Yamashita T, Nakano S, Ishihara H, Kitahara T, Kashiwagi S, Katoh S, Takasago T, Wakuta Y, Abiko S, Ito H
Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.
Acta Neurol Scand Suppl. 1996;166:74-8. doi: 10.1111/j.1600-0404.1996.tb00554.x.
The purpose of this study was to evaluate hemodynamic compromise in terms of baseline CBF and CRC in patients with chronic cerebral occlusive lesions and its modulation by a superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis. The study subjects were 10 healthy volunteers and 49 chronic ischemic patients with stenosis or occlusion of the internal carotid artery (ICA) or middle cerebral artery (MCA). The hemodynamics were measured using stable xenon enhanced computed tomographic CBF measurement with the acetazolamide challenge. The compromised hemodynamics in patients with chronic steno-occlusive lesions did not improve during their natural course after two months. STA-MCA bypass modulated hemodynamic compromise in the ischemic patients. We recommend STA-MCA bypass for patients with reduced CRC, regardless of whether baseline CBF is reduced or normal. Hemodynamic classification using a combination of baseline CBF values and CRC values is useful for evaluating cerebral hemodynamics and for choosing the best treatment for cerebral ischemia with occlusive lesions.
本研究的目的是根据慢性脑闭塞性病变患者的基线脑血流量（CBF）和脑循环储备（CRC）评估血流动力学损害情况，以及颞浅动脉-大脑中动脉（STA-MCA）吻合术对其的调节作用。研究对象为10名健康志愿者和49名患有颈内动脉（ICA）或大脑中动脉（MCA）狭窄或闭塞的慢性缺血患者。使用稳定氙增强计算机断层扫描CBF测量并进行乙酰唑胺激发试验来测量血流动力学。慢性狭窄闭塞性病变患者受损的血流动力学在两个月的自然病程中并未改善。STA-MCA搭桥术可调节缺血患者的血流动力学损害。我们建议，无论基线CBF降低还是正常，对于CRC降低的患者均应行STA-MCA搭桥术。结合基线CBF值和CRC值进行血流动力学分类，有助于评估脑血流动力学，并为选择最佳的脑缺血闭塞性病变治疗方法提供依据。
