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流量体积不匹配极大地影响莫亚莫亚病直接绕道后的过渡性神经症状

Yuyo Maeda¹, Takahito Okazaki², Shinji Kume³

¹Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan. maedayuyo4.18@gmail.com.

Neurosurgical review

|October 17, 2023

概括

莫亚莫亚病 (MMD) 手术后的过渡性神经事件 (TNEs) 与表面动脉 (STA) 血流的显著变化有关. 手术后的高STA流量体积不匹配与TNE和皮层超强度带 (CHB) 信号相关.

科学领域:

神经外科神经外科
血管外科血管外科
神经学神经学

背景情况:

过渡性神经事件 (TNEs) 是莫亚莫亚病 (MMD) 绕道手术后的一个已知的并发症.
这些TNE的潜在病理生理学仍然不太清楚.
表面动脉 (STA) 血流动力学可能在TNE发育中发挥作用.

研究的目的:

调查外科手术期间STA血流量变化与MMD患者直接绕道手术中TNE的发生之间的关系.
探索STA流量体积不匹配,TNE和磁共振成像 (MRI) 发现,如皮层超强度带 (CHB) 之间的关联.

主要方法:

包括49名接受直接旁路手术的MMD患者,并分为TNE和非TNE组.
在多个术后时间点使用超声波评估STA血流量.
计算了流量体积不匹配,并使用单变量和路径分析分析了其与TNE和CHB标志的关联.

主要成果:

两组患者在术后初步增加了STA血流量,随后逐渐减少.
与非TNE组相比,TNE组表现出明显更大的STA流量体积不匹配.
路径分析显示,STA流量体积不匹配与CHB标志和TNEs有积极的关联,CHB标志部分调解了这种关系.

结论:

在MMD中直接绕道手术后的急性术后期STA血流量显著变化与TNE相关.
这些发现表明,STA流量体积不匹配和CHB标志参与了MMD手术后TNE的病理生理学.
这些结果强调了监测MMD患者的外科手术期间血液动力学的重要性,以潜在地预测和减轻TNE.

关键词:

直接绕道手术是一种直接的绕道手术.流量量不匹配流量不匹配莫亚莫亚病是莫亚莫亚病的一种疾病.表面动脉表面动脉短暂的神经事件短暂的神经事件

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