Microsurgery for Stroke

ISBN-13: 9781461263517 / Angielski / Miękka / 2011 / 292 str.

P. Schmiedek; O. Gratzl;R. F. Spetzler

Opis

This volume is dedicated to the Third International Symposium on Microneurosurgical Anastomoses for Cerebral Ischemia, which took place in Rottach-Egern, June 2&-30, 1976, under the sponsorship of Professor F. Marguth, Director of the Depart ment of Neurosurgery, Ludwig-Maximilians-University of Munich (West Germany). It contains the continuing devel opments of the extra- intracranial arterial bypass (EIAB) for cerebrovascular occlusive disease since the First International Symposium in Lorna Linda, California, in June, 1973, and the Second International Symposium in Chicago, Illinois, in June, 1974. The EIAB was developed by Donaghy and Yasargil, and it consists of a microsurgical anastomosis of the superficial tem poral artery or the occipi tal branch of the external carotid artery to the middle cerebral artery on the surface of the brain and, very recently, the anastomosis of the occipital artery to the posterior-inferior cerebellar artery for the treatment of verte brobasilar insufficiency. From the presentations at the sym posium it became evident that the greatest potential in the pre vention of a stroke in a susceptible patient is the presence of an adequate collateral cerebral blood flow. The basic diagnostic procedure is cerebral angiography in cluding both carotid and vertebral arteries. Regional cerebral blood flow (rCBF) studies and computerized tomography add further diagnostic information and are particularly important in the selection of potential surgical candidates.

Spis treści

I. Basic Problems of Cerebral Ischemia.- 1. Comments on the History of External-Internal Anastomosis for Cerebral Ischemia.- 2. Experimental Ischemia of the Brain.- 3. Thresholds of Cerebral Ischemia.- 4. Focal Flow and Neuronal Activity in Experimental Cerebral Ischemia.- 5. Cerebral Changes During Recirculation following Temporary Ischemia in Mongolian Gerbils, with Special Reference to Blood-Brain-Barrier Change.- 6. Simulated Transient Ischemic Attacks in Cat and Man.- 7. Experimental and Clinical Use of Barbiturates in Focal Cerebral Ischemia.- 8. Combined Use of Regional Cerebral Blood Flow Measurement and Computerized Tomography for the Diagnosis of Cerebral Ischemia.- 9. Microvascular Bypass for Cerebral Ischemia—An Overview, 1966–1976.- II. Experimental.- 10. Experimental Middle Cerebral Artery Microsurgical Embolectomy.- 11. Cerebral Arterial Spasm: In Vitro Contractile Activity of Vasoactive Agents on Human Cortical and Temporal Arteries.- 12. Comparative Merits of Autogenous Arterial and Venous Bypass Grafts as Alternatives to Direct Arterial Anastomosis.- 13. Endothelial Changes after Vascular Surgery: A Scanning Electron Microscopic Study.- 14. Morphologic Changes after Vascular Microanastomoses as a Function of the Technique Used.- 15. Morphometric Approach to Fine Structural Changes in the Intima of the Common Carotid Artery of the Rat following Microsurgery.- 16. Scanning Electron Microscope Studies of Endothelial Injury in Microsurgical Anastomosis.- 17. Importance of the Histologic Structure of the Superficial Temporal Artery for the Function of Extra-Intracranial Bypass.- 18. Evaluation of 2-mm Arterial Grafts for Extra- to Intracranial Bypass in Occlusive Cerebrovascular Disease.- 19. Comparative Evaluation of Conventionally Sutured and Clot-Sutured Microsurgical Anastomoses.- 20. Spontaneous Cerebral Revascularization: An Experimental Study Supporting Microneurovascular Bypass Surgery.- 21. End-to-Side Anastomosis Between Carotid Arteries and Serial Angiographic Controls in Rats.- 22. Potential of Reconstructive Vascular Surgery in the Spinal Cord—An Experimental Study.- III. Clinical.- 23. A Method to Identify and Treat Reversible Ischemic Alterations of Brain Tissue.- 24. Selection of Completed Stroke Patients for STA-MCA Anastomosis Based on Measurements of Somatosensory Evoked Potential and CBF Dynamics.- 25. Relationship between rCBF Changes and Restitution of Neurologic, Psychopathologic, and Electroencephalographic Disturbances in Patients with Occlusion of Middle Cerebral Artery and Internal Carotid Artery.- 26. Evaluation of Patients with Cerebral Ischemia Using Computerized Tomography.- 27. Preoperative Evaluation of STA-MCA Anastomosis Candidates with rCBF Studies.- 28. Some Comments on the Technique of STA-Cortical MCA Anastomoses.- 29. Angiographic Features of the Cortical Extra-Intracranial Anastomosis.- 30. Results of Multiple Angiographic Studies on Cerebral Revascularization Patients.- 31. Dopplersonographic Control of Microvascular Bypass Function.- 32. Cortical Arterial Pressure in Occlusive Cerebrovascular Disease and Results of Bypass Surgery.- 33. Cerebral Revascularization for Stroke in Evolution.- 34. STA-MCA Bypass for Acute Focal Cerebral Ischemia.- 35. Multiple-Vessel Occlusions in Cerebrovascular Disease—a Further Followup of the Effects of Microvascular Bypass on the Quality of Life and the Incidence of Stroke.- 36. Extra- Intracranial Arterial Anastomosis in Ten Patients with Moya-Moya Syndrome (Occlusion of the Circle of Willis).- 37. Microsurgical Anastomosis for Cerebral Ischemia in Ninety Patients.- 38. Long-Term Clinical Results following Extra- Intracranial Arterial Bypass Surgery.- 39. Late Followup Studies in a Selected Group of Patients with Extra- Intracranial Arterial Bypass.- 40. Bypass Surgery for Vascular Disease of the Carotid and Vertebral Artery Systems.