Regional cerebral blood flow and oxygen utilization in superficial temporal-middle cerebral artery anastomosis patients

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Abstract
Regional cerebral blood flow (rCBF) and regional cerebral O2 utilization (rCMRO2) were measured before and after surgery in 9 patients undergoing a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis to bypass cerebrovascular lesions not amenable to extracranial surgery. The applications of these measurements to objective criteria for surgery and in assessment of the effect of surgery were studied. Measurements of regional cerebral hemodynamics and metabolism in these patients before and after surgery may provide valuable data upon which to develop criteria and assess results. A significant depression of rCBF and rCMRO2 in patients in whom a major cerebral infarction has not occurred or relative preservation of rCMRO2 despite depressed rCBF seem to be favorable indications for establishing a functioning STA-MCA anastomosis. In such patients, STA-MCA anastomosis can return rCBF and rCMRO2 to virtually normal levels. Relatively normal rCBF and rCMRO2 in the presence of an occluded internal carotid artery in asymptomatic patients indicates satisfactory collateral circulation and is probably a contraindication for surgery.