Extracranial‐intracranial bypass surgery

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Abstract
After superficial temporal artery-middle cerebral artery bypass, cerebral blood flow (CBF) to th operated hemisphere increased in 6 of 17 patients. Preoperatively, the symptomatic hemisphere showed lower CBF in a. six, lower oxygen metabolism in five, higher blood volume in four, and higher oxygen extraction in two. With th postoperative increase in hemispheric CBF, there was a decrease in oxygen extraction, but no change in blood volume o oxygen metabolism. In these patients, chronic regional hypoperfusion followed major vascular occlusion. Compensator responses included dilation of intraparenchymal vessels and increased transport of oxygen from blood to tissue. These changes were partially reversed by cerebral revascularization.