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Hyperperfusion syndrome after superficial temporal artery-middle cerebral artery bypass for non-moyamoya steno-occlusive disease.
Turpin, Justin; Lynch, Daniel G; White, Timothy; Shah, Kevin A; Yang, Kaiyun; Katz, Jeffrey M; Dehdashti, Amir R.
Afiliación
  • Turpin J; Donald and Barbera Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Electronic address: jturpin@northwell.edu.
  • Lynch DG; Donald and Barbera Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Electronic address: dlynch8@northwell.edu.
  • White T; Donald and Barbera Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Electronic address: twhite7@northwell.edu.
  • Shah KA; Donald and Barbera Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Electronic address: kshah8@northwell.edu.
  • Yang K; Department of Neurosurgery, Community Health Partners, Fresno, CA, USA. Electronic address: ky8508@gmail.com.
  • Katz JM; North Shore University Hospital Department of Vascular Neurology, Manhasset, NY, USA. Electronic address: jkatz2@northwell.edu.
  • Dehdashti AR; Donald and Barbera Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Electronic address: adehdashti@northwell.edu.
J Stroke Cerebrovasc Dis ; 32(8): 107222, 2023 Aug.
Article en En | MEDLINE | ID: mdl-37384979
BACKGROUND AND OBJECTIVES: Stroke is a major cause of morbidity and mortality worldwide, and intracranial stenoses increase the risk for stroke. Superficial temporal artery to middle cerebral artery bypass can be beneficial in selected patients with non-moyamoya steno-occlusive disease, however data is limited regarding the postoperative occurrence of hyperperfusion syndrome in this population. This case series describes the outcomes and complications, including hyperperfusion, in these patients who underwent bypass. METHODS: This is a retrospective review of bypass procedures done for medically refractory intracranial stenosis at a single institution by a single surgeon between 2014 and 2021. RESULTS: 30 patients underwent 33 bypass procedures for unequivocal non-moyamoya steno-occlusive disease. All patients had immediate bypass patency on post-operative day one. Major perioperative complications (9%) included one stroke and two cases of hyperperfusion syndrome. Minor perioperative complications (12%) included two seizures, one superficial wound infection and one deep vein thrombosis. Modified Rankin Score improved in 20 patients (74%), worsened in one patient (4%), and remained stable in seven patients (22%) at the last follow up. Twenty-three patients (85%) had scores ≤ 2. The recurrent stroke rate was 3% at 30 days and 7% at two years. The bypass patency rate at one year was 87.5%. CONCLUSION: In this series, bypass for patients with medically refractory non-moyamoya steno-occlusive disease was well tolerated and effective, with overall favorable outcomes. The occurrence of hyperperfusion syndrome is rare but significant and should be considered in post-operative management of this population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Revascularización Cerebral / Accidente Cerebrovascular / Enfermedad de Moyamoya Tipo de estudio: Etiology_studies Límite: Humans Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Revascularización Cerebral / Accidente Cerebrovascular / Enfermedad de Moyamoya Tipo de estudio: Etiology_studies Límite: Humans Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos