Tsuda Y, Kimura K, Iwata Y, Hayakawa T, Etani H, Fukunaga R, Yoneda S, Abe H
Surg Neurol. 1984 Dec;22(6):595-604. doi: 10.1016/0090-3019(84)90437-3.
The effect of extracranial-intracranial bypass anastomosis on cerebral blood flow and CO2 reactivity during hypocapnia was investigated in ten patients with transient ischemic attacks or watershed infarctions due to carotid occlusive diseases. Six patients had occlusion and four had stenosis (greater than 50%) of the internal carotid artery. Those with infarctions had increased cerebral blood flow and CO2 reactivity postoperatively, and improved clinically. Those with transient ischemic attacks due to stenosis (greater than 50%) of the internal carotid artery had increased CO2 reactivity postoperatively but constant normal regional blood flow. Cerebral blood flow improved in those with poorer flow, CO2 reactivity increased in those with better reactivity, and better CO2 reactivity preoperatively brought about a greater flow increase. The pre- and postoperative evaluation of cerebral blood flow and CO2 reactivity is believed to be useful in evaluating the effectiveness of bypass anastomosis. Preoperative evaluation might be informative in selecting candidates for bypass.
在10例因颈动脉闭塞性疾病导致短暂性脑缺血发作或分水岭梗死的患者中，研究了颅外 - 颅内搭桥吻合术对低碳酸血症期间脑血流量和二氧化碳反应性的影响。6例患者存在颈动脉闭塞，4例患者存在颈内动脉狭窄（大于50%）。发生梗死的患者术后脑血流量和二氧化碳反应性增加，临床症状改善。因颈内动脉狭窄（大于50%）导致短暂性脑缺血发作的患者术后二氧化碳反应性增加，但局部血流保持正常。血流较差的患者脑血流量改善，反应性较好的患者二氧化碳反应性增加，术前较好的二氧化碳反应性导致更大的血流增加。脑血流量和二氧化碳反应性的术前和术后评估被认为有助于评估搭桥吻合术的有效性。术前评估可能有助于选择搭桥手术的候选者。
