{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:58:03Z","timestamp":1761580683680},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1987,4]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Pre- and postoperative positron emission tomography (PET) was performed in six patients undergoing extracranial to intracranial bypass procedures for the treatment of symptomatic extracranial carotid occlusion. The six patients were all men, aged 52 to 68 years. Their symptoms included transient ischemic attacks (five cases), amaurosis fugax (two cases), and completed stroke with good recovery (one case). Positron emission tomography was performed within 4 weeks prior to surgery and between 3 to 6 months postoperatively, using oxygen-15-labeled CO, O<jats:sub>2<\/jats:sub>, and CO<jats:sub>2<\/jats:sub> and fluorine-18-labeled fluorodeoxyglucose. Cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rates for oxygen and glucose (CMRO<jats:sub>2<\/jats:sub> and CMRGlu), and the oxygen extraction fraction (OEF) were measured in both hemispheres. Preoperatively, compared to five elderly control subjects, patients had increased CBV, a decreased CBF\/CBV ratio, and decreased CMRO<jats:sub>2<\/jats:sub>, indicating reduced cerebral perfusion pressure and depressed oxygen metabolism. The CBF was decreased in only one patient who had bilateral carotid occlusions; the OEF, CMRGlu, and CMRO<jats:sub>2<\/jats:sub>\/CMRGlu and CMRGlu\/CBF ratios were not significantly different from control measurements.<\/jats:p>\n<jats:p content-type=\"fine-print\">All bypasses were patent and all patients were asymptomatic following surgery. Postoperative PET revealed decreased CBV and an increased CBF\/CBV ratio, indicating improved hemodynamic function. This was associated with increased CMRO<jats:sub>2<\/jats:sub> in two patients in whom the postoperative OEF was also increased. The CMRGlu and CMRGlu\/CBF ratio were increased in five patients. Changes in CBF and the CMRO<jats:sub>2<\/jats:sub>\/CMRGlu ratio were variable. One patient with preoperative progressive mental deterioration, documented by serial neuropsychological testing and decreasing CBF and CMRO<jats:sub>2<\/jats:sub>, had improved postoperative CBF, CBV, and CMRO<jats:sub>2<\/jats:sub> concomitant with improved neuropsychological functioning and oxygen hypometabolism. It is concluded that symptomatic carotid occlusion is associated with altered hemodynamic function. Cerebral revascularization results in decreased CBV, indicating improved hemodynamic reserve, but does not consistently improve oxygen metabolism.<\/jats:p>","DOI":"10.3171\/jns.1987.66.4.0529","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:18:00Z","timestamp":1241799480000},"page":"529-535","source":"Crossref","is-referenced-by-count":51,"title":["Hemodynamic and metabolic effects of cerebral revascularization"],"prefix":"10.3171","volume":"66","author":[{"given":"Richard","family":"Leblanc","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane L.","family":"Tyler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e9rard","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernst","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Diksic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laughlin","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge","family":"Gauthier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Hakim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Stroke and the Extracranial Vessels.","first-page":"285","article-title":"Neuropsychological outcome","author":"Adams","year":"1984"},{"key":"b2","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1161\/01.STR.12.4.454","article-title":"Reversal of focal \u201cmisery-perfusion syndrome\u201d by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. 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