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Cerebral hyperperfusion produces widespread, minimal injury to the ipsilateral white matter and cortical regions. The aim of the present prospective study was to determine how changes in CBF due to arterial bypass surgery affect cognitive function in adult patients with symptomatic ischemic MMD and misery perfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Thirty-two patients with cerebral misery perfusion, as determined on the basis of <jats:sup>15<\/jats:sup>O gas positron emission tomography, underwent single superficial temporal artery\u2013middle cerebral artery (M<jats:sub>4<\/jats:sub> in the precentral region) anastomosis. Brain perfusion single-photon emission computed tomography (SPECT) studies were performed preoperatively, on the 1st postoperative day, and 2 months after surgery. Neuropsychological tests were also performed preoperatively and 2 months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Postoperative neuropsychological assessments demonstrated cognitive improvement in 10 cases (31%), no change in 8 cases (25%), and decline in 14 cases (44%). Based on brain perfusion SPECT and symptoms, 10 patients were considered to have cerebral hyperperfusion syndrome, and all of these patients exhibited a postoperative decline in cognition. Relative precentral CBF on the 1st postoperative day was significantly greater in patients with postoperative cognitive decline (167.3% \u00b1 15.3%) than in those with improved (105.3% \u00b1 18.2%; p &lt; 0.0001) or unchanged (131.4% \u00b1 32.1%; p = 0.0029) cognition. The difference between relative precentral CBF 2 months after surgery and that before surgery was significantly greater in patients with postoperative cognitive improvement (17.2% \u00b1 3.8%) than in those with no postoperative change (10.1% \u00b1 2.4%; p = 0.0003) or with postoperative decline (11.5% \u00b1 3.2%; p = 0.0009) in cognition.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Cerebral hyperperfusion in the acute stage after arterial bypass surgery impairs cognitive function. An increase in CBF in the chronic stage without acute-stage cerebral hyperperfusion improves cognitive function in adult patients with symptomatic ischemic MMD and misery perfusion.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.7.jns18149","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:13:18Z","timestamp":1551226398000},"page":"1716-1724","source":"Crossref","is-referenced-by-count":42,"title":["Impact of cerebral blood flow changes due to arterial bypass surgery on cognitive function in adult patients with symptomatic ischemic moyamoya disease"],"prefix":"10.3171","volume":"131","author":[{"given":"Wataru","family":"Yanagihara","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Chida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Terasaki","sequence":"additional","affiliation":[{"name":"Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniaki","family":"Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1093\/bja\/68.5.486","article-title":"Pharmacokinetics of propofol during and after long-term continuous infusion for maintenance of sedation in ICU patients","volume":"68","author":"Bailie GR","year":"1992","unstructured":"Bailie GR, Cockshott ID, Douglas EJ, Bowles BJ: Pharmacokinetics of propofol during and after long-term continuous infusion for maintenance of sedation in ICU patients. 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