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Steal affecting the central nervous system.

Christopher L Taylor1, Warren R Selman, Robert A Ratcheson

  • 1Department of Neurological Surgery, University of Texas Southwestern Medical School, Dallas, Texas 75390-8855, USA. CTaylorMD@msn.com

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|March 21, 2002
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Summary
This summary is machine-generated.

This review examines three conditions causing neurological deficits due to the "steal" phenomenon, where blood flow is diverted from the brain or spinal cord. Treatments for these steal syndromes, including surgical and endovascular options, can alleviate symptoms.

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Background:

  • The "steal" phenomenon describes reduced blood flow to the central nervous system (CNS) due to increased flow in another vascular bed.
  • Neurological deficits can arise from CNS ischemia caused by various steal syndromes.

Purpose of the Study:

  • To review three disease states associated with the steal phenomenon: subclavian steal, cerebral arteriovenous malformations, and coarctation of the aorta.
  • To discuss the potential for neurological deficits and treatment options for these conditions.

Main Methods:

  • Review of existing literature on the pathophysiology and clinical presentation of steal syndromes.
  • Discussion of diagnostic tools including intra-arterial pressure measurements, transcranial velocity studies, and single-photon emission computed tomography (SPECT).

Main Results:

  • Subclavian steal, though often asymptomatic, can rarely cause posterior circulation ischemia.
  • Cerebral arteriovenous malformations may lead to neurological deficits via steal, potentially treatable with intervention.
  • Coarctation of the aorta might cause myelopathology through spinal cord blood diversion, a mechanism requiring further proof.

Conclusions:

  • Steal syndromes represent a significant cause of neurological deficits and can be treated through surgical or endovascular interventions.
  • Further research with precise definitions and advanced technology is needed to fully understand the pathophysiology of steal.