Grubb R L, Ratcheson R A, Raichle M E, Kliefoth A B, Gado M H
J Neurosurg. 1979 Jun;50(6):733-41. doi: 10.3171/jns.1979.50.6.0733.
Regional cerebral blood flow (rCBF) and regional cerebral oxygen utilization (rCMRO2) were measured before and after surgery in nine patients undergoing a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis to bypass cerebrovascular lesions not amenable to extracranial operative procedures. The objective of these studies was to determine whether measurements of this type could provide objective criteria for surgery as well as assess the effect of surgery. The preliminary data, although limited, suggest that measurements of regional cerebral hemodynamics and metabolism in these patients before and after surgery provide valuable data upon which to develop criteria and assess results. For example, 1) a significant depression of rCBF and rCMRO2 in patients in whom a major cerebral infarction has not occurred, or 2) relative preservation of rCMRO2 despite depressed rCBF seem to be favorable indications for establishing a functioning STA-MCA anastomosis. In such patients, STA-MCA anastomosis can be followed by a return of rCBJ and rCMRO2 to virtually normal levels. Relatively normal rCBF and rCMRO2 in the presence of an occluded internal carotid artery in asymptomatic patients indicates satisfactory collateral circulation and is probably a contraindication to surgery.
对9例接受颞浅动脉-大脑中动脉（STA-MCA）吻合术以绕过不适于颅外手术的脑血管病变的患者，在手术前后测量了局部脑血流量（rCBF）和局部脑氧利用率（rCMRO2）。这些研究的目的是确定这类测量是否可为手术提供客观标准以及评估手术效果。初步数据虽然有限，但表明对这些患者手术前后的局部脑血流动力学和代谢进行测量可提供有价值的数据，据此制定标准并评估结果。例如，1）在尚未发生大面积脑梗死的患者中rCBF和rCMRO2显著降低，或2）尽管rCBF降低但rCMRO2相对保持不变，似乎都是建立有效的STA-MCA吻合术的有利指征。在这类患者中，STA-MCA吻合术后rCBF和rCMRO2可恢复到几乎正常的水平。无症状患者在颈内动脉闭塞的情况下rCBF和rCMRO2相对正常，表明侧支循环良好，可能是手术的禁忌证。
