysms of the basilar artery are rare. With a diameter of 25 mm or more they are often partially thrombosed and show atheromatous plaques. There are some problems in the treatment especially when the aneurysm is broadbased with bulbous origin encorporating the origin of the posterior cerebral artery (PCA). In many of these cases neither operative clipping alone nor coil embolization alone will be practical without causing an ischemia in the depending brain areas. We will report about two patients with giant aneurysms of the basilar artery involving the origin of the PCA and a combined surgical and interventional neuroradiological approach. Preoperatively both patients showed only mild neurological symptoms (slight left hemiparesis, incomplete hemianopsia). We anastomosed the superficial temporal artery as an extracranial-intracranial bypass end-to-side to the PCA followed by clipping the PCA out of the aneurysm. Next day embolization of the aneurysm with Guglielmi ditachable coils was done. Both patients recovered without complications. An angiographic control showed no more filling of the aneurysm and a free running bypass feeding the PCA. In our opinion this combined approach is an effective method to treat giant aneurysms of the basilar artery which involve the origin of the PCA when clipping alone is impossible.  (+info)

An indirect revascularization method in the surgical treatment of moyamoya disease--various kinds of indirect procedures and a multiple combined indirect procedure. (2/349)

The indirect non-anastomotic bypass procedures for moyamoya disease are herein reviewed, and our multiple combined indirect procedure, i.e. a fronto-parieto-temporal combined indirect bypass procedure, is also introduced. Direct procedures such as superficial temporal artery-middle cerebral artery anastomosis are able to form collaterals with a high reliability, but these procedures are often difficult to technically perform in small children, and complications, when they occur, tend to be severe. Indirect procedures, such as encephalo-duro-arterio-synangiosis (EDAS), encephalo-myo-synangiosis (EMS), and encephalo-myo-arterio-synangiosis (EMAS) etc., are safe and easy and also successfully form collaterals especially in children with moyamoya disease. However, there are a few drawbacks with such procedures. They do not always form sufficient collaterals. The area where the original EDAS using the posterior branch of the superficial temporal artery can be done is also limited. Moreover, because the area covered by each single procedure is small, the collateral formation obtained by a single procedure is not always satisfactory. For these reasons we developed a fronto-temporoparietal combined indirect bypass procedure for child patients in order to overcome these problems. This multiple combined indirect procedure can cover a wider area of the ischemic brain through the EMAS in the frontal and the EDAS and EMS in the temporo-parietal regions. It is also safe and easy to perform, and one or two of these three procedures form sufficient collaterals with a relatively high reliability. This technique is described and the results are presented.  (+info)

Surgical reconstruction of the extracranial vertebral artery: management and outcome. (3/349)

PURPOSE: The purpose of this study was to identify the risk and outcome of reconstruction of the extracranial vertebral artery (ECVA). METHOD: The study was conducted as a retrospective review of 369 consecutive ECVA reconstructions. RESULTS: The clinical presentations consisted of hemispheric symptoms alone in 4% of the cases, hemispheric and vertebrobasilar symptoms in 30%, and vertebrobasilar symptoms alone in 60%. The cause of the lesion was atherosclerosis (n = 300), extrinsic compression (n = 42), dissection (n = 7), radiation arteritis (n = 5), intimal hyperplasia (n = 3), fibromuscular dysplasia (n = 2), previous surgical ligation (n = 3), aneurysm (n = 2), and other (n = 5). All the patients underwent preoperative arteriography. There were 252 proximal ECVA reconstructions (218 transpositions, 42 bypass grafting procedures, and two other) and 117 distal ECVA reconstructions (85 bypass grafting procedures, 25 transpositions, and seven other). In 83 patients, the ECVA operation was performed concomitant with a carotid or supraaortic trunk reconstruction. This series was analyzed in two separate sets: before 1991 (n = 215), when changes in indications and management were occurring; and after 1991 (n = 154), when we acquired a dedicated anesthesia team and digital arteriography in the operating room and established uniform protocols for the management of ECVA disease. The stroke, death, and stroke/death rates for the period before 1991 were, respectively, 4. 1%, 3.2% and 5.1%. The stroke, death, and stroke/death rates for the period after 1991 were, respectively, 1.9%, 0.6% and 1.9%. The patency rate at 5 years was 80%. The survival rate at 5 years was 70%. Most of the deaths during the follow-up period were caused by cardiac disease. Among the survivors, the protection rate from stroke was 97%. CONCLUSION: The changes in operative selection and management have improved the results of ECVA reconstruction. The data reported for ECVA reconstruction in patients who underwent operation since 1991 reflect the outcome of ECVA reconstruction today. In our experience, a reconstruction of the ECVA is less risky than a carotid reconstruction.  (+info)

Dynamic CT perfusion to assess the effect of carotid revascularization in chronic cerebral ischemia. (4/349)

We present the case of a female patient who was studied with dynamic contrast-enhanced CT perfusion before and after carotid revascularization. Before treatment, there was decreased perfusion in the ipsilateral insula, which was shown to be resolved on the scan obtained 1 day after treatment, indicating the technical success of the revascularization. In the ipsilateral basal ganglia, there was delayed contrast agent clearance from the tissue, which was attributed to vasodilation; after revascularization, there remained a subtle stenotic effect. The observed changes in the dynamic CT perfusion study suggest that this technique may be a useful tool in the evaluation of patients with asymmetrical cerebral blood flow.  (+info)

Cost-effectiveness analysis of therapy for symptomatic carotid occlusion: PET screening before selective extracranial-to-intracranial bypass versus medical treatment. (5/349)

The St. Louis Carotid Occlusion Study (STLCOS) demonstrated that increased cerebral oxygen extraction fraction (OEF) detected by PET scanning predicted stroke in patients with symptomatic carotid occlusion. Consequently, a trial of extracranial-to-intracranial (EC/IC) arterial bypass for these patients was proposed. The purpose of this study was to examine the cost-effectiveness of using PET in identifying candidates for EC/IC bypass. METHODS: A Markov model was created to estimate the cost-effectiveness of PET screening and treating a cohort of 45 symptomatic patients with carotid occlusion. The primary outcome was incremental cost for PET screening and EC/IC bypass (if OEF was elevated) per incremental quality-adjusted life year (QALY) saved. Rates of stroke and death with surgical and medical treatment were obtained from EC/IC Bypass Trial and STLCOS data. Costs were estimated from the literature. Sensitivity analyses were performed for all assumed variables, including the PET OEF threshold used to select patients for surgery. RESULTS: In the base case, PET screening of the cohort followed by EC/IC bypass on 36 of the 45 patients yielded 23.2 additional QALYs at a cost of $20,000 per QALY, compared with medical therapy alone. A more specific PET threshold, which identified 18 surgical candidates, gained 22.6 QALYs at less cost than medical therapy alone. The results were sensitive to the perioperative stroke rate and the stroke risk reduction conferred by EC/IC bypass surgery. CONCLUSION: If postoperative stroke rates are similar to stroke rates observed in the EC/IC Bypass Trial, EC/IC bypass will be cost-effective in patients with symptomatic carotid occlusion who have increased OEF. A clinical trial of medical therapy versus PET followed by EC/IC bypass (if OEF is elevated) is warranted.  (+info)

Frontal lobe infarction due to hemodynamic change after surgical revascularization in moyamoya disease--two case reports. (6/349)

A 60-year-old female and a 40-year-old male underwent surgical revascularization for moyamoya disease and suffered small infarction in the ipsilateral frontal lobe 3 or 4 days postoperatively. Neuroimaging suggested that the bypass flow had caused rapid progression of occlusive changes in the carotid forks, a diminishing of moyamoya vessels, and flow reduction in the anterior cerebral artery ipsilateral to surgery, leading to critical ischemia in the frontal lobe. Surgical revascularization improves the outcome of patients with moyamoya disease, but postoperative management such as hydration is important to avoid ischemic complications due to frontal lobe infarction.  (+info)

Intracerebral hemorrhage from a ruptured pseudoaneurysm after STA-MCA anastomosis--case report. (7/349)

A 43-year-old hypertensive male developed a pseudoaneurysm at the site of a superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis, causing massive intracerebral hemorrhage 5 years after the operation. He first experienced repeated transient ischemic attacks, and cerebral angiography disclosed complete occlusion in the cervical portion of the left internal carotid artery. STA-MCA anastomosis was performed, and the ischemic attacks stopped. Postoperative angiography confirmed patency of the anastomosis and good filling of the cortical branches of the left MCA. Five years after surgery, the patient suffered sudden onset of generalized convulsions and consciousness disturbance. Computed tomography disclosed a massive intracerebral hemorrhage in the left frontoparietal region, and angiography revealed an aneurysmal dilatation at the site of the anastomosis that was not seen before. Emergency evacuation of the hematoma and clipping of the aneurysmal dilatation were performed. The patient recovered well and became ambulatory. Histological examination of the surgical specimen showed collagen tissue, indicating a pseudoaneurysm. Patients who undergo STA-MCA anastomosis, especially hypertensive patients, should be followed up by repeated magnetic resonance angiography to confirm the patency of the anastomosis and cerebral perfusion, and to detect the formation of pseudoaneurysms at the anastomosis site, which can cause fatal bleeding.  (+info)

Intraoperative sonographic assessment of graft patency during extracranial-intracranial bypass. (8/349)

Extracranial-intracranial (EC-IC) bypass may be necessary to facilitate treatment of unclippable posterior circulation fusiform aneurysms. Although intraoperative digital subtraction angiography (DSA) allows assessment of graft patency, this technique, because of difficulties inherent in performing selective catheterization and angiography in the operating room, has limitations. Duplex sonography, in contrast, is easily performed, and provides information regarding graft patency and blood flow direction during EC-IC bypass procedures. This latter information proved useful in determining the time of parent artery occlusion after two EC-IC bypass procedures performed for treatment of a fusiform midbasilar artery aneurysm.  (+info)

*James I. Ausman

"New approaches in cerebral revascularization. In: Fourth International Symposium on Microsurgical Anastomoses for Cerebral ... "Cerebral revascularization by extracranial to intracranial anastomosis". In: Wilson SE, Veith FJ, Hobson RW, Williams RA (eds ... cerebral arteriovenous malformations Ausman is a pioneer in the field of revascularization techniques to improve cerebral blood ... anastomosis and revascularization non-invasive monitoring of cerebral hemodynamics, blood gases and pH in surgical patients ...

*Andrew Nicolaides

1993). Cerebral Revascularisation, Med-Orion Publishing. ISBN 978-9963-592-54-8 Bergqvist D. et al. (1994). Prevention of ...

*Saleem Abdulrauf

Cerebral Revascularization: Techniques in Extracranial to Intracranial Bypass Surgery. Copyright 2011 Elsevier, Inc. ISBN 978-1 ... Abdulrauf has authored the main reference textbook for bypass brain surgery titled Cerebral Revascularization: Techniques in ... Short segment internal maxillary artery to middle cerebral artery: A novel technique for extracranial-to-intracranial bypass. ... NeurosurgeryMarch 2011, 68(3);804-8. "Short Segment Internal Maxillary Artery to Middle Cerebral A... : Neurosurgery". Journals ...

*Endoscopic thoracic sympathectomy

There are reports of ETS being used to achieve cerebral revascularization for people with moyamoya disease, and to treat ... Dimitriadou, V; Aubineau, P; Taxi, J; Seylaz, J (1988). "Ultrastructural changes in the cerebral artery wall induced by long- ... have died during this procedure due to major intrathoracic bleeding and cerebral disruption. Bleeding during and following the ... Ultrastructural changes in the cerebral artery wall induced by long-term sympathetic denervation Sympathectomy eliminates the ...

*List of MeSH codes (E04)

... cerebral revascularization MeSH E04.494.575 --- mohs surgery MeSH E04.520.050 --- abortion, induced MeSH E04.520.050.050 --- ... cerebral revascularization MeSH E04.100.814.445 --- embolectomy MeSH E04.100.814.456 --- endarterectomy MeSH E04.100.814.456. ... cerebral decortication MeSH E04.525.160.500 --- hemispherectomy MeSH E04.525.170 --- cerebrospinal fluid shunts MeSH E04.525. ... myocardial revascularization MeSH E04.100.376.719.100 --- angioplasty, transluminal, percutaneous coronary MeSH E04.100.376.719 ...

*Cerebral infarction

Lutsep HL, Rymer MM, Nesbit GM (2008). "Vertebrobasilar revascularization rates and outcomes in the MERCI and multi-MERCI ... A cerebral infarction is an area of necrotic tissue in the brain resulting from a blockage or narrowing in the arteries ... Cerebral artery gas embolism (e.g. during ascent from a SCUBA dive) is also a possible cause of infarction (Levvett & Millar, ... If cerebral infarction is caused by a thrombus occluding blood flow to an artery supplying the brain, definitive therapy is ...

*Dural arteriovenous fistula

... occurring in response to thrombosis and collateral revascularization of a venous sinus. Cerebral angiography is the diagnostic ... 1995). "Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous ...

*CA1 (gene)

In diabetic mellitus type 2 patients with postinfarct heart failure who were undergoing surgical coronary revascularization, ... CA1 also mediates hemorrhagic retinal and cerebral vascular permeability through prekallikrein activation and serine protease ... "Extracellular carbonic anhydrase mediates hemorrhagic retinal and cerebral vascular permeability through prekallikrein ...

*Heart failure

Severe hyponatremia can result in accumulation of fluid in the brain, causing cerebral oedema and intracranial haemorrhage. ... coronary catheterization may be used to identify possibilities for revascularisation through percutaneous coronary intervention ...

*Carotid endarterectomy

3.9%). The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) funded by the National Institutes of Health ( ... 2005). "Cerebral hyperperfusion syndrome". Lancet Neurol. 4 (12): 877-888. doi:10.1016/S1474-4422(05)70251-9. PMID 16297845. ... Revascularization of symptomatic stenoses has a much higher therapeutic index compared to asymptomatic lesions. The North ... For patients to benefit from revascularization, the surgeon's complication rate (30 day stroke and death) must remain ≤3% for ...

*Prostacyclin receptor

This variant was associated with an increase in platelet activation responses in vitro and an increase in incidence of cerebral ... as an adjunct to revascularization or as an alternative to major amputation in cases which cannot undergo revascularization. IP ...

*Acute decompensated heart failure

Acute myocardial infarction can precipitate acute decompensated heart failure and will necessitate emergent revascularization ... and cerebral symptoms of varying severity, ranging from anxiety to memory impairment and confusion. Chronic stable heart ...

*Acute limb ischaemia

CTA uses radiation and may not pick up on vessels for revascularization that are distal to the occlusion, but it is much ... Mesenteric ischemia Cerebral ischemia Cardiac ischemia In order to treat acute limb ischaemia there are a series of things that ... MRA are used most often because the duplex ultrasonography although non-invasive is not precise in planning revascularization. ...

*Watershed stroke

The most frequent location for a watershed stroke is the region between the anterior cerebral artery and middle cerebral artery ... Endovascular interventions, including surgical revascularization, can increase blood flow in the area of the stroke, thereby ... middle cerebral artery (MCA), and posterior cerebral artery (PCA). Internal watershed strokes (IWS), or subcortical brain ... Damage to the cerebral cortex may lead to aphasia or confusion and damage to the cerebellum may lead to lack of motor movement ...

*Glial scar

developed monoclonal antibodies to TGFβ2, cerebral wounds were generated in rat brains, and the antibodies were administered ... Moreover, the glial scar stimulates revascularization of blood capillaries to increase the nutritional, trophic, and metabolic ...

*Vascular endothelial growth factor

... and angiogenic factors after focal cerebral ischemia: correlations with angiogenesis and cerebral edema". Neurochem Int. 58 (8 ... This time-span of VEGF-A expression corresponds with the endogenous re-vascularization capacity after injury. This would ... 2010). "Induction of vascular endothelial growth factor receptor-3 mRNA in glial cells following focal cerebral ischemia in ... Cerebral Cortex. 18 (7): 1630-39. doi:10.1093/cercor/bhm190. PMC 2430152 . PMID 17986606. Zan L, Wu H, Jiang J, Zhao S, Song Y ...

*Carotid stenting

A number of other steps may or may not be performed, including the use of a cerebral protection device, pre- or post-stent ... Carotid Revascularization Endarterectomy Versus Stenting Trial)". Journal of the American College of Cardiology. 58 (15): 1557- ... balloon dilation and cerebral angiography. Carotid stenting is the preferred therapy for patients who are at an increased risk ...

*Vein graft disease

VGD that progresses to VGF may result in death, myocardial infarction, the need for repeat revascularization and/or lower limb ... Artery Atheroma Atherosclerosis Coronary circulation Cerebral circulation Peripheral circulation vein graft disease, coronary ... The success rate of revascularization or re-intervention of a failed graft is very poor and therefore addressing early vein ... MI and revascularization".(14) The correlation between graft failure and adverse outcomes is known to exist; "bypass graft ...

*ICD-9-CM Volume 3

... and cerebral meninges (01.2) Craniotomy and craniectomy (01.3) Incision of brain and cerebral meninges (01.32) Lobotomy and ... Heart revascularization by arterial implant (36.3) Other heart revascularization (36.9) Other operations on vessels of heart ( ... and cerebral meninges (02.2) Ventriculostomy (03) Operations on spinal cord and spinal canal structures (03.0) Exploration and ...

*Propofol

Diminishing cerebral blood flow, cerebral metabolic oxygen consumption, and intracranial pressure are also characteristics of ... Bailey, J; Mora, C; Shafer, S (1996). "Pharmacokinetics of propofol in adult patients undergoing coronary revascularization". ...

*Atherosclerosis

While coronary artery disease is more prevalent in men than women, atherosclerosis of the cerebral arteries and strokes equally ... has demonstrated reduced rates of postoperative stroke and mortality compared to traditional on-pump coronary revascularization ... A Comparative Study of Cerebral Atherosclerosis in Males and Females. Circulation 38, 859-869 http://circ.ahajournals.org/ ...

*Cardiology

Hypertension can increase the risk of cerebral, cardiac, and renal events. Secondary hypertension is a type of hypertension ... "Coronary artery bypass graft surgery vs percutaneous interventions in coronary revascularization: a systematic review". JAMA. ...

*History of invasive and interventional cardiology

2002). "A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization". N Engl J ... angiography itself was first developed in 1927 by the Portuguese physician Egas Moniz at the University of Lisbon for cerebral ... The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. (1996). "Comparison of coronary bypass surgery ... a general feeling in the interventional cardiology community that these devices would be part of the perfect revascularization ...
... : Techniques in Extracranial-to-Intracranial Bypass Surgery Author(s): Saleem I. Abdulrauf MD FAAN FACS Publisher: Saunders Date: 2010
Cerebral revascularization is used to augment or replace cerebral blood flow in patients at risk of developing cerebral ischemia. These include patients with moyamoya disease, occlusive cerebrovascular disease, skull base tumors, and complex aneurysms. Our aim in this review is to provide a comprehensive update of both surgical and anesthetic aspects of cerebral revascularization procedures. The anesthetic concerns for most patients presenting for different types of bypass procedures are similar and include the maintenance of adequate cerebral perfusion to prevent cerebral ischemia. Patients with complex aneurysms and tumors have additional considerations related to the surgical treatment of the underlying pathology.. ...
TY - JOUR. T1 - Computed tomographic angiography in evaluation of superficial temporal to middle cerebral artery bypass. AU - Besachio, David A.. AU - Ziegler, Jordan. AU - Duncan, Timothy D.. AU - Wanebo, John S.. PY - 2010/5/1. Y1 - 2010/5/1. N2 - Catheter-directed digital subtraction angiography (DSA) is considered the standard for evaluation of superficial temporal to middle cerebral artery (STA-MCA) bypass patency. Few clinical investigations have been performed that evaluate the efficacy of computed tomographic angiography (CTA) in the assessment of extracranial-intracranial bypass. Using multi-detector row CTA, STA-MCA bypass patency was assessed in the initial postoperative period and several months afterward and compared with DSA. No significant difference was identified in the evaluation of graft patency between DSA and CTA. Although multiple modalities exist to evaluate STA-MCA bypass graft patency, the multidetector CTA is widely available and allows for rapid, accurate patency ...
TY - JOUR. T1 - Use of extracranial-intracranial bypass in the management of symptomatic vasospasm. AU - Batjer, H.. AU - Samson, D.. PY - 1986. Y1 - 1986. UR - http://www.scopus.com/inward/record.url?scp=0022517563&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0022517563&partnerID=8YFLogxK. M3 - Article. C2 - 3748351. AN - SCOPUS:0022517563. VL - 19. SP - 235. EP - 246. JO - Neurosurgery. JF - Neurosurgery. SN - 0148-396X. IS - 2. ER - ...
While the use of CTA to assess EC-IC bypass postoperatively has been described [3], we demonstrate how CTA may be used for the preoperative assessment of the STA for potential use in EC-IC bypass. Although use of preoperative CTA for anatomic evaluation of the external carotid anatomy has been described for head and neck surgery [4, 5], to our knowledge, no report has yet been made demonstrating the utility of CTA for preoperative planning for EC-IC bypass. EC-IC bypass has remained one area where invasive catheter angiography has been thought necessary, specifically for evaluation of the STA vessel caliber as a bypass conduit. The patient described in this case illustration did not go on to surgery, therefore, no direct intraoperative comparison could be made between the findings at CTA and at DSA. To prove the utility of CTA for preoperative evaluation of the STA, intraoperative comparison of vessel caliber with DSA findings would be needed. If findings of vessel caliber at operation reliably ...
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Intracranial Arterial Reconstruction. Microvascular techniques are utilized in order to prevent Strokes from occurring in patients with certain types of Obstructive Cerebrovascular conditions that do not respond to other therapies. Examples of this include extensive multivessel atherosclerosis (hardening of the arteries) that results in decreased blood supply to the Brain. An example of this is Extracranial to Intracranial Arterial Bypass Grafting as illustrated in Figures 5 through 8.. These operations are referred to as Cerebral Revascularization (or Extracranial-Intracranial [EC-IC] Bypass Graft). Patients requiring the reconstruction of the arterial blood supply to their Brain (either to deal with an obstructive blood vessel problem that would lead to Stroke, or where tumor removal requires the sacrifice of a major cerebral artery) will understand the requirement to have a Neurosurgeon with special skills, knowledge and expertise to undertake this extremely delicate task.. Several techniques ...
Endovascular Approaches to Cerebral Ischemia Drs. Aaron Dumont and Max Kole discuss intracranial angioplasty and stent implantation for direct cerebral revascularization.
Zumofen, D; Khan, N; Roth, P; Samma, A; Yonekawa, Y (2008). Bonnet bypass in multiple cerebrovascular occlusive disease. In: Yonekawa, Y; Tsukahara, T; Valavanis, A; Khan, N. Changing Aspects in Stroke Surgery: Aneurysms, Dissections, Moyamoya Angiopathy and EC-IC Bypass. Austria - Wien, 2008: Springer Viena, 103-107.. ...
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Wang MY, Steinberg GK. Rapid and near-complete resolution of moyamoya vessels in a patient with moyamoya disease treated with superficial temporal artery-middle cerebral artery bypass. Pediatr Neurosurg. 1996;24(3):145-150.. Bowen M, Marks MP, Steinberg GK. Neuropsychological recovery from childhood moyamoya disease. Brain Dev.1998;20(2):119-123.. Golby AJ, Marks MP, Thompson RC, Steinberg GK. Direct and combined revascularization in pediatric moyamoya disease. Neurosurgery. 1999;45(1):50-58; discussion 58-60.. Woolfenden AR, Albers GW, Steinberg GK, Hahn JS, Johnston DC, Farrell K. Moyamoya syndrome in children with Alagille syndrome: additional evidence of a vasculopathy. Pediatrics. 1999;103(2):505-508.. Fleetwood I, Steinberg GK. Moyamoya disease. Can J Neurol Sci. 2000;27(4):325-327.. Lim M, Cheshier S, Steinberg GK. New vessel formation in the central nervous system during tumor growth, vascular malformations, and Moyamoya. Curr Neurovasc Res. 2006;3(3):237-245.. Kelly ME, Bell-Stephens ...
Moyamoya syndrome is a rare condition in which blood vessels at the base of the skull progressively narrow, limiting the flow of oxygenated blood to the brain. Surgical treatment options for Moyamoya syndrome include direct revascularization procedures such as an EC-IC bypass as well as indirect revascularization procedures like encephaloduroarteriosynangiosis (EDAS) and pial synangiosis. Here at Columbia University Medical Center/NewYork-Presbyterian Hospital, our neurosurgeons have particular expertise using these and other surgeries to treat patients with Moyamoya syndrome.. "Moyamoya" means "puff of smoke" in Japanese, and the condition is so named because the body grows a secondary network of small vessels in an effort to compensate for the restricted blood flow. On an arteriogram, the network of new vessels resembles a cloud-or puff of smoke. Moyamoya is more common in Japan than in the U.S., but it is unusual everywhere.. The blood vessel network that gives Moyamoya its name may lead to ...
TY - JOUR. T1 - Targeted extracranial-intracranial bypass with intra-aneurysmal administration of indocyanine green. T2 - Case report. AU - Bain, Mark D.. AU - Moskowitz, Shaye I.. AU - Rasmussen, Peter A.. AU - Hui, Ferdinand. PY - 2010/12. Y1 - 2010/12. N2 - BACKGROUND AND IMPORTANCE: Early origin of the middle cerebral artery M2 segment is a normal variant. When such a vessel is occluded proximally, the parenchyma distal to the vessel may become ischemic. Targeted extracranial to intracranial bypass to such a specific branch may preserve perfusion to the end organ. We describe the use of intra-aneurysmal injection of indocyanine green to identify a target middle cerebral artery branch (MCA) for bypass, immediately followed by proximal parent vessel sacrifice via endovascular embolization. CLINICAL PRESENTATION: A 45-year-old woman presented to an outside hospital with headaches. Magnetic resonance imaging revealed a giant aneurysm of the right MCA. The aneurysm gave rise to an M2 branch that ...
Introduction: Silent cerebral microbleeds (CMB) are common in Moyamoya Disease (MMD) and Moyamoya syndrome (MMS) in Asia. The incidence was reported to be 30-40%. The presence of CMB was found to be a predictor for subsequent cerebral hemorrhage in MMD. The significance of CMB in MMD/MMS in non-Asian population has not been reported. We try to investigate the prevalence of CMB in MMD/MMS in United States and its predictive value for subsequent cerebral hemorrhage.. Methods: Moyamoya Database was established in our institution after reviewing patients with ICD9 code of Moyamoya Disease or Moyamoya Syndrome or cerebrovascular occlusive disease from 2007 to 2015. Patients in the database were reviewed retrospectively and included in the study if there were MR images (including GRE, SWI or T2* sequences) at diagnosis or during follow up and available for review. Patients with poor image quality were excluded. Patients were noted to have microbleeds if it was found on initial or follow up MRI. ...
A complete occlusion of the internal carotid artery (ICA) is an important cause of cerebrovascular disease. A never-symptomatic ICA occlusion has a relatively benign course, whereas symptomatic occlusion increases future risk of strokes. Ultrasonography, magnetic resonance imaging and contrast angiography are useful diagnostic tests, and functional imaging of the brain (eg, with positron emission tomography) helps to understand haemodynamic factors involved in the pathophysiology of brain ischaemia. Recently, there has been a resurgence of interest in the role of extracranial-intracranial bypass surgery for the treatment of completely occluded ICA. With advances in the measurement of cerebral haemodynamics, it may be possible to identify high-risk patients who could benefit from the bypass surgery ...
Moyamoya syndrome (sometimes referred as Moyamoya disease also) is predominantly a problem observed in kids. It is a rare medical complexity when the walls of carotid arteries
Traditionally, carotid endarterectomy belonged to vascular surgeons in our hospital, but the tendency of conversion from conventional carotid endarterectomy to endovascular PTA and/or stenting seemed to be marked, while microvascular revascularization procedure represented by extracranial intracranial EC-IC bypass remained constant (around 20/year) in various occasion (277 times on 203 cases: atherosclerosis 93, Moyamoya angiopathy (MMA) 47, aneurysm 57 and skull base tumour 6, during the last 13 years], in spite of negative results of EC-IC bypass international cooperative study for stroke prevention in 1985 ...
Expertise, Disease and Conditions: Aneurysmal Subarachnoid Hemorrhage (ASH), Arteriovenous Malformations (AVM), Brain Cancer, Brain Hemorrhage, Brain Tumors, Carotid Artery Stenosis, Cavernous Malformations, Cerebellar Ataxia, Cerebral Aneurysms, Cerebral Revascularization, Cerebrovascular Diseases, Cervical Degenerative Disc Disease, Chiari Malformations, Complex Skull Reconstruction, Cranioplasty, Dural Arteriovenous Fistulas, Intracerebral Hemorrhage, Moyamoya Disease, Neurosurgery, Spinal Vascular ...
BACKGROUND AND PURPOSE: It is unclear whether very old patients benefit from organized inpatient (stroke unit) care. The aim of this work was to compare the clinical outcome of patients with first-ever ischemic stroke aged either ,/=80 or ,80 years who were treated conservatively (without cerebral revascularization) in a university-based stroke unit. PATIENTS AND METHODS: We included 147 (11%) patients ,/=80 years and 1241 (89%) patients, ,80 years. All patients underwent clinical examination, blood tests, electrocardiography (ECG), brain imaging and cerebrovascular ultrasound. Additional investigations were done at the discretion of the treating physician. The modified Rankin scale (mRS) score was used to assess the 3-month outcome (favorable: mRS, 0-1; poor: mRS, 2-6; death of any cause). RESULTS: Stroke severity did not differ between both groups [median National Institutes of Health Stroke Scale (NIHSS) score, 4]. Younger patients underwent magnetic resonance (MR) imaging of the brain, MR ...
Four patients with giant intracranial aneurysms, which measured over 2.5 cm in diameter, were treated by ligation of the proximal parent artery. The location of the aneurysms were intracavernous in two patients, paraophthalmic in one patient, and ver
Computed Tomography Angiography (CTA) plays an essential role in the diagnosis, treatment evaluation, and monitoring of cerebral aneurysms. Segmentation of CTA medical images of giant intracranial aneurysms (GIA) provides quantitative measurements of
A total of 1,377 patients with symptomatic obstructive cerebrovascular disease (most commonly, internal carotid artery occlusion) entered a trial in which they were randomized to either medical or surgical (extracranial-intracranial bypass) therapy. All but 8 had hemoglobin estimations performed at entry. The patients were followed for an average of 55.8 months. In the medical group, the 325 patients with high normal hemoglobin concentration (15 g/l or more) suffered no more ischemic strokes than the 382 patients with lower values (less than 15 g/l). Those strokes that did occur were no more severe in the high than the low hemoglobin group. Hemoglobin concentration did not emerge as a prognostic factor in those patients treated surgically (n = 662). This prospective study counters the hypothesis that high normal hemoglobin concentration is associated with poor outcome in patients with symptomatic obstructive disease of the carotid and cerebral arteries. ...
With only few reports of large artery occlusion due to a fat embolus, the diagnosis can be a challenge, delaying correct diagnosis and management.1 Knowledge of the hallmark hypodense artery sign and the differentiation with an air embolus, which typically has a density less than −1000 HU (vs −30 to −70 HU for fat) is mandatory.. In patients with acute or evolving stroke, outcome is related to timing of reperfusion.7 Unlike thromboembolic arterial occlusion, no guidelines exist for the management of ischaemic stroke secondary to fat emboli. Endovascular thrombectomy is now the standard of care for patients with acute ischaemic stroke secondary to acute large vessel occlusion, and seems the most appropriate first-line treatment for large fat emboli.4 Multiple successful fat emboli retrievals have been reported.4 In our case, endovascular retrieval was unsuccessful, possibly due to the time elapsed between initial onset and the endovascular attempt (24 hours).. As the patient was further ...
The department is one of Germanys largest neurosurgical departments, serving patients from Duisburg and the surrounding area, other regions of Germany as well as many Arab countries, Russia and other countries of the former Soviet Union. The latest operating technologies are used in the department, such as a special mouth-controlled surgical microscope that ensures that both of the surgeons hands are free to perform the operation at all times.. The three operating theatres, fitted with state-of-the-art equipment, are used for microsurgery and endoscopy. As well as common neurosurgical conditions, the department treats a high number of rare illnesses.. Vascular neurosurgery employs modern videoangiography and micro-Doppler sonography to operate on conditions including spinal fistulas, haemangioblastomas, angiomas, complex aneurysms and EC/IC bypasses.. Paediatric neurosurgeons collaborate closely with the paediatrics department to operate in cases such as calvarial deformities and hydrocephalus ...
SUMMARY: Giant intracranial aneurysms are rare vascular pathologies associated with high morbidity and mortality. The purpose of this in vivo study was to assess giant intracranial aneurysms and their wall microstructure by 7T MR imaging, previously only visualized in histopathologic examinations. Seven giant intracranial aneurysms were evaluated, and 2 aneurysms were available for histopathologic examination. Six of 7 (85.7%) showed intraluminal thrombus of various sizes. Aneurysm walls were depicted as hypointense in TOF-MRA and SWI sequences with excellent contrast ratios to adjacent brain parenchyma (range, 0.01-0.60 and 0.58-0.96, respectively). The triple-layered microstructure of the aneurysm walls was visualized in all aneurysms in TOF-MRA and SWI. This could be related to iron deposition in the wall, similar to the findings in 2 available histopathologic specimens. In vivo 7T TOF-MRA and SWI can delineate the aneurysm wall and the triple-layered wall microstructure in giant intracranial ...
A 45-year-old male patient with moyamoya disease is scheduled for a superficial temporal to middle cerebral artery bypass. He has a past medical history of hypertension and stroke with residual left...
Symptoms, treatment, risks, and surgery | Dr. Newell has 25+ years of experience helping with Moyamoya Disease. Moyamoya disease is a progressive disorder of the cerebral vessel.
Dr. Koslow responded: Never, most of time. Total occlusion is rarely treated and if treated it is with temporal artery to middle cerebral artery bypass (done very very rarely). Just follow stenosis of other side.
The described features are those of Moyamoya disease with occluded distal ICAs as well as left MCA causing extensive acute left cerebral infarction. The Ivy sign refers to the leptomeningeal hyper intense FLAIR signal or brighnt sulci due to sl...
Dr. Peter Nakaji in Phoenix, AZ, treats Moyamoya Disease, a rare cerebrovascular disease caused by blocked arteries at the base of the brain.
The course of MMD spans from clinical silence for several years to rapid progression.5,7 Its severity can be classified into six stages based on Suzukis classification, which highlights the angiographic evolution of the disease (Table 1).8,9 A management plan is decided accordingly.. There is no curative treatment for arterial occlusion regression or Moyamoya vessel prevention. Due to the more progressive nature of the disease in the pediatric population, treatment is geared toward preventing irreversible brain damage.8,12 Treatment is strongly recommended for symptomatic adults since the stroke rate is estimated at 10% to 15% per year compared with 3% in asymptomatic patients.7,9,11,12. The mainstay of treatment in symptomatic patients with ischemic MMD is surgical revascularization.9,12 The goal is to improve cerebral blood flow and prevent infarction. Direct or indirect bypass has been shown to improve blood flow and decrease ischemic events postoperatively.12 Post-op complications may ...
Moyamoya is a disease in which certain arteries in the brain are constricted and blood flow in the brain is blocked by the constriction.
Moyamoya Disease is a progressive disease that affects the blood vessels in the brain (cerebrovascular). It is characterized by narrowing and/or closing of the main artery to the brain (carotid).
A 67-year-old man, who had suffered from right cerebral infarction that resulted in left hemiparesis, underwent right superficial temporal artery-middle cerebral artery anastomosis in 1991. From March 2000, dizziness occurred during use of his right hand. His arteriogram revealed late filling of the occluded right subclavian artery by reversed flow from the right vertebral artery and 50% stenosis of the left internal carotid artery. We performed subcutaneous axillo-axillary bypass grafting with mild hypothermia on June 1st, 2000. An 8mm ePTFE tube with a ring was anastomosed to both axillary arteries in end-to-side fashion with continuous sutures. Thereafter, symptoms disappeared. One month after the procedure, his arteriogram showed that the bypass filled the right vertebral artery in an antegrade fashion as well as the right axillary artery. Axillo-axillary bypass grafting with mild hypothermia seemed to be safe and effective for high-risk subclavian steal syndrome ...
TY - JOUR. T1 - Surgical Treatment for Patients with Moyamoya Syndrome and Type 1 Neurofibromatosis. AU - Porras,Jose L.. AU - Yang,Wuyang. AU - Garzon-Muvdi,Tomas. AU - Xu,Risheng. AU - Blakeley,Jaishri. AU - Belzberg,Allan. AU - Caplan,Justin M.. AU - Khalid,Syed. AU - Colby,Geoffrey P.. AU - Coon,Alexander L.. AU - Tamargo,Rafael J.. AU - Ahn,Edward S.. AU - Huang,Judy. PY - 2017/3/1. Y1 - 2017/3/1. N2 - Introduction The current study describes the impact of surgery in preventing follow-up ipsilateral transient ischemic attacks (TIAs)/strokes in an East Coast North American cohort of patients with both moyamoya syndrome (MMS) and neurofibromatosis type 1 (NF1) (MMS-NF1). Methods We retrospectively reviewed records of patients with MMS and NF1 at the Johns Hopkins Medical Institutions from 1990-2014. Baseline characteristics and follow-up results including subsequent ipsilateral strokes were collected and compared between a revascularization group (group 1) and a conservatively managed group ...
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TY - JOUR. T1 - Understanding and treating moyamoya disease in children. AU - Jodi, L. Smith. PY - 2009/10/13. Y1 - 2009/10/13. N2 - Moyamoya disease, a known cause of pediatric stroke, is an unremitting cerebrovascular occlusive disorder of unknown etiology that can lead to devastating, permanent neurological disability if left untreated. It is characterized by progressive stenosis of the intracranial internal carotid arteries and their distal branches and the nearly simultaneous appearance of basal arterial collateral vessels that vascularize hypoperfused brain distal to the occluded vessels. Moyamoya disease may be idiopathic or may occur in association with other syndromes. Most children with moyamoya disease present with recurrent transient ischemic attacks or strokes. Although there is no definitive medical treatment, numerous direct and indirect revascularization procedures have been used to improve the compromised cerebral circulation, with outcomes varying according to procedure type. ...
This is the first case report of a CADASIL patient with MCA stenosis who underwent STA-MCA bypass to increase cerebral perfusion in the localized ischemic area. In CADASIL, reductions in both CBF and CVR occur in white matter showing T2-hyperintensity. It has been suggested that the degeneration of vascular smooth muscle cells causes arteriopathy, which leads to cerebral hypoperfusion and impaired autoregulation (Chabriat et al. 2000; Huang et al. 2010; Singhal and Markus 2005; van den Boom et al. 2003). Interestingly, the white-matter hyperintensity in the temporal lobe was found predominant in the left side in this case. This asymmetry of white-matter hyperintensity is very unusual rare in CADASIL, since it would suggest that these lesions do not originate from ischemia, but edema instead. The lower extent observed in the most hypoperfused temporal lobe further support that these lesions are not related to ischemia but mat actually result from edema with blood brain barrier dysfunction. ...
Moyamoya disease: Find the most comprehensive real-world symptom and treatment data on moyamoya disease at PatientsLikeMe. 24 patients with moyamoya disease experience fatigue, depressed mood, pain, anxious mood, and insomnia and use Aspirin and MRI (magnetic resonance imaging) to treat their moyamoya disease and its symptoms.
Direct revascularization. A surgical procedure in which a branch of a scalp artery is connected to a branch of the brain artery on the outer surface of the brain, providing immediate improvement in blood supply to the brain.. Indirect revascularization. Various indirect surgical methods to provide more blood flow to the brain include EDAS, EMS and Omental-Cerebral Transposition. Encephalo-duro-arterio-synangiosis (EDAS). A procedure that uses a branch of temporal artery, which is laid directly on the surface of the brain without making a direct connection, to form a new blood supply ...
Moyamoya disease diagnostics (costs for program #260949) ✔ Academic Hospital Bogenhausen ✔ Department of Neurology, Neurophysiology, Neuropsychology and Stroke Unit ✔ BookingHealth.com
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first reported the use of EIAB for maintaining flow in an electively ligated MCA in the management of an aneurysm. 18 Several reports have followed, further supporting this rationale. 6, 14, 15 Ferguson, et al. , 2 reported good results with the use of EIAB in "giant" intracranial aneurysms. Aneurysms greater than 2.5 cm in diameter are by convention classified as "giant aneurysms." In a recent report of direct surgery on 24 patients, 12 the mortality rate was 20.8%, and the overall morbidity (including deaths) was 37.5%. Eight of these patients had aneurysms of. ...
Solitaire™ FR Revascularization Device is a mechanical thrombectomy device combining the ability to restore blood flow, administer medical therapy, and retrieve clot in patients experiencing acute ischemic stroke.
Linfante, Italo, "How Do I Decide Between Coiling and Flow Diversion for Intracranial Aneurysms?" (2016). All Publications. 1263 ...
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Intracranial arterial atherosclerosis is a significant medical problem, with elevated rates of recurrent stroke despite medical therapy, with annual recurrence rates for ischemic stroke reported in the SAMMPRIS Trial as high as 12.2% in the intensive medical therapy arm. The incidence of recurrence stroke can be even higher in some high-risk groups, as high as 25% in African-Americans and females. The ultimate goal of this project is to advance a promising surgical treatment for symptomatic atherosclerotic intracranial stenosis - encephaloduroarteriosynangiosis (EDAS). Compared with direct revascularization operations (bypass), EDAS has the advantages of being less technically demanding, avoiding temporary occlusion of cerebral vessels, and allowing gradual development of collateral circulation where the brain demands it, deterring early hyperperfusion and hemorrhage. There has been no systematic trial exploring the use of EDAS in cases of symptomatic, non-moyamoya intracranial arterial ...
Intracranial arterial atherosclerosis is a significant medical problem, with elevated rates of recurrent stroke despite medical therapy, with annual recurrence rates for ischemic stroke reported in the SAMMPRIS Trial as high as 12.2% in the intensive medical therapy arm. The incidence of recurrence stroke can be even higher in some high-risk groups, as high as 25% in African-Americans and females. The ultimate goal of this project is to advance a promising surgical treatment for symptomatic atherosclerotic intracranial stenosis - encephaloduroarteriosynangiosis (EDAS). Compared with direct revascularization operations (bypass), EDAS has the advantages of being less technically demanding, avoiding temporary occlusion of cerebral vessels, and allowing gradual development of collateral circulation where the brain demands it, deterring early hyperperfusion and hemorrhage. There has been no systematic trial exploring the use of EDAS in cases of symptomatic, non-moyamoya intracranial arterial ...
MATERIALS AND METHODS: This retrospective study included patients with Moyamoya disease who underwent superficial temporal artery-MCA single anastomosis. TOF-MRA and SPECT were performed before and 1-6 days after anastomosis. Bilateral ROIs on the source image of TOF-MRA were manually placed directly on the parietal branch of the superficial temporal artery just after branching the frontal branch of the superficial temporal artery and on the contralateral superficial temporal artery on the same axial image, respectively. The change ratio of the maximum signal intensity of the superficial temporal artery on TOF-MRA was calculated by using the following formula: (Postoperative Ipsilateral/Postoperative Contralateral)/(Preoperative Ipsilateral/Preoperative Contralateral). ...
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Moyamoya disease (MMD) is an occlusive cerebrovascular disease characterized by stenosis of the terminal aspect of the internal carotid artery and an abnormal network of basal vessels.1 The etiology of MMD is unknown, but both congenital and acquired processes may play a role in its development. The incidence of disease is 4.6 times higher in Asian Americans as compared to their Caucasian counterparts and shows a predominance for females.1 Catheter angiography is the gold standard for diagnosis, but due to its invasive nature MRA has gained in popularity. On MRA, the classic "puff of smoke" may be visualized due to collateral vessel formation after arterial stenosis. Patients who are conservatively managed experience stroke at a rate of 3.2%-15.0% annually.2 In those who underwent postoperative direct revascularization, the annual stroke rate decreased to 0.0%-1.6%, while those who had undergone postoperative indirect revascularization presented an annual stroke rate of 0%-14.3% ...
The balance between heat production (metabolism) and heat removal (blood flow) helps in keeping the temperature of the brain constant. In patients with moyamoya disease, this balance may be disturbed. The purpose of this study was to assess the thermal pathophysiology of the brain in patients with moyamoya disease. The study included 12 consecutive patients with moyamoya disease and 10 controls. Temperature was measured by image postprocessing of diffusion-weighted images. Our noninvasive thermometry showed that the ventricular temperature of moyamoya disease patients was higher than that of normal controls. The mean temperature difference of 1.1 degrees C between the two groups was significant. Patients with moyamoya disease tend to have elevated ventricular temperatures, which may represent a mismatch between cerebral metabolism and perfusion.
We read with interest the article by Mokin et al Thrombus density predicts successful recanalization with Solitaire stent retriever thrombectomy in acute ischemic stroke.1 Based on their results, the authors conclude that thrombus density assessed by plain cranial CT scans predicts recanalization after Solitaire stent retriever thrombectomy for acute ischemic stroke. Some methodological shortcomings of this study may have led to erroneous interpretation of the results. The authors investigated patients treated solely by Solitaire stent retriever thrombectomy, which reduced the cohort to 41 patients, and does not represent current practice as stent retrievers are very often combined with preceding intravenous … ...
Despite a lack of solid evidence in applying the angiosome concept (AC) in current chronic limb threatening ischemia (CLTI) treatment, several encouraging results for improved wound healing and less for limb preservation were reported in various consistency studies. Direct revascularization (DR) following the foot angiosomes distribution (whenever feasible) may afford better clinical results compared to angiosome indifferent, or indirect revascularization (IR), however without clear benefit on survival and for major adverse limb events (MALE). Inside this interrogation, the notable influence of the remnant collaterals, the foot arches, the wound characteristics, and the type of revascularization (bypass versus endovascular) still remain ardent topics. Current evidence suggests that applying DR in daily vascular practice requires practitioners to be committed to every individual hemodynamic variable in a thorough macro- and micro-vascular evaluation of the ischemic foot. It becomes clearer nowadays that
Dr. Rudrajit Kanjilal, Neuro-surgeon at CMRI. Moyamoya disease is a well recognized phenomenon since 1940s, though it is a relatively uncommon cerebrovascular disorder which at times occur due to familial reason or genetic mutation. Originally, it was thought that the disease was region specific, specially Japan and other Asian countries, since it was first discovered in Japan. However, now we have seen that all races are equally prone to developing this disease. Arguably, its occurance is higher in Asian countries than in Europe or North America. The name of the disorder "Moyamoya" has been derived from Japanese language which means "puff of smoke". This exactly describes the appearance of the bunch of tangled tiny vessels formed at the base of the brain. In Japan it is a genetic, familial disease, while in India, it is sporadic, we dont see a familial trend in Indian subcontinent. It is idiopathic and mostly happen due to genetic mutation, but the incidence is not very rare. Causes and ...
Objective: The etiology of Moyamoya disease is still widely unknown. Several publications on Moyamoya describe differences of cytokine and growth factor concentrations in different specimen. We analyzed the DNA of patients with Moyamoya disease for single nucleotide polymorphisms in and upstream of the genes for previously described associated cytokines and growth factors.. Methods: 13 SNPs were genotyped in or upstream to 4 genes (bFGF, CRABP1, PDGFRB, TGFB1) comparing 40 DNA samples of Moyamoya disease patients to 68 healthy controls from central Europe. Genotyping was performed by sequencing the SNP containing genetic regions with custom made primers.. Results: We found association of two SNPs: rs382861 [A/C] (p=0.0373, OR=1.81, 95% CI=1.03-3.17) in the promoter region of PDGFR and rs1800471[C/G] (p=0.0345, OR=7.65, 95% CI=0.97-59.95), located in the first exon of TGFB1.. Conclusions: Our results indicate possible genetic risk factors for the genesis of Moyamoya disease. TGFB1 and PDGF(R) are ...
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The exact function of RNF213 is unknown. Recent in vivo experiments using genetically engineered RNF213 mice addressed the mechanism underlying the RNF213 SNPs in the development of MMD pathology. The target disruption of RNF213 did not induce MMD in the RNF213-defcient mice under normal conditions [33]. Kanoke and colleagues alternatively generated RNF213-knock-in mice that expressed a missense mutation in the mouse RNF213, p.R4828K, on Exon 61, which corresponds to the human RNF213, p.R4859K, on Exon 60 in MMD patients; however, these mice did not develop MMD under normal conditions [34]. These negative results could be consistent with the low penetrance rate of the RNF213 polymorphisms in patients with MMD, and may indicate the importance of environmental factors in addition to the genetic factors [35]. They subjected the RNF213-deficient mice to an ischemic insult, and found that the post-ischemic angiogenesis was significantly enhanced in the mice lacking RNF213 after a chronic hindlimb ...
TY - GEN. T1 - LARTERIOGRAFIA NELLA DIAGNOSI DI MALATTIA DI MOYAMOYA IN PAZIENTI CON SINDROME DI DOWN. AU - Vicari, S.. AU - Albertini, G.. PY - 1990. Y1 - 1990. UR - http://www.scopus.com/inward/record.url?scp=0025589297&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0025589297&partnerID=8YFLogxK. M3 - Contributo a conferenza. AN - SCOPUS:0025589297. VL - 36. SP - 977. EP - 981. BT - Rivista di Neurobiologia. ER - ...
... (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical...
Emergency superficial temporal artery to middle cerebral artery bypass after intravenous recombinant tissue plasminogen activator administration for acute cerebral ischemia in a patient with moyamoya disease. - Sadaharu Tabuchi, Sadao Nakajima, Yutaka Suto, Hiroyuki Nakayasu
R Loch Macdonald, MD, PhD, FRCSC, FACS, is board certified in Neurosurgery.. He earned his medical degree from University of British Columbia, Vancouver and completed his fellowship in Cerebrovascular Neurosurgery at University or Toronto, Toronto. His professional interests include intracranial neurosurgery including neurovascular surgery, cerebral revascularization and neurovascular bypass surgery, carotid artery disease, cerebral aneurysms and subarachnoid hemorrhage, brain vascular malformations and brain tumors including meningiomas, gliomas, pituitary tumors and skull base tumors.. Dr. Macdonald is currently faculty of UCSF in the UCSF Fresno Department of Neurosurgery. He previously had faculty appointments at the University of Chicago and the University of Toronto. He was the Head of the Division of Neurosurgery at St. Michaels Hospital of University of Toronto and the Keenan endowed chair in Surgery at St. Michaels Hospital.. His hobbies include running and cycling.. ...
Article abstract-The postoperative hyperperfusion syndrome describes an abrupt increase in blood flow with loss of autoregulation in surgically reperfused brain. Reports described a spectrum of findings, including severe headache, transient ischemia, seizures, and intracerebral hemorrhage. Hypertension is common after carotid artery surgery and often plays a role in the pathophysiology. We now report five patients with severe white matter edema after carotid surgery, a finding not previously included in the hyperperfusion syndrome. Five to 8 days after carotid surgery and after hospital discharge, each patient developed hypertension, headache, hemiparesis, seizures, and aphasia or neglect due to severe white matter edema ipsilateral to the carotid surgery. One patient had a small hemorrhage within the edematous area. Hypertension was severe in four patients and moderate in one. The carotid artery was patent by ultrasound or angiography in each patient after surgery. Transcranial Doppler showed ...
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Results A total of 91 infarct patterns were observed from 66 patients. The gyral, atypical territorial, and honeycomb patterns, which are not usually seen in conventional stroke patients, were common in MMD (68.1%). Among all patterns, a gyral pattern was most common (40/91, 44.0%). Borderzone and deep lacunar patterns were infrequent. Gyral and borderzone patterns were more frequently seen in the C-MMD group, whereas a honeycomb pattern was not seen in young patients. Honeycomb pattern was more common at advanced vascular stages. Infarctions confined to the cortex were more common in the C-MMD group (26/32, 75.0%) than in A-MMD patients (14/34, 41.2%). ...
Authors Mark S. Gerber, MD Robert F. Spetzler, MD Division of Neurological Surgery, Barrow Neurological Institute, St. Josephs Hospital and Medical
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2017-11-09 17:35:29. Proposal Rings In Dublin Whether you want to create impact with one of the stunning solitaires coming from our Evermore Collection, or perhaps give her a little more luster with a three rock ring, we have an engagement ring to match every style and budget. Three diamonds on the engagement ring are usually said to represent the couples past, existing, and future, but other people give religious importance to the arrangement. In the long lasting relationship, there always comes the time any time both parties feel that its time to take things to the next stage.... ...
Giant fusiform aneurysms of the middle cerebral artery (MCA) bifurcation pose significant treatment challenges. A giant fusiform aneurysm of the left MCA in a pediatric patient, which persisted despite Hunterian ligation of the M1 and double barrel superficial temporal artery (STA) to M2 bypasses, is reported. The aneurysm was trapped by endovascular coiling of the feeding M2 trunk through the STA anastamosis. Hunterian ligation combined with extracranial-intracranial bypass is an effective technique for treating giant fusiform aneurysms of the MCA bifurcation for patients who fail balloon test occlusions. However, in certain cases, flow reversal may not eliminate the aneurysm and continued aneurysm filling may occur through retrograde filling from the bypass recipient vessels. In these cases, endovascular trapping of the aneurysm may be undertaken through the bypass graft. The feasibility of this management scheme is demonstrated. ...
Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. The frequency of pseudoaneurysms of the superficial temporal artery developing after craniotomy is exceedingly low and only a few cases have been reported. We present a case of pseudoaneurysm of this type in a 45-year-old male who underwent craniotomy for excision of meningioma. One month postoperatively, the craniotomy flap exhibited an enormous diffuse pulsate swelling. The suspected diagnosis of pseudoaneurysm arising from superficial temporal artery was confirmed on angiography. Surgical excision was done and no recurrences of the tumor or aneurysm were noted on subsequent follow up.
Pseudoaneurysms of the superficial temporal artery are a rare and potentially critical cause of facial masses. Most pseudoaneurysms form as a result of blunt trauma and present as painless, pulsatile tumors that may be associated with neuropathic findings and enlarged size. Without careful evaluation in the primary care setting, pseudoaneurysms can be easily misdiagnosed and improperly managed. They can, however, be accurately diagnosed through physical examination alone and subsequently treated with surgical ligation. The authors present two cases of traumatic pseudoaneurysms of the superficial temporal artery caused by blunt injury and discuss pertinent diagnosis and treatment options, as well as provide a brief review of the anatomy and histopathology of pseudoaneurysms. ...
MACHADO, Sheila Braga; MENDES, Florentino Fernandes and ANGELINI, Adriana de Campos. Moyamoya disease and sevoflurane anesthesia outside the surgery center: case report. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.3, pp.344-347. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942002000300010.. BACKGROUND AND OBJECTIVES: Moyamoya disease is a progressive cerebrovascular disorder implying anesthetic challenges due to patients poor brain perfusion, in addition to being a major cause for stroke in young people. This report aimed at describing a case of Moyamoya s disease in a patient submitted to general anesthesia with sevoflurane for a diagnostic procedure outside the surgery center. CASE REPORT: Male child, 13 years old, physical status ASA IV, with Moyamoya disease and neurological sequelae after three previous strokes, chronic renal failure and systemic hypertension admitted for high digestive endoscopy. In the supine position and after monitoring, inhalational induction was attained ...
UniProtKB/Swiss-Prot : 73 Moyamoya disease 2: A progressive cerebral angiopathy characterized by bilateral intracranial carotid artery stenosis and telangiectatic vessels in the region of the basal ganglia. The abnormal vessels resemble a puff of smoke (moyamoya) on cerebral angiogram. Affected individuals can develop transient ischemic attacks and/or cerebral infarction, and rupture of the collateral vessels can cause intracranial hemorrhage. Hemiplegia of sudden onset and epileptic seizures constitute the prevailing presentation in childhood, while subarachnoid bleeding occurs more frequently in adults ...
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In the body there are two deep temporal arteries . These arteries are called the posterior and anterior deep temporal arteries . The anterior deep temporal artery and its partner are located between the pericranium (a membrane that covers the outer surface of the skull) and the temporal muscles, which
In the body there are two deep temporal arteries . These arteries are called the posterior and anterior deep temporal arteries . The anterior deep temporal artery and its partner are located between the pericranium (a membrane that covers the outer surface of the skull) and the temporal muscles, which
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Moyamoya.com - Online Store Online Store Search page. Worldwide support group for sufferers of MoyaMoya Disease and their families. Help stread the word by getting your Moyamoya.com merchandise here!
관자 동맥 체온계 Temporal Artery Thermometer(Exergen Temporal Scanner) 관자 동맥 체온계는 병원용 TAT-5000과 TAT-2000 등이 있다. Exergen
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Moyamoya disease is a rare, progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in an area called the basal ganglia. The name
OBJECTIFS. tiologies des NPSReconnatre un NPSLa place de l\imagerie dans le diagnostic des NPSConnatre les critres de malignitConnatre les critres de bnignitIdentifier un NPS indterminDmarche diagnostique . INTRODUCTION. 150000 CAS / AN AUX USASYNONYME DE CANCER (50%)CAUSES MU Slideshow 840847 by tyra
CONCLUSION: Introduction of intra-saccular flow diversion can be accomplished within a care trial context. PMID: 31690151 [PubMed - as supplied by publisher]...
Cardium Therapeutics (OTCBB:CDTP) and its subsidiary InnerCool Therapies announced today that its endovascular temperature modulation technology was featured in the March 2007 issue of Mens Health. The article "The Miracle on Ice" highlights the benefits of InnerCools Celsius Control System during a cranial bypass surgery performed at Stanford University Medical Center. A copy of the article can be accessed at http://www.nxtbook.com/nxtbooks/rms/menh_1-19934755/. A reporter for Mens Health, Mikel Jollett, follows Gary K. Steinberg, M.D., Ph.D., Chairman of Neurosurgery at Stanford University Medical Center, while he performs an intracranial bypass surgery. The patient is cooled to 33 degrees Celsius, or 91.4 degrees Fahrenheit, with InnerCools Celsius Control system providing Dr. Steinberg with the valuable time necessary to bypass the blockages in the brain without causing brain-cell death. The patients underlying condition is Moyamoya disease, a progressive cerebrovascular disorder caused ...
Backgrounds: Acute myocardial infarction (AMI) is the most common cause of sudden cardiac arrest. ILCOR has suggested that AMI patients with post cardiac arrest should undergo emergency coronary angiography, with subsequent revascularization therapy (Circulation 2008; 118:2452-2483). AHA guidelines for AMI have recommended early coronary revascularization for patients with cardiogenic shock complicating AMI (Circulation 2004;110: 586-636). We investigated whether emergency coronary revascularization therapy had survival benefits for AMI patients with post-cardiac arrest.. Methods: We did a multicenter observation study of emergency cardiovascular care in the Tokyo CCU Network. Of the AMI patients who admitted the CCU, patients with post cardiac arrest syndrome or cardiogenic shock were enrolled in this study. The primary endpoint was survival to hospital discharge.. Results: Of the 5,337 AMI patients who admitted the CCU, 413 were enrolled in this study; 142 was post cardiac arrest (Arrest ...
TY - JOUR. T1 - Revascularization grading in endovascular acute ischemic stroke therapy. AU - Zaidat, O. O.. AU - Lazzaro, M. A.. AU - Liebeskind, D. S.. AU - Janjua, N.. AU - Wechsler, L.. AU - Nogueira, R. G.. AU - Edgell, R. C.. AU - Kalia, J. S.. AU - Badruddin, A.. AU - English, J.. AU - Yavagal, Dileep R. AU - Kirmani, J. F.. AU - Alexandrov, A. V.. AU - Khatri, P.. PY - 2012/9/25. Y1 - 2012/9/25. N2 - Background: Recanalization and angiographic reperfusion are key elements to successful endovascular and interventional acute ischemic stroke (AIS) therapy. Intravenous recombinant tissue plasminogen activator (rt-PA), the only established revascularization therapy approved by the US Food & Drug Administration for AIS, may be less effective for large artery occlusion. Thus, there is enthusiasm for endovascular revascularization therapies, which likely provide higher recanalization rates, and trials are ongoing to determine clinical efficacy and compare various methods. It is anticipated that ...
The invention is directed to a self-expanding stent for implantation into a body lumen, such as an artery. The stent consists of a plurality of radially expandable cylindrical elements generally aligned on a common longitudinal stent axis and interconnected by a plurality of interconnecting members placed on the stent in a collinear arrangement such as to create at least one continuous spine which extends along the length of the stent. The invention is also directed to a stent delivery system for implantation of a stent in a vessel which includes an outer tubular member having a restraining sheath and an inner tubular member having a distal end which has a compressed stent mounted thereto. The proximal end of the inner tubular member is connected to a housing assembly which prevents the inner tubular member from moving when the outer tubular member is retracted to deploy the stent. The proximal end of the outer tubular member is attached to a pull-back handle which is slidably mounted on the base of the

Understanding and treating moyamoya disease in children<...Understanding and treating moyamoya disease in children<...

keywords = "Cerebral revascularization, Children, Ischemia, Moyamoya disease, Pial synangiosis, Stroke",. author = "Jodi, {L. ... numerous direct and indirect revascularization procedures have been used to improve the compromised cerebral circulation, with ... numerous direct and indirect revascularization procedures have been used to improve the compromised cerebral circulation, with ... numerous direct and indirect revascularization procedures have been used to improve the compromised cerebral circulation, with ...
more infohttps://indiana.pure.elsevier.com/en/publications/understanding-and-treating-moyamoya-disease-in-children-2

Moyamoya Syndrome - Columbia NeurosurgeryMoyamoya Syndrome - Columbia Neurosurgery

Cerebral Ischemia Cerebrl Serebral Cerbral Cerebrall ishemia Ischema ichemia Cerebral Palsy Cerrebral Cerebal Palsie Plasy ... Surgical treatment options for Moyamoya syndrome include direct revascularization procedures such as an EC-IC bypass as well as ... Cerebral Ischemia Cerebrl Serebral Cerbral Cerebrall ishemia Ischema ichemia Cerebral Palsy Cerrebral Cerebal Palsie Plasy ... This can lead to cerebral ischemia. In addition, the new vessels are fragile and may rupture. ...
more infohttp://www.columbianeurosurgery.org/conditions/moyamoya-syndrome/

Cerebral Revascularization Imaging: Presentation of Stroke, ImagingCerebral Revascularization Imaging: Presentation of Stroke, Imaging

encoded search term (Cerebral Revascularization Imaging) and Cerebral Revascularization Imaging What to Read Next on Medscape. ... Cerebral arterial calcification is an imaging prognostic marker for revascularization treatment of acute middle cerebral ... Cerebral Revascularization Imaging Updated: Aug 24, 2016 * Author: Jeffrey P Kochan, MD; Chief Editor: James G Smirniotopoulos ... Cerebral perfusion, as related to perfusion MRI (Graph A) and CT perfusion imaging (Graph B). Graph A shows the effect of a ...
more infohttps://emedicine.medscape.com/article/420186-overview

Cerebral revascularization and carotid artery resection at the skull base for treatment of advanced head and neck malignancies ...Cerebral revascularization and carotid artery resection at the skull base for treatment of advanced head and neck malignancies ...

Wolfe SQTummala RPMorcos JJ: Cerebral revascularization in skull base tumors. Skull Base 15:71-822005 ... Wolfe SQTummala RPMorcos JJ: Cerebral revascularization in skull base tumors. Skull Base 15:71-822005 ... Sekhar LNNatarajan SKEllenbogen RGGhodke B: Cerebral revascularization for ischemia, aneurysms, and cranial base tumors. ... Sekhar LNNatarajan SKEllenbogen RGGhodke B: Cerebral revascularization for ischemia, aneurysms, and cranial base tumors. ...
more infohttps://thejns.org/view/journals/j-neurosurg/118/3/article-p637.xml

Cerebral RevascularizationCerebral Revascularization

... : Techniques in Extracranial-to-Intracranial Bypass Surgery Author(s): Saleem I. Abdulrauf MD FAAN ... Cerebral Revascularization. MEDICAL LITERATURES AND UNIVERSITY PASSWORDS. :: Medical E-books Departments :: Neurology & ... Cerebral Revascularization: Techniques in Extracranial-to-Intracranial Bypass Surgery. Author(s): Saleem I. Abdulrauf MD FAAN ... Re: Cerebral Revascularization. by [email protected] on 27/12/2016, 8:34 pm ...
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Assessing the effect of unilateral cerebral revascularisation on the vascular reactivity of the non-intervened hemisphere: a...Assessing the effect of unilateral cerebral revascularisation on the vascular reactivity of the non-intervened hemisphere: a...

... whether revascularisation improves total cerebral blood flow volume (TCBF), and how cerebral veins would respond to altered ... Haemodynamic alterations in cerebral blood vessels after carotid artery revascularisation: quantitative analysis using 2D phase ... Assessing the effect of unilateral cerebral revascularisation on the vascular reactivity of the non-intervened hemisphere: a ... Home » Assessing the effect of unilateral cerebral revascularisation on the vascular reactivity of the non-intervened ...
more infohttp://connection.ebscohost.com/c/articles/101328397/assessing-effect-unilateral-cerebral-revascularisation-vascular-reactivity-non-intervened-hemisphere-retrospective-observational-study

The role of cerebral revascularization in patients with intracranial aneurysms. - Semantic ScholarThe role of cerebral revascularization in patients with intracranial aneurysms. - Semantic Scholar

Cerebral revascularization offers an important adjunct to parent-vessel ligation in the treatment of large and otherwise ... internal carotid artery will improve and be cured in the majority of patients treated with universal revascularization approach ... The role of cerebral revascularization in patients with intracranial aneurysms.. *. Saman P Javedan, Vaibhav Deshmukh, Robert F ... Cerebral revascularization offers an important adjunct to parent-vessel ligation in the treatment of large and otherwise ...
more infohttps://www.semanticscholar.org/paper/The-role-of-cerebral-revascularization-in-patients-Javedan-Deshmukh/fa63d385152c7ff3a4db99e34472f3403835954c

Current Open Surgical Indications for Revascularization in Cerebral Ischemia | SpringerLinkCurrent Open Surgical Indications for Revascularization in Cerebral Ischemia | SpringerLink

Cerebral revascularization was pioneered half a century ago. Gradual improvements in microsurgical instrumentation and training ... Cerebral bypass Cerebral ischemia Revascularization Flow augmentation Flow replacement Vertebrobasilar insufficiency ... However, there is still a select group of patients with chronic cerebral ischemia, for whom open cerebral revascularization ... Cerebral revascularization: direct versus indirect bypass. Case presentation and review. Rom Neurosurg. 2014;21:459-69. https ...
more infohttps://link.springer.com/chapter/10.1007%2F978-3-030-04615-6_31

The European Workshops on Basic Techniques of Microsurgery and Cerebral Revascularization, AKH, Vienna, Austria / Neurosurgery ...The European Workshops on Basic Techniques of Microsurgery and Cerebral Revascularization, AKH, Vienna, Austria / Neurosurgery ...

The European Workshops on Basic Techniques of Microsurgery and Cerebral Revascularization, AKH, Vienna, Austria Neurosurgery ... The European Workshops on Basic Techniques of Microsurgery and Cerebral Revascularization , которое выглядело приблизительно ...
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Abstract TP123: Efficacy of Staged Angioplasty to Prevent Cerebral Hyperperfusion Syndrome After Endovascular Revascularization...Abstract TP123: Efficacy of Staged Angioplasty to Prevent Cerebral Hyperperfusion Syndrome After Endovascular Revascularization...

Abstract TP123: Efficacy of Staged Angioplasty to Prevent Cerebral Hyperperfusion Syndrome After Endovascular Revascularization ... Abstract TP123: Efficacy of Staged Angioplasty to Prevent Cerebral Hyperperfusion Syndrome After Endovascular Revascularization ... Abstract TP123: Efficacy of Staged Angioplasty to Prevent Cerebral Hyperperfusion Syndrome After Endovascular Revascularization ... Abstract TP123: Efficacy of Staged Angioplasty to Prevent Cerebral Hyperperfusion Syndrome After Endovascular Revascularization ...
more infohttp://stroke.ahajournals.org/content/48/Suppl_1/ATP123

Trends in the Management of Cerebrovascular Diseases | Springer for Research & DevelopmentTrends in the Management of Cerebrovascular Diseases | Springer for Research & Development

Cerebral Revascularization. * Front Matter Pages 71-71 PDF. * Cerebral Bypass Surgery: Level of Evidence and Grade of ... Clipping of Recurrent Cerebral Aneurysms After Coil Embolization Shingo Toyota, Tetsuya Kumagai, Tetsu Goto, Kanji Mori, Takuyu ... Stroke Diagnosis Stroke Management Stroke Surgery Cerebral Blood Flow Intracranial Aneurysms Arteriovenous Malformations ... Role of Indocyanine Green Videoangiography in Identification of Donor and Recipient Arteries in Cerebral Bypass Surgery ...
more infohttps://rd.springer.com/book/10.1007/978-3-319-73739-3

Search Results | jnsSearch Results | jns

The purpose of this report is to review the use of flow measurement in cerebral revascularization, presenting algorithms for ...
more infohttps://thejns.org/search?f_0=author&q_0=John+H.+Shin

Shop and Discover over 51,000 Books and Journals - ElsevierShop and Discover over 51,000 Books and Journals - Elsevier

Cerebral Revascularization Product Type: Book. Edition: 1. First Published: 2010. eBook: 978-1-4377-3639-7 ...
more infohttps://www.elsevier.com/catalog?page=3&cat0=medicine&cat1=neurosurgery&series=&sort=datedesc

Search of: Recruiting, Not yet recruiting, Available Studies | Cerebrovascular Disorders - List Results - ClinicalTrials.govSearch of: Recruiting, Not yet recruiting, Available Studies | 'Cerebrovascular Disorders' - List Results - ClinicalTrials.gov

The Safety and Efficacy of Peri-procedure Blood Pressure Management of Revascularization. *Cerebral Revascularization ... Cerebral Vasomotor Reactivity. 30. All. 18 Years to 80 Years (Adult, Senior). NCT02553655. 20150648. October 2015. July 2019. ... Secondary Technical Clinical Performance Endpoint: Cerebral Infarct volume at 24 Hours. 120. All. 18 Years to 85 Years (Adult, ... National Cerebral and Cardiovascular Center Osaka. Osaka, Kansai, Japan. *Department of Neurology, University Hospital Basel. ...
more infohttps://clinicaltrials.gov/ct2/results?recr=Open&cond=%22Cerebrovascular+Disorders%22&show_flds=Y

KAKEN - Research Projects | Investigation of causative gene of familial occurrence of idiopathic occlusion of Willis ring ...KAKEN - Research Projects | Investigation of causative gene of familial occurrence of idiopathic occlusion of Willis ring ...

Journal Article] Pitfalls in cerebral revascularization surgery2004. *. Author(s). Houkin K. ... Journal Article] Pitfalls in cerebral revascularization surgery2004. *. Author(s). Houkin K ... Publications] Houkin K: Pitfalls in cerebral revascularization surgeryInternational Congress Series. 1259. 313-320 (2004). * ... Control value was measured using asymptomatic cerebral aneurysm patients and other ischemic cerebrovascular disease. As results ...
more infohttps://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-14370441/

Direct and indirect revascularization for moyamoya disease surgical techniques and peri-operative complications.Direct and indirect revascularization for moyamoya disease surgical techniques and peri-operative complications.

We have performed surgical treatment for Moyamoya disease using the superficial temporal artery to middle cerebral artery (STA- ... Cerebral Angiography. Cerebral Revascularization*. Child. Child, Preschool. Hematoma, Subdural / etiology. Humans. Moyamoya ... STA-MCA anastomosis to the frontal branch of the middle cerebral artery is indispensable for improving cerebral circulation of ... Dissection of the STA, which is the most powerful resource of direct revascularization, should be carefully carried out using a ...
more infohttp://www.biomedsearch.com/nih/Direct-indirect-revascularization-moyamoya-disease/9409425.html

Neovascularization (angiogenesis) after revascularization in moyamoya disease. Which technique is most useful for moyamoya...Neovascularization (angiogenesis) after revascularization in moyamoya disease. Which technique is most useful for moyamoya...

The effects of direct and indirect revascularization for moyamoya disease were analyzed for each donor artery to determine ... Cerebral Revascularization / methods*. Child. Follow-Up Studies. Humans. Moyamoya Disease / radiography, surgery*. ... and direct revascularization via the superficial temporal artery and the middle cerebral artery (STA-MCA) bypass. Among those ... In indirect revascularization surgery for moyamoya disease, the temporal muscle (the deep temporal artery) and the dura mater ( ...
more infohttp://www.biomedsearch.com/nih/Neovascularization-angiogenesis-after-revascularization-in/10819257.html

Publications by Kevin A. Walter, M.D. -  University of Rochester Medical CenterPublications by Kevin A. Walter, M.D. - University of Rochester Medical Center

Book Title: Cerebral Revascularization. Author List: Walter, K.A.; Brem, H.. Edited By: Bernstein, E.P.; Callow, A.D.; ...
more infohttps://www.urmc.rochester.edu/people/26957180-kevin-a-walter/publications

Multidisciplinary Management of Leaks After One-Anastomosis Gastric Bypass in a Single-Center Series of 2780 Consecutive...Multidisciplinary Management of Leaks After One-Anastomosis Gastric Bypass in a Single-Center Series of 2780 Consecutive...

Cerebral Revascularization. Microsurgical revascularization to improve intracranial circulation. It usually involves joining ... Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, ... the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian- ...
more infohttps://www.bioportfolio.com/resources/pmarticle/2281616/Multidisciplinary-Management-of-Leaks-After-One-Anastomosis-Gastric-Bypass-in-a-Single.html

Mid-term outcomes of simultaneous coronary artery bypass graft surgery and septal myectomy in patients with hypertrophic...Mid-term outcomes of simultaneous coronary artery bypass graft surgery and septal myectomy in patients with hypertrophic...

Cerebral Revascularization. Microsurgical revascularization to improve intracranial circulation. It usually involves joining ... Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, ... The purpose of this study is to determine completeness of revascularization, graft patency, clinical outcomes, health-related ... The right gastroepiploic artery is frequently used in CORONARY ARTERY BYPASS GRAFTING; MYOCARDIAL REVASCULARIZATION, and other ...
more infohttps://www.bioportfolio.com/resources/pmarticle/2258160/Mid-term-outcomes-of-simultaneous-coronary-artery-bypass-graft-surgery-and-septal.html

Kuroda S[au] - PubMed - NCBIKuroda S[au] - PubMed - NCBI

The unrealized gain of cerebral revascularization.. Russin JJ, Dehdashti AR, Vajkoczy P, Kuroda S, Mao Y. ... Persistent Primitive Olfactory Artery as Novel Collateral Channel to the Anterior Cerebral Artery in Moyamoya Disease. ...
more infohttps://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Kuroda+S%5Bau%5D&dispmax=50

Guidelines for Carotid Endarterectomy | StrokeGuidelines for Carotid Endarterectomy | Stroke

Concomitant coronary and cerebral revascularization under cardiopulmonary bypass. Ann Thorac Surg.. 1986;41:431-435. ... Concomitant cerebral and myocardial revascularization. Surg Clin North Am.. 1986;66:385-395. ... Duchateau J, Nevelsteen A, Sergeant P, Flameng W, Suy R. Combined myocardial and cerebral revascularization: a ten year ... Use of computerized cerebral tomography in selection of patients for elective and urgent carotid endarterectomy. Ann Surg.. ...
more infohttp://stroke.ahajournals.org/content/26/1/188

Chordomas and Chondrosarcomas of the Skull Base and Spine - 2nd EditionChordomas and Chondrosarcomas of the Skull Base and Spine - 2nd Edition

Cerebral Revascularization for Skull Base Tumors. 22. Skull base reconstruction following resection of skull base chordomas and ...
more infohttps://www.elsevier.com/books/chordomas-and-chondrosarcomas-of-the-skull-base-and-spine/harsh-iv/978-0-12-804257-1
  • Although there is no definitive medical treatment, numerous direct and indirect revascularization procedures have been used to improve the compromised cerebral circulation, with outcomes varying according to procedure type. (elsevier.com)
  • This is a randomized, prospective European Multicenter Study comparing complete arterial revascularization of the coronary arteries using arterial graft material exclusively and "conven. (bioportfolio.com)
  • Despite maximal surgical intervention, including ICA sacrifice at the skull base with revascularization, patient survival was dismal, and the complication rate was significant. (thejns.org)
  • Susceptibility weighted imaging in cerebral hypoperfusion-can we predict increased oxygen extraction fraction? (ebscohost.com)
  • The purpose of this study was to explore cerebral activation of swallowing in dysphagia using functional MRI (fMRI) to. (ebscohost.com)
  • Studies the effects of ethyl alcohol on cerebral hemispheric specialization of language and on hand movements. (ebscohost.com)