{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:42:12Z","timestamp":1785332532989,"version":"3.55.0"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Hyperperfusion is believed to be the cause of transient neurological events (TNEs) in patients with moyamoya disease (MMD) who have undergone an extracranial-to-intracranial (EC-IC) bypass between the superficial temporal artery (STA) and the middle cerebral artery (MCA). The objective of this study was to evaluate this possibility by analyzing cerebral blood flow (CBF) data obtained with thermal diffusion probes used at the authors' center.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors examined postoperative cerebral perfusion in 31 patients with MMD who underwent a direct EC-IC STA-MCA bypass. A Hemedex Q500 flow probe was placed in the frontal lobe adjacent to the bypass and connected to a Bowman cerebral perfusion monitor, and CBF data were statistically analyzed using JMP 8.0.2 software. Seven patients experienced a TNE after surgery in the left hemisphere (that is, after left-sided surgery), manifesting as dysphasia approximately 24 hours postoperatively and which had improved by 48 hours. No TNEs were observed after right-sided surgeries. Operative and postoperative CBFs in the left side with the TNE were compared with those in the left side with no TNE and on the right side.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A detailed analysis of 64,980 minute-by-minute flow observations showed that the initial postbypass CBF was higher on the left side where the TNEs occurred. This CBF increase was followed by a widely fluctuating pattern and a statistically significant and sharp drop in perfusion (p &lt; 0.001, mean difference of CBF between groups, paired t-test) associated with a TNE not observed in the other 2 groups.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>On the basis of the authors' initial observations, an early-onset altered pattern of CBF was identified. These findings suggest local hypoperfusion as the cause of the TNEs. This hypoperfusion may originate from competing blood flows resulting from impaired cerebral autoregulation and a fluctuating flow in cerebral microcirculation.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.8.jns132413","type":"journal-article","created":{"date-parts":[[2014,10,24]],"date-time":"2014-10-24T14:12:05Z","timestamp":1414159925000},"page":"90-94","source":"Crossref","is-referenced-by-count":58,"title":["Is local hypoperfusion the reason for transient neurological deficits after STA-MCA bypass for moyamoya disease?"],"prefix":"10.3171","volume":"122","author":[{"given":"Nitin","family":"Mukerji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary K.","family":"Steinberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns132413","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.surneu.2006.07.017","article-title":"Temporary neurologic deterioration due to cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with adult-onset moyamoya disease","volume":"67","author":"Fujimura","year":"2007"},{"key":"b2-jns132413","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1007\/s00381-007-0361-2","article-title":"Symptomatic hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in a child with moyamoya disease","volume":"23","author":"Fujimura","year":"2007"},{"key":"b3-jns132413","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1007\/s00381-004-1118-9","article-title":"Revascularisation surgery for paediatric moyamoya: a review of the literature","volume":"21","author":"Fung","year":"2005"},{"key":"b4-jns132413","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"927","DOI":"10.3171\/2009.4.JNS081649","article-title":"Clinical outcome after 450 revascularization procedures for moyamoya disease. Clinical article","volume":"111","author":"Guzman","year":"2009"},{"key":"b5-jns132413","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.nec.2010.03.013","article-title":"Direct bypass techniques for the treatment of pediatric moyamoya disease","volume":"21","author":"Guzman","year":"2010"},{"key":"b6-jns132413","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s00701-004-0408-z","article-title":"Correlation of continuously monitored regional cerebral blood flow and brain tissue oxygen","volume":"147","author":"Jaeger","year":"2005"},{"key":"b7-jns132413","series-title":"Zentralbl Neurochir","first-page":"41","article-title":"Assessment of cerebral perfusion in EC-IC bypass patients","volume":"52","author":"Kobayashi","year":"1991"},{"key":"b8-jns132413","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1038\/jcbfm.2010.85","article-title":"Intraoperative blood flow analysis of direct revascularization procedures in patients with moyamoya disease","volume":"31","author":"Lee","year":"2011"},{"key":"b9-jns132413","series-title":"No Shinkei Geka","first-page":"467","article-title":"[Seizure following superficial temporal-middle cerebral artery anastomosis in patients with moyamoya disease: possible contribution of postoperative cerebral hyperperfusion]","volume":"35","author":"Narisawa","year":"2007"},{"key":"b10-jns132413","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.surneu.2007.01.047","article-title":"Postoperative temporary neurological deficits in adults with moyamoya disease","volume":"69","author":"Ohue","year":"2008"},{"key":"b11-jns132413","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3304","DOI":"10.1161\/STROKEAHA.110.598565","article-title":"Neurosurgical advances in the treatment of moyamoya disease","volume":"42","author":"Pandey","year":"2011"},{"key":"b12-jns132413","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3171\/2010.6.JNS091360","article-title":"Incorporating a parenchymal thermal diffusion cerebral blood flow probe in bedside assessment of cerebral autoregulation and vasoreactivity in patients with severe traumatic brain injury. Clinical article","volume":"114","author":"Rosenthal","year":"2011"},{"key":"b13-jns132413","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.3171\/jns.2003.98.6.1227","article-title":"Regional cerebral blood flow monitoring in the diagnosis of delayed ischemia following aneurysmal subarachnoid hemorrhage","volume":"98","author":"Vajkoczy","year":"2003"},{"key":"b14-jns132413","series-title":"Skull Base","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1055\/s-2005-868161","article-title":"Moyamoya disease in adults: the role of cerebral revascularization","volume":"15","author":"Zipfel","year":"2005"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/122\/1\/article-p90.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/122\/1\/article-p90.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/122\/1\/article-p90.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T22:41:54Z","timestamp":1658702514000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/122\/1\/article-p90.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":14,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2014.8.jns132413","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1]]}}}