Neural damage caused by cerebral hyperperfusion after arterial bypass surgery in a patient with Moyamoya disease: Case report

被引：89

作者：

Ogasawara, K ^{[1
]}

Komoribayashi, N ^{[1
]}

Kobayashi, M ^{[1
]}

Fukuda, T ^{[1
]}

Inoue, T ^{[1
]}

Yamadate, K ^{[1
]}

Ogawa, A ^{[1
]}

机构：

[1] Iwate Med Univ, Dept Neurosurg & Cyclotron Res Ctr, Morioka, Iwate, Japan

来源：

NEUROSURGERY | 2005年 / 56卷 / 06期

关键词：

arterial bypass; cerebral hyperperfusion; Moyamoya disease;

D O I：

10.1227/01.NEU.0000159719.47528.2E

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE AND IMPORTANCE: The prognosis of cerebral hyperperfusion syndrome after vascular reconstructive surgery, including extracranial-intracranial arterial bypass, is not poor unless intracerebral hemorrhage develops secondary to hyperperfusion. CLINICAL PRESENTATION: A 48-year-old man with symptomatic moyamoya disease with misery perfusion in the right cerebral hemisphere underwent double right superficial temporal artery-to-middle cerebral artery bypasses. The postoperative course was uneventful until the patient developed headache and agitated delirium on the 4th postoperative day. INTERVENTION: Perfusion computed tomographic imaging demonstrated hyperperfusion in the right temporal lobe. The symptoms resolved by institution of intensive blood pressure control. Positron emission tomography performed 2 months after surgery demonstrated a postoperative reduction of the cerebral metabolic rate of oxygen in the right temporal lobe, where brain atrophy was observed on magnetic resonance images 3 months postoperatively. Neuropsychological testing performed 3 months postoperatively showed worsening digit span, which adversely affected the patient's quality of life. CONCLUSION: The current case suggests that cerebral hyperperfusion after vascular reconstructive surgery can cause irreversible neural damage, which results in cognitive impairment.

引用

页码：1380 / 1381

页数：2