Long-term changes in cerebrovascular reactivity following EC-IC bypass for intracranial steno-occlusive disease

Publication date: August 2018Source: Journal of Clinical Neuroscience, Volume 54Author(s): Casey Rosen, Larissa McKetton, Jeremy Russell, Kevin Sam, Julien Poublanc, Adrian Crawley, Jay S. Han, Olivia Sobczyk, James Duffin, Danny M. Mandell, Michael Tymianski, Joseph A. Fisher, David J. Mikulis, Lashmi VenkatraghavanAbstractThe purpose of this retrospective observational study is to investigate the long-term changes in cerebrovascular reactivity (CVR) as a measure of cerebral hemodynamics in patients with intracranial steno-occlusive disease (IC-SOD) after they have undergone an Extracranial–intracranial (EC-IC) bypass. Twenty-six patients suffering from IC-SOD were selected from our CVR database. Nineteen patients underwent unilateral and 7 underwent bilateral revascularization. CVR measurements were done using BOLD-MRI and precisely controlled CO2 and expressed as ΔBOLD (%)/Δ PETCO2 (mmHg). Trends in CVR over time were compared in both vascularized and non-vascularized hemispheres. Repeated measures analysis of variance with Greenhouse-Geisser correction was used to determine CVR changes within the grey matter MCA for longitudinal assessments. Overall, re-vascularized hemisphere showed a significant increase in CVR at the first follow-up, followed by a slight decrease at the second follow-up that significantly increased compared to the pre-bypass. However, the changes in the postoperative CVR were quite variable across the patients. Similar variability was seen in subse...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research