651
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Tomsick TA. Mechanical embolus removal: a new day dawning. Stroke 2005; 36:1439-40. [PMID: 15994450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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652
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Melgar MA, Sahni D, Weinand M. Thyrocervical trunk—external carotid artery bypass for positional cerebral ischemia due to common carotid artery occlusion. J Neurosurg 2005; 103:170-5. [PMID: 16121988 DOI: 10.3171/jns.2005.103.1.0170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
✓ Medically refractory positional cerebral ischemia (PCI) and concomitant orthostatic hypotension associated with chronic common carotid artery (CCA) occlusion are rare. In this technical report, the authors describe an extracranial bypass in which the thyrocervical trunk was used as a donor vessel to treat three cases of CCA occlusion with PCI. Postoperatively, although orthostatic hypotension remained, ischemia-related symptoms resolved in all three patients and long-term graft patency was demonstrated. It is possible to treat cerebral ischemia due to CCA occlusion with extracranial bypass surgery. In these patients, the thyrocervical trunk proved to be a suitable donor vessel for the reconstitution of blood flow within the external carotid artery.
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653
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Smith WS, Sung G, Starkman S, Saver JL, Kidwell CS, Gobin YP, Lutsep HL, Nesbit GM, Grobelny T, Rymer MM, Silverman IE, Higashida RT, Budzik RF, Marks MP. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke 2005; 36:1432-8. [PMID: 15961709 DOI: 10.1161/01.str.0000171066.25248.1d] [Citation(s) in RCA: 866] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The only Food and Drug Administration (FDA)-approved treatment for acute ischemic stroke is tissue plasminogen activator (tPA) given intravenously within 3 hours of symptom onset. An alternative strategy for opening intracranial vessels during stroke is mechanical embolectomy, especially for patients ineligible for intravenous tPA. METHODS We investigated the safety and efficacy of a novel embolectomy device (Merci Retriever) to open occluded intracranial large vessels within 8 hours of the onset of stroke symptoms in a prospective, nonrandomized, multicenter trial. All patients were ineligible for intravenous tPA. Primary outcomes were recanalization and safety, and secondary outcomes were neurological outcome at 90 days in recanalized versus nonrecanalized patients. RESULTS Recanalization was achieved in 46% (69/151) of patients on intention to treat analysis, and in 48% (68/141) of patients in whom the device was deployed. This rate is significantly higher than that expected using an historical control of 18% (P<0.0001). Clinically significant procedural complications occurred in 10 of 141 (7.1%) patients. Symptomatic intracranial hemorrhages was observed in 11 of 141 (7.8%) patients. Good neurological outcomes (modified Rankin score < or =2) were more frequent at 90 days in patients with successful recanalization compared with patients with unsuccessful recanalization (46% versus 10%; relative risk [RR], 4.4; 95% CI, 2.1 to 9.3; P<0.0001), and mortality was less (32% versus 54%; RR, 0.59; 95% CI, 0.39 to 0.89; P=0.01). CONCLUSIONS A novel endovascular embolectomy device can significantly restore vascular patency during acute ischemic stroke within 8 hours of stroke symptom onset and provides an alternative intervention for patients who are otherwise ineligible for thrombolytics.
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654
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Roitberg B. Research news and notes. ACTA ACUST UNITED AC 2005; 63:495-6. [PMID: 15936360 DOI: 10.1016/j.surneu.2005.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 03/14/2005] [Indexed: 11/23/2022]
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655
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Correa P, Felix R, Mendonca ML, Freitas G, Azevedo J, Dohmann H, Alves S, Mesquita C. Dual-head coincidence gamma camera FDG-PET before and after autologous bone marrow mononuclear cell implantation in ischaemic stroke. Eur J Nucl Med Mol Imaging 2005; 32:999. [PMID: 15909195 DOI: 10.1007/s00259-005-1808-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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656
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Imai K, Mori T, Izumoto H, Watanabe M, Majima K. Emergency carotid artery stent placement in patients with acute ischemic stroke. AJNR Am J Neuroradiol 2005; 26:1249-58. [PMID: 15891193 PMCID: PMC8158596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND AND PURPOSE An effective intervention has not yet been established for patients with acute ischemic stroke who present with serious neurologic symptoms due to occlusion or a high-grade stenosis of the internal carotid artery (ICA). The aim of our retrospective study was to investigate the feasibility, safety, and efficacy of emergency carotid artery stent placement to improve neurologic symptoms and clinical outcome. METHODS Of 896 consecutive patients with acute ischemic stroke who were admitted to our institution within 7 days of onset from July 2000 to June 2003, 17 patients (1.9%) with occlusion or a high-grade stenosis of the ICA underwent emergency carotid artery stent placement. We reviewed their records for neurologic outcome, per the National Institutes of Health Stroke Scale (NIHSS) score, before and at 7 days after stent placement; clinical outcome, per the modified Rankin Scale score (mRS), at 90 days; frequency of procedure-related complications within 30 days; and recurrence rate of ipsilateral ischemic stroke within 90 days. RESULTS Carotid lesions were dilated completely in all patients. Median NIHSS scores before emergency stent placement and at 7 days were 12 and 5, respectively, showing significant improvement (P < .01, Wilcoxon rank sum test). Ten patients (59%) had favorable outcomes (mRS score 0-1) at 90 days. Irreversible complications occurred in two patients (12%): distal embolism in one and intracerebral hemorrhage in the other. No ipsilateral ischemic stroke recurred. CONCLUSION Emergency carotid artery stent placement can improve the 7-day neurologic outcome and may improve the 90-day clinical outcome in selected patients with ischemic stroke.
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657
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Sakaguchi G, Komiya T, Tamura N, Obata S, Masuyama S, Kimura C, Kobayashi T. Cerebral malperfusion in acute type A dissection: Direct innominate artery cannulation. J Thorac Cardiovasc Surg 2005; 129:1190-1. [PMID: 15867808 DOI: 10.1016/j.jtcvs.2004.09.036] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
MESH Headings
- Acute Disease
- Aortic Dissection/classification
- Aortic Dissection/complications
- Aortic Dissection/diagnosis
- Aortic Dissection/surgery
- Aortic Aneurysm, Thoracic/classification
- Aortic Aneurysm, Thoracic/complications
- Aortic Aneurysm, Thoracic/diagnosis
- Aortic Aneurysm, Thoracic/surgery
- Blood Vessel Prosthesis Implantation/methods
- Brachiocephalic Trunk/surgery
- Brain Chemistry
- Brain Ischemia/etiology
- Brain Ischemia/surgery
- Catheterization, Peripheral/instrumentation
- Catheterization, Peripheral/methods
- Cerebrovascular Circulation
- Echocardiography, Doppler, Color
- Emergencies
- Glasgow Coma Scale
- Humans
- Male
- Middle Aged
- Monitoring, Intraoperative/methods
- Patient Selection
- Reperfusion/instrumentation
- Reperfusion/methods
- Spectroscopy, Near-Infrared
- Time Factors
- Tomography, X-Ray Computed
- Unconsciousness/etiology
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658
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Hill MD, Shrive FM, Kennedy J, Feasby TE, Ghali WA. Simultaneous carotid endarterectomy and coronary artery bypass surgery in Canada. Neurology 2005; 64:1435-7. [PMID: 15851737 DOI: 10.1212/01.wnl.0000158477.55659.fe] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Stroke neurologists are commonly asked to review patients who require coronary artery bypass grafting (CABG) but who also have comorbid severe carotid stenosis; such patients may be offered simultaneous carotid endarterectomy (CEA). In Canada, 0.51% of CABG procedures were combined CEA-CABG. The adjusted stroke and death rate was 2.67-fold greater in the combined CEA-CABG group compared to CABG alone. Randomized trials of the combined procedure are needed.
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659
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Krylov VV, Iartsev VV, Kondakov EN, Pirskaia TN. [Problems in the organization of surgical treatment of patients with cerebrovascular diseases in the Russian Federation]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2005:38-40. [PMID: 16078634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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660
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Cerrato P, Giraudo M, Baima C, Grasso M, Azzaro C, Lentini A, Perozzo P, Doveil G, Bergamasco B. Asymptomatic white matter ischemic lesions in a patient with pseudoxanthoma elasticum. J Neurol 2005; 252:848-9. [PMID: 15765271 DOI: 10.1007/s00415-005-0757-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Revised: 11/18/2004] [Accepted: 11/24/2004] [Indexed: 10/25/2022]
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661
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Felten RP, Ogden NRP, Peña C, Provost MC, Schlosser MJ, Witten CM. The Food and Drug Administration medical device review process: clearance of a clot retriever for use in ischemic stroke. Stroke 2005; 36:404-6. [PMID: 15625290 DOI: 10.1161/01.str.0000153063.54972.91] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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662
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663
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Mori K. [Therapeutic cerebral hypothermia after Clifton shock in 2001]. NO TO SHINKEI = BRAIN AND NERVE 2005; 57:14-24. [PMID: 15782595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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664
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Charbel FT, Meglio G, Amin-Hanjani S. Superficial Temporal Artery-to-Middle Cerebral Artery Bypass. Oper Neurosurg (Hagerstown) 2005; 56:186-90; discussion 186-90. [PMID: 15799809 DOI: 10.1227/01.neu.0000144487.85531.fd] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Accepted: 06/09/2004] [Indexed: 11/19/2022] Open
Abstract
Abstract
THE SUPERFICIAL TEMPORAL artery-to-middle cerebral artery bypass represents the mainstay of bypass operations for cerebral revascularization. The role of this operation in the setting of cerebrovascular occlusive disease, with compromised cerebral hemodynamic reserve, is a topic of current investigation. In this report, we describe technical nuances to avert potential pitfalls in the performance of this procedure. The use of intraoperative quantitative blood flow measurements as a reliable method of assessing the success of the bypass is also described.
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665
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Zhu W, Mao Y, Zhou LF. Reduction of neural and vascular damage by transplantation of VEGF-secreting neural stem cells after cerebral ischemia. ACTA NEUROCHIRURGICA. SUPPLEMENT 2005; 95:393-7. [PMID: 16463888 DOI: 10.1007/3-211-32318-x_80] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We determined the role of VEGF-transfected neural stem cells (NSCs) transplantation in rat brain subjected to ischemia. Fetal NSCs were cultured from E14 days SD rats and transfected with VEGF121 gene by using lipofectamine technique. Temporary middle cerebral artery occlusion (tMCAO) models were established and randomly divided into 1: control group, 2: PBS transplantation group, 3: NSCs transplantation group and 4: VEGF-secreting NSCs transplantation group. Grafts were transplanted into the penumbra zones 3 days after tMCAO model established. Neurological Severity Score (NSS) was checked in all groups 2-12 weeks after transplantation. By using immunofluorescent staining, VEGF expression of transplanted cells, differentiation and migration of transplanted NSCs after transplantation were detected. VEGF gene-transfected neural stem cells expressed gene products during the first 2 weeks. NSS in this group was significantly lower compared with that in other 3 groups 12 weeks after transplantation. VEGF gene-transfected NSCs migrated and expressed VEGF in hosts' brains, some of them differentiated to neurons 12 weeks after transplantation. VEGF-transfected NSCs expressed gene products during the early time after transplantation, which reduce brain injury through protecting the vascular system against ischemic attack.
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666
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Chang KC. Editorial comment--A mercy to victims of cerebrovascular diseases. Stroke 2004; 35:2853-4. [PMID: 15564569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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667
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668
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Gobin YP, Starkman S, Duckwiler GR, Grobelny T, Kidwell CS, Jahan R, Pile-Spellman J, Segal A, Vinuela F, Saver JL. MERCI 1: a phase 1 study of Mechanical Embolus Removal in Cerebral Ischemia. Stroke 2004; 35:2848-54. [PMID: 15514171 DOI: 10.1161/01.str.0000147718.12954.60] [Citation(s) in RCA: 341] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE To report the result of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) 1 study, a phase 1 trial to evaluate the safety and efficacy of mechanical embolectomy in the cerebral vasculature. METHODS MERCI 1 enrolled 30 patients in 7 US centers. Main inclusion criteria were: National Institutes of Health Stroke Scale score (NIHSS) > or =10; treatment performed within 8 hours from symptoms onset and contra-indication to intravenous thrombolysis; no large hypodensity on computed tomography; and occlusion of a major cerebral artery on the angiogram. Safety was defined by the absence of vascular injury or symptomatic intracranial hemorrhage. Efficacy was assessed by recanalization rate and clinical outcome at 1 month. Significant recovery was defined as 30-day modified Rankin of 0 to 2 in patients with baseline NIHSS 10 to 20 and 30-day modified Rankin of 0 to 3 in patients with baseline NIHSS >20. The procedures were performed with the Merci Retrieval System, a system specially designed for intracranial embolectomy. RESULTS Twenty-eight patients were treated. Median NIHSS was 22. Median time from onset to completion of treatment was 6 hours and 15 minutes. Successful recanalization with mechanical embolectomy only was achieved in 12 (43%) patients, and with additional intra-arterial tissue plasminogen activator in 18 (64%) patients. There was one procedure related technical complication, with no clinical consequence. Twelve asymptomatic and no symptomatic intracranial hemorrhages occurred. At 1 month, 9 of 8 revascularized patients and 0 of 10 nonrevascularized patients had achieved significant recovery. CONCLUSIONS This phase 1 study shows that cerebral embolectomy with the Merci Retriever was safe and that successful recanalization could benefit a significant number of patients, even when performed in an extended 8-hour time window.
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669
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Jonas R, Nguyen S, Hu B, Asarnow RF, LoPresti C, Curtiss S, de Bode S, Yudovin S, Shields WD, Vinters HV, Mathern GW. Cerebral hemispherectomy: hospital course, seizure, developmental, language, and motor outcomes. Neurology 2004; 62:1712-21. [PMID: 15159467 DOI: 10.1212/01.wnl.0000127109.14569.c3] [Citation(s) in RCA: 209] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare hemispherectomy patients with different pathologic substrates for hospital course, seizure, developmental, language, and motor outcomes. METHODS The authors compared hemispherectomy patients (n = 115) with hemimegalencephaly (HME; n = 16), hemispheric cortical dysplasia (hemi CD; n = 39), Rasmussen encephalitis (RE; n = 21), infarct/ischemia (n = 27), and other/miscellaneous (n = 12) for differences in operative management, postsurgery seizure control, and antiepilepsy drug (AED) usage. In addition, Vineland Adaptive Behavior Scale (VABS) developmental quotients (DQ), language, and motor assessments were performed pre- or postsurgery, or both. RESULTS Surgically, HME patients had the greatest perioperative blood loss, and the longest surgery time. Fewer HME patients were seizure free or not taking AEDs 1 to 5 years postsurgery, but the differences between pathologic groups were not significant. Postsurgery, 66% of HME patients had little or no language and worse motor scores in the paretic limbs. By contrast, 40 to 50% of hemi CD children showed near normal language and motor assessments, similar to RE and infarct/ischemia cases. VABS DQ scores showed +5 points or more improvement postsurgery in 57% of patients, and hemi CD (+12.7) and HME (+9.1) children showed the most progress compared with RE (+4.6) and infarct/ischemia (-0.6) cases. Postsurgery VABS DQ scores correlated with seizure duration, seizure control, and presurgery DQ scores. CONCLUSIONS The pathologic substrate predicted pre- and postsurgery differences in outcomes, with hemimegalencephaly (but not hemispheric cortical dysplasia) patients doing worse in several domains. Furthermore, shorter seizure durations, seizure control, and greater presurgery developmental quotients predicted better postsurgery developmental quotients in all patients, irrespective of pathology.
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670
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Rowed DW, Houlden DA, Burkholder LM, Taylor AB. Comparison of monitoring techniques for intraoperative cerebral ischemia. Can J Neurol Sci 2004; 31:347-56. [PMID: 15376479 DOI: 10.1017/s0317167100003437] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To prospectively compare somatosensory evoked potentials, electroencephalography (EEG) and transcranial Doppler ultrasound (TCD) for detection of cerebral ischemia during carotid endarterectomy (CEA). METHODS Somatosensory evoked potentials and EEG recordings were attempted in 156 consecutive CEAs and TCD was also attempted in 91 of them. Recordings from all three modalities were obtained for at least 10 minutes before CEA, during CEA and for at least 15 minutes after CEA. Somatosensory evoked potentials peak-to-peak amplitude decrease of >50%, EEG amplitude decrease of >75%, and ipsilateral middle cerebral artery mean blood flow velocity (mean VMCAi) decrease >75% persisting for the entire period of internal carotid artery occlusion were individually considered to be diagnostic of cerebral ischemia. Clinical neurological examination was performed immediately prior to surgery and following recovery from general anaesthesia. RESULTS Somatosensory evoked potentials, EEG, and TCD were successfully obtained throughout the entire period of internal carotid artery occlusion in 99%, 95%, and 63% of patients respectively. Two patients (1.3%) suffered intraoperative cerebral infarction detected by clinical neurological examination and subsequent magnetic resonance imaging. Somatosensory evoked potentials accurately predicted intraoperative cerebral infarction in both instances without false negatives or false positives, EEG yielded one false negative result and no false positive results and VMCAi one true positive, four false positive and no false negative results. Transcranial Doppler ultrasound detection of emboli did not correlate with postoperative neurological deficits. Nevertheless the sensitivity and specificity of each test was not significantly different than the others because of the small number of disagreements between tests. CONCLUSION A >50% decrease in the cortically generated P25 amplitude of the median somatosensory evoked potentials, which persisted during the entire period of internal carotid artery occlusion, appears to be the most reliable method of monitoring for intraoperative ischemia in our hands because it accurately detected both intraoperative strokes with no false positive or false negative results.
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671
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Jiang HS, Lu BX, Ji Z, Wang LX, Zhang SJ. [Surgical procedure improvement to produce rat ischemia-reperfusion injury model with intraluminal suture]. DI 1 JUN YI DA XUE XUE BAO = ACADEMIC JOURNAL OF THE FIRST MEDICAL COLLEGE OF PLA 2004; 24:1156-9. [PMID: 15485789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To describe a modified surgical approach to produce rat ischemia-reperfusion injury model with intraluminal suture. METHODS After exposure and ligation of the common carotid artery (CCA), the left external carotid artery and pterygopalatine artery were opened in which a 3-0 nylon suture was introduced intraluminally from the distal end of the ligature of the CCA using a scalp needle. Reperfusion injury was induced by withdrawal of the suture. RESULTS The length of the suture was about 20.0+/-1.8 mm and the success rate of model establishment was nearly 70%. The rats developed typical symptoms and pathological manifestations after the surgery. CONCLUSION This modified surgical approach is simple for model establishment and does not require special microsurgical skills to ensure the high success rate.
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672
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Chu K, Kim M, Park KI, Jeong SW, Park HK, Jung KH, Lee ST, Kang L, Lee K, Park DK, Kim SU, Roh JK. Human neural stem cells improve sensorimotor deficits in the adult rat brain with experimental focal ischemia. Brain Res 2004; 1016:145-53. [PMID: 15246850 DOI: 10.1016/j.brainres.2004.04.038] [Citation(s) in RCA: 178] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2004] [Indexed: 01/10/2023]
Abstract
Ischemic stroke is caused by the interruption of cerebral blood flow that leads to brain damage with long-term sensorimotor deficits. Stem cell transplantation may recover functional deficit by replacing damaged brain. In this study, we attempted to test whether the human neural stem cells (NSCs) can improve the outcome in the rat brain with intravenous injection and also determine the migration, differentiation and the long-term viabilities of human NSCs in the rat brain. Focal cerebral ischemia was induced by intraluminal thread occlusion of middle cerebral artery (MCA). One day after surgery, the rats were randomly divided into two groups: NSCs-ischemia vs. Ischemia-only. Human NSCs infected with retroviral vector encoding beta galactosidase were intravenously injected in NSCs-ischemia group (5 x 10(6) cells) and the same amount of saline was injected in Ischemia-only group for control. The animals were evaluated for 4 weeks using turning in an alley (TIA) test, modified limb placing test (MLPT) and rotarod test. Transplanted cells were detected by X gal cytohistochemistry or beta gal immunohistochemistry with double labeling of other cell markers. The NSCs-ischemia group showed better performance on TIA test at 2 weeks, and MLPT and rotarod test from 3 weeks after ischemia compared with the Ischemia-only group. Human NSCs were detected in the lesion side and labeled with marker for neurons or astrocytes. Postischemic hemispheric atrophy was noted but reduced in NSCs-ischemia group. X gal+ cells were detected in the rat brain as long as 540 days after transplantation. Our data suggest intravenously transplanted human NSCs can migrate and differentiate in the rat brain with focal ischemia and improve functional recovery.
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673
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Zhang SM, Chu Q. [Stem cell transplantation in the treatment of cerebral ischemia in rats]. ZHONGHUA YI XUE ZA ZHI 2004; 84:1328. [PMID: 15633282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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674
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Wanebo JE, Zabramski JM, Spetzler RF. Superficial Temporal Artery-to-Middle Cerebral Artery Bypass Grafting for Cerebral Revascularization. Neurosurgery 2004; 55:395-8; discussion 398-9. [PMID: 15271247 DOI: 10.1227/01.neu.0000129549.99061.94] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2002] [Accepted: 03/24/2004] [Indexed: 11/19/2022] Open
Abstract
Abstract
SUPERFICIAL TEMPORAL ARTERY-to-middle cerebral artery bypass procedures are an important tool in the armamentarium of cerebrovascular surgeons for the treatment of carotid occlusion and revascularization for complex aneurysms and brain tumors. This article enumerates the essential steps in performing superficial temporal artery-to-middle cerebral artery bypass procedures. The nuances of this technique reflect the extensive experience of the senior authors (RFS, JMZ).
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675
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Falavigna A, Ferraz FAP, Breunig JDA, Michelin MM. [Extra-intracranial arterial bypass for treatment of patient with clinical refractory cerebral ischemia]. ARQUIVOS DE NEURO-PSIQUIATRIA 2004; 62:330-3. [PMID: 15235740 DOI: 10.1590/s0004-282x2004000200025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The extra-intracranial bypass may be used in selected cases of brain vascular insufficiency refractory to clinical treatment. We report a case of encephalic ischemia in the territory of the right middle cerebral artery due to occlusion of the ipsilateral internal carotid artery, with consequent reduction of the perfusion and vascular reserve in the parietal and frontal regions. Despite the clinical treatment, motor deficit improvement was directly related to the maintenance of high systemic arterial tension levels due to the use of vasopressor agent. After lateral-terminal extra-intracranial bypass between the superficial temporal and right middle cerebral artery, there was significant improvement of cerebral perfusion with remission of the motor deficit.
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