Commentary

详细信息	查看全文 | 推荐本文 |

• 作者：Christopher M. Loftus
• 关键词：Bypass surgery ; Carotid artery ; Hemodynamic ischemia ; Near-infrared spectroscopy
• 刊名：Surgical Neurology
• 出版年：2007
• 期刊代码：244_00903019
• 类别：med
• 出版时间：September 2007
• 卷：68
• 期：3
• 页码：295
• 文件大小：30 K

摘要

It is still difficult to directly prove the involvement of hemodynamic ischemia in ischemic attacks in patients with occlusive carotid artery diseases.

Case Description

In this report, we describe the case of a 52-year-old woman with right ICA occlusion who experienced repeated transient weakness of the left extremities during HD for chronic renal failure. Single-photon emission computed tomography showed reductions in CBF and CVR to acetazolamide in the right hemisphere. Real-time NIRS monitoring clearly showed a deterioration in the cerebral oxygenation state in the right hemisphere in response to a BP decrease during HD. Superficial temporal artery–MCA anastomosis improved SPECT as well as NIRS findings and resolved ischemic attacks during HD.

Conclusion

This is the first study to show that NIRS can be a useful tool in detecting hemodynamic ischemia in patients with impaired cerebral perfusion reserves noninvasively and in real time.