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Case Reports
Risky cerebrovascular anatomical orientation: implications for brain revascularization.
- Alhusain Nagm, Tetsuyoshi Horiuchi, Takao Yanagawa, and Kazuhiro Hongo.
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Neurosurgery, Al-Azhar University Faculty of Medicine-Nasr City, Cairo, Egypt. Electronic address: nagm@shinshu-u.ac.jp.
- World Neurosurg. 2016 Dec 1; 96: 610.e15-610.e20.
AbstractThis study documents a risky vascular anatomic orientation that might play an important role in the postoperative hemodynamics following anterior cerebral artery (ACA) revascularization. A 71-year-old woman presented with uncontrollable frequent right lower limb transient ischemic attacks (TIAs) attributed to a left cerebral ischemic lesion due to severe left ACA stenosis. She underwent successful left-sided superficial temporal artery-ACA bypass using interposed vascular graft. The patient awoke satisfactory from anesthesia; however, on postoperative day 1, she developed right-sided hemiparesis. Extensive postoperative investigations disclosed that watershed shift infarction was considered the etiology for this neurologic deterioration.Copyright © 2016 Elsevier Inc. All rights reserved.
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