| EC-IC Bypass for Acute Infarction with Distal ICA Severe Stenosis
|
|
Hong Suk Ahn1 , Jong Young Lee1 , Hong Jun Jeon1,2 , Jong Hwa Park1,2 |
|
1Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul;
2Department of Neurosurgery, Gangwon National University College of Medicine, Chuncheon, Korea |
| 내경동맥 원위부 협착이 동반된 급성 뇌경색 환자에서의 두개강 내외 동맥 우회술
|
|
안홍석1·이종영1·전홍준1,2·박종화1,2
|
|
한림대학교 의과대학 강동성심병원 신경외과학교실1, 강원대학교 의과대학 신경외과학교실2
|
|
|
| Abstract |
|
We report a case of emergency extracranial-intracranial(EC-IC) bypass surgery in patient with distal internal carotid artery(ICA) stenosis. A 81-year-old male who developed left side hemiparesis at 3 hours before arrival. Symptoms worsened during hospitalization and mild aphasia also occurred. Initial National Institutes of Health Stroke Scale(NIHSS) score was 5. And right distal ICA stenosis was suggested by multiphase computed tomography(CT) angiography and confirmed by cerebral angiography. And right middle cerebral artery, and anterior cerebral artery territory perfusion delay was shown in magnetic resonance image(MRI) perfusion sequence. We decided to perform superficial temporal artery (STA)-middle cerebral artery(MCA) bypass to prevent further progression of cerebral ischemia. Because the patient was determined to be tolerable for operation, and distal ICA angioplasty can cause additional embolic infarction. Post-opera- tive cerebral angiography showed patency of bypass flow, and MRI taken in post-operative day 9 showed no newly developed infarction and improved time delay. On a 2-week follow-up, NIHSS score was improved to 2. |
| Key Words:
Cerebral infarction, Carotid stenosis, Cerebral revascularization |
|
PDF Links
Download Citation
