Impact of cerebral blood flow changes due to arterial bypass surgery on cognitive function in adult patients with symptomatic ischemic moyamoya disease Article Swipe
Wataru Yanagihara
,
Kohei Chida
,
Masakazu Kobayashi
,
Yoshitaka Kubo
,
Kenji Yoshida
,
Kazunori Terasaki
,
Kuniaki Ogasawara
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.3171/2018.7.jns18149
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.3171/2018.7.jns18149
OBJECTIVE Some adult patients with moyamoya disease (MMD) undergoing revascularization surgery show an improvement or decline in cognition postoperatively. Revascularization surgery for ischemic MMD augments cerebral blood flow (CBF) and improves cerebral oxygen metabolism. However, cerebral hyperperfusion, which is a short-term, major increase in ipsilateral CBF that is much greater than the metabolic needs of the brain, sometimes occurs as a complication. 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. METHODS Thirty-two patients with cerebral misery perfusion, as determined on the basis of 15 O gas positron emission tomography, underwent single superficial temporal artery–middle cerebral artery (M 4 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. RESULTS 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% ± 15.3%) than in those with improved (105.3% ± 18.2%; p < 0.0001) or unchanged (131.4% ± 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% ± 3.8%) than in those with no postoperative change (10.1% ± 2.4%; p = 0.0003) or with postoperative decline (11.5% ± 3.2%; p = 0.0009) in cognition. CONCLUSIONS 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.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3171/2018.7.jns18149
- https://thejns.org/downloadpdf/journals/j-neurosurg/131/6/article-p1716.pdf
- OA Status
- bronze
- Cited By
- 48
- References
- 37
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2916498118
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Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2916498118Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3171/2018.7.jns18149Digital Object Identifier
- Title
-
Impact of cerebral blood flow changes due to arterial bypass surgery on cognitive function in adult patients with symptomatic ischemic moyamoya diseaseWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2019Year of publication
- Publication date
-
2019-02-27Full publication date if available
- Authors
-
Wataru Yanagihara, Kohei Chida, Masakazu Kobayashi, Yoshitaka Kubo, Kenji Yoshida, Kazunori Terasaki, Kuniaki OgasawaraList of authors in order
- Landing page
-
https://doi.org/10.3171/2018.7.jns18149Publisher landing page
- PDF URL
-
https://thejns.org/downloadpdf/journals/j-neurosurg/131/6/article-p1716.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://thejns.org/downloadpdf/journals/j-neurosurg/131/6/article-p1716.pdfDirect OA link when available
- Concepts
-
Medicine, Cerebral blood flow, Moyamoya disease, Cerebral perfusion pressure, Cognitive decline, Anesthesia, Bypass surgery, Perfusion, Cardiology, Surgery, Internal medicine, Dementia, Artery, DiseaseTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
48Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 2, 2024: 11, 2023: 7, 2022: 12, 2021: 11Per-year citation counts (last 5 years)
- References (count)
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37Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.ipsilateral | 44, 70 |
| abstract_inverted_index.metabolism. | 33 |
| abstract_inverted_index.prospective | 81 |
| abstract_inverted_index.short-term, | 40 |
| abstract_inverted_index.superficial | 129 |
| abstract_inverted_index.symptomatic | 102, 347 |
| abstract_inverted_index.tomography, | 126 |
| abstract_inverted_index.widespread, | 65 |
| abstract_inverted_index.anastomosis. | 140 |
| abstract_inverted_index.demonstrated | 177 |
| abstract_inverted_index.Postoperative | 174 |
| abstract_inverted_index.complication. | 61 |
| abstract_inverted_index.postoperative | 155, 219, 229, 237, 283, 294, 304 |
| abstract_inverted_index.significantly | 232, 278 |
| abstract_inverted_index.single-photon | 143 |
| abstract_inverted_index.hyperperfusion | 63, 210, 316, 339 |
| abstract_inverted_index.preoperatively | 167 |
| abstract_inverted_index.artery–middle | 131 |
| abstract_inverted_index.hyperperfusion, | 36 |
| abstract_inverted_index.preoperatively, | 151 |
| abstract_inverted_index.postoperatively. | 18 |
| abstract_inverted_index.Revascularization | 19 |
| abstract_inverted_index.revascularization | 9 |
| abstract_inverted_index.Neuropsychological | 162 |
| abstract_inverted_index.neuropsychological | 175 |
| cited_by_percentile_year.max | 99 |
| cited_by_percentile_year.min | 94 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 7 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.6000000238418579 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.95986405 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |