Department of Neurosurgery and Neuro-Medical Scientific Center, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 97004, Taiwan.
J Clin Neurosci. 2012 Jun;19(6):814-9. doi: 10.1016/j.jocn.2011.08.031. Epub 2012 Apr 6.
Augmentation of the cerebral blood supply to correct cerebral hemodynamic insufficiency by extracranial-intracranial bypass may be an appropriate method to reduce the risk of ischemic stroke. Eighty-five patients with ischemic symptoms, decreased regional cerebral blood flow, and decreased regional cerebrovascular reactivity were recruited for surgery. The post-bypass mean regional blood flow increased by 35.8% compared to the pre-bypass value (p<0.001). Only minor re-establishment of vasculature after anastomosis was detected in three of four patients with middle cerebral artery stenosis, which suggests that there are fewer benefits of bypass surgery in this situation. Cerebral infarction occurred immediately post-operation in one patient who was predisposed to stroke due to a bilateral carotid occlusion. Hyperperfusion injury was infrequent in this series; only one patient developed intracerebral hemorrhage three weeks after the bypass. One ischemic and one hemorrhagic stroke occurred during the 90 months following surgery.
通过颅外-颅内旁路术增加脑血供以纠正脑血流动力学不足可能是降低缺血性卒中风险的一种合适方法。85 例有缺血症状、局部脑血流减少和局部脑血管反应性降低的患者接受了手术。与术前相比，旁路术后平均局部脑血流增加了 35.8%（p<0.001）。在 4 例大脑中动脉狭窄患者中，仅在 3 例患者中检测到吻合后血管再通的轻微重建，这表明在这种情况下旁路手术的益处较少。由于双侧颈动脉闭塞，一名有中风倾向的患者在手术后立即发生脑梗死。在本系列中，高灌注损伤并不常见；仅 1 例患者在旁路术后 3 周发生颅内出血。在手术后的 90 个月内，发生了 1 例缺血性卒中和 1 例出血性卒中。
