もやもや病に対するSTA-MCAバイパス術中に生じる脳表静脈の赤色化と術後脳血流増加との関連
「はじめに」脳血流不全を有するもやもや病患者に対して, 直接もしくは間接的血行再建術が行われる. このうち, 浅側頭動脈 - 中大脳動脈(superficial temporal artery-middle cerebral artery: STA-MCA)吻合術に代表される直接バイパス術は, 血流改善作用においては即効性をもつ一方で, 過灌流症候群などの急激な血行動態の変化に起因する合併症がまれならず生ずることが報告されている. もやもや病患者に発生する過灌流症候群は, 動脈硬化性患者のそれに比べ症候化する頻度が高く, 特に注意を要する病態である. われわれは以前, STA-MCA吻合術後に...
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| Published in | 脳卒中の外科 Vol. 43; no. 6; pp. 448 - 453 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脳卒中の外科学会
2015
日本脳卒中の外科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-5508 1880-4683 |
| DOI | 10.2335/scs.43.448 |
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| Abstract | 「はじめに」脳血流不全を有するもやもや病患者に対して, 直接もしくは間接的血行再建術が行われる. このうち, 浅側頭動脈 - 中大脳動脈(superficial temporal artery-middle cerebral artery: STA-MCA)吻合術に代表される直接バイパス術は, 血流改善作用においては即効性をもつ一方で, 過灌流症候群などの急激な血行動態の変化に起因する合併症がまれならず生ずることが報告されている. もやもや病患者に発生する過灌流症候群は, 動脈硬化性患者のそれに比べ症候化する頻度が高く, 特に注意を要する病態である. われわれは以前, STA-MCA吻合術後に過灌流症候群を併発したもやもや病症例において, STA開放直後に脳表静脈に著明な赤色化が生じたことを報告した. |
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| AbstractList | 「はじめに」脳血流不全を有するもやもや病患者に対して, 直接もしくは間接的血行再建術が行われる. このうち, 浅側頭動脈 - 中大脳動脈(superficial temporal artery-middle cerebral artery: STA-MCA)吻合術に代表される直接バイパス術は, 血流改善作用においては即効性をもつ一方で, 過灌流症候群などの急激な血行動態の変化に起因する合併症がまれならず生ずることが報告されている. もやもや病患者に発生する過灌流症候群は, 動脈硬化性患者のそれに比べ症候化する頻度が高く, 特に注意を要する病態である. われわれは以前, STA-MCA吻合術後に過灌流症候群を併発したもやもや病症例において, STA開放直後に脳表静脈に著明な赤色化が生じたことを報告した. |
| Author | 石毛, 聡 永野, 修 小野, 純一 藤川, 厚 沖山, 幸一 町田, 利生 奥山, 翼 青柳, 京子 |
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| References | 7) Kuroda S, Houkin K : Bypass surgery for moyamoya disease: concept and essence of sugical techniques. Neurol Med Chir (Tokyo) 52: 287-294, 2012 5) Hoshino T, Katayama Y, Sakatani K, et al : Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system. Surg Neurol 65: 569-576, 2006 11) Uchino H, Kuroda S, Hirata K, et al : Predictors and clinical features of postoperative hyperperfusion after surgical revascularization for moyamoya disease: a serial single photon emission CT/positron emission tomography study. Stroke 43: 2610-2616, 2012 4) Horie N, Fukuda Y, Izumo T, et al : Indocyanine green videoangiography for assessment of postoperative hyperperfusion in moyamoya disease. Acta Neurochir (Wien) 156: 919-926, 2014 6) Kaku Y, Iihara K, Nakajima N, et al : Cerebral blood flow and metabolism of hyperperfusion after cerebral revascularization in patients with moyamoya disease. J Cereb Blood Flow Metab 32: 2066-2075, 2012 3) Fujimura M, Shimizu H, Inoue T, et al : Significance of focal cerebral hyperperfusion as a cause of transient neurologic deterioration after extracranial-intracranial bypass for moyamoya disease: comparative study with non-moyamoya patients using N-isopropyl-p-[(123)I]iodoamphetamine singlephoton emission computed tomography. Neurosurgery 68: 957-964, 2011 9) Nakagawa A, Fujimura M, Arafune T, et al : Clinical implications of intraoperative infrared brain surface monitoring during superficial temporal artery-middle cerebral artery anastomosis in patients with moyamoya disease. J Neurosurg 111: 1158-1164, 2009 10) Sheinberg M, Kanter MJ, Robertson CS, et al : Continuous monitoring of jugular venous oxygen saturation in head-injured patients. J Neurosurg 76: 212-217, 1992 1) Derdeyn CP, Videen TO, Yundt KD, et al : Variability of cerebral blood volume and oxygen extraction: stages of cerebral haemodynamic impairment revisited. Brain 125: 595-607, 2002 8) Machida T, Ono J, Nomura R, et al : Venous reddening as a possible sign of hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease: case report. Neurol Med Chir (Tokyo) 54: 827-831, 2014 2) Fujimura M, Mugikura S, Kaneta T, et al : Incidence and risk factors for symptomatic cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with moyamoya disease. Surg Neurol 71: 442-447, 2009 |
| References_xml | – reference: 1) Derdeyn CP, Videen TO, Yundt KD, et al : Variability of cerebral blood volume and oxygen extraction: stages of cerebral haemodynamic impairment revisited. Brain 125: 595-607, 2002 – reference: 5) Hoshino T, Katayama Y, Sakatani K, et al : Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system. Surg Neurol 65: 569-576, 2006 – reference: 8) Machida T, Ono J, Nomura R, et al : Venous reddening as a possible sign of hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease: case report. Neurol Med Chir (Tokyo) 54: 827-831, 2014 – reference: 4) Horie N, Fukuda Y, Izumo T, et al : Indocyanine green videoangiography for assessment of postoperative hyperperfusion in moyamoya disease. Acta Neurochir (Wien) 156: 919-926, 2014 – reference: 10) Sheinberg M, Kanter MJ, Robertson CS, et al : Continuous monitoring of jugular venous oxygen saturation in head-injured patients. J Neurosurg 76: 212-217, 1992 – reference: 11) Uchino H, Kuroda S, Hirata K, et al : Predictors and clinical features of postoperative hyperperfusion after surgical revascularization for moyamoya disease: a serial single photon emission CT/positron emission tomography study. Stroke 43: 2610-2616, 2012 – reference: 9) Nakagawa A, Fujimura M, Arafune T, et al : Clinical implications of intraoperative infrared brain surface monitoring during superficial temporal artery-middle cerebral artery anastomosis in patients with moyamoya disease. J Neurosurg 111: 1158-1164, 2009 – reference: 6) Kaku Y, Iihara K, Nakajima N, et al : Cerebral blood flow and metabolism of hyperperfusion after cerebral revascularization in patients with moyamoya disease. J Cereb Blood Flow Metab 32: 2066-2075, 2012 – reference: 2) Fujimura M, Mugikura S, Kaneta T, et al : Incidence and risk factors for symptomatic cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with moyamoya disease. Surg Neurol 71: 442-447, 2009 – reference: 7) Kuroda S, Houkin K : Bypass surgery for moyamoya disease: concept and essence of sugical techniques. Neurol Med Chir (Tokyo) 52: 287-294, 2012 – reference: 3) Fujimura M, Shimizu H, Inoue T, et al : Significance of focal cerebral hyperperfusion as a cause of transient neurologic deterioration after extracranial-intracranial bypass for moyamoya disease: comparative study with non-moyamoya patients using N-isopropyl-p-[(123)I]iodoamphetamine singlephoton emission computed tomography. Neurosurgery 68: 957-964, 2011 |
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| Title | もやもや病に対するSTA-MCAバイパス術中に生じる脳表静脈の赤色化と術後脳血流増加との関連 |
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