AI Article Synopsis
- Cerebral hyperperfusion syndrome (CHS) is a serious complication following STA-MCA surgery for moyamoya disease, leading to neurological deficits due to increased cerebral blood flow.
- The study aims to link the occurrence of CHS to pre- and post-anastomosis blood flow metrics by using intraoperative laser speckle contrast imaging to monitor cerebral circulation in 48 patients.
- Results indicate that patients with low pre-anastomosis cerebral blood flow levels are at a higher risk for experiencing CHS after surgery, particularly shown through significant differences in blood flow metrics between CHS and non-CHS patients.
Article Abstract
Significance: Cerebral hyperperfusion syndrome (CHS), characterized by neurologic deficits due to postoperative high cerebral perfusion, is a serious complication of superficial temporal artery-middle cerebral artery (STA-MCA) surgery for moyamoya disease (MMD).
Aim: We aim to clarify the importance of assessing pre-anastomosis cerebral microcirculation levels by linking the onset of CHS to pre- and post-anastomosis hemodynamics.
Approach: Intraoperative laser speckle contrast imaging (LSCI) measured changes in regional cerebral blood flow (rCBF) and regional blood flow structuring (rBFS) within the cerebral cortical microcirculation of 48 adults with MMD.
Results: Following anastomosis, all MMD patients exhibited a significant increase in rCBF ( , ). Changes in rCBF and rBFS showed a negative correlation with their respective baseline levels (rCBF, ; rBFS, ). Baseline rCBF differed significantly between CHS and non-CHS groups ( ). The areas under the receiver operating characteristic (ROC) curve for baseline rCBF was 0.753. Hemorrhagic MMD patients showed higher baseline rCBF than ischemic patients ( ), with a marked correlation between pre- and post-anastomosis rCBF in hemorrhagic cases ( ), whereas ischemic MMD patients did not.
Conclusion: Patients with low levels of pre-anastomosis baseline CBF induce a dramatic increase in post-anastomosis and show a high risk of postoperative CHS.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372418 | PMC |
| http://dx.doi.org/10.1117/1.NPh.11.3.035008 | DOI Listing |
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