Advertisement

Anatomical studies of the posterior circulation relevant to occipital artery bypass

  • Philip R. Weinstein
  • Norman L. Chater
  • Roderick Lamond

Abstract

With the advent of microsurgical techniques, extra- to intracranial arterial anastomosis has become technically feasible for the treatment of inoperable or inaccessible intra- or subcranial occlusive cerebrovascular disease.(1) Patency rates for end-to-side superficial temporal to middle cerebral artery anastomosis are acceptable at 90%, morbidity rates are 2%, and collateral augmentation has been documented angiographically as well as with clinical and experimental cerebral blood flow studies. (2,4,6,7,11,12) The value of such procedures for preventing completed stroke in patients suffering transient ischemic attacks will be demonstrated only when a large randomized study has been performed. Previous work in our laboratory has shown that a cortical branch of the middle cerebral artery at least 1 mm in diameter could be found under a 4-cm craniectomy centered 6 cm above the external auditory meatus, in 90% of 50 brains dissected. (5) The purpose of the current study was to determine if the occipital artery could be used for anastomosis, with suitable cerebellar or cerebral cortical branches, in patients with vertebrobasilar occlusive disease.

Keywords

Basilar Artery Posterior Circulation Blood Flow Measurement External Auditory Meatus Occipital Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Austin GM (ed): Microsurgical Anastomosis for Cerebral Ischemia. Springfield, Ill. Thomas, 1974Google Scholar
  2. 2.
    Austin G, Laffin D, Hayward W: Cerebral blood flow and pressure in patients undergoing STA-MCA anastomosis. Presented at the Second International Symposium on Microneurosurgical Anastomoses, Chicago, June 1974Google Scholar
  3. 3.
    Bradshaw P, McQuaid P: The syndrome of vertebro-basilar insufficiency. J Med 128:279, 1963Google Scholar
  4. 4.
    Chater N, Peerless SJ: The early effects of neurosurgical microvascular bypass operations on problems of cerebrovascular occlusive disease. Presented at the American Academy of Neurology Meeting, San Francisco, April 1974Google Scholar
  5. 5.
    Chater N, Spetzler R: Anatomical studies of the cerebral cortical vasculature of microvascular surgical significance. Presented at the Symposium on Microneurosurgery, Kyoto, Japan, October 14–15, 1973Google Scholar
  6. 6.
    Crowell RM, Olsson Y: Effect of extracranial-intracranial vascular bypass graft on experimental acute stroke in dogs. J Neurosurg 38:26, 1973PubMedCrossRefGoogle Scholar
  7. 7.
    Fein JM, Molinari G: Experimental augmentation of regional cerebral blood flow by microvascular anastomosis. J Neurosurg 41:421, 1974PubMedCrossRefGoogle Scholar
  8. 8.
    Hass WK, Fields WS, North RR, et al: Joint study of extracranial arterial occlusion. JAMA 203:961, 1968PubMedCrossRefGoogle Scholar
  9. 9.
    Meyer JS, Sheehan S, Bauer RB: An arteriographic study of cerebrovascular disease in man. Arch Neurol 2:37, 1960Google Scholar
  10. 10.
    Moscow NP, Newton TH: Angiographic implications in diagnosis and prognosis of basilar artery occlusion. Am J Roentgenol Radium Ther Nucl Med 119:597, 1973PubMedGoogle Scholar
  11. 11.
    Schmiedek P, Steinhoff H, Gratzl O. Current status of regional blood flow measurement in revascularization microsurgery of the brain. Presented at the Second International Symposium on Microneurosurgical Anastomoses, Chicago, June 1974Google Scholar
  12. 12.
    Spetzler RF, Chater N: Superficial temporal artery-middle cerebral artery blood flow measurements. Presented at the American Association of Neurological Surgeons Meeting, St. Louis, April 1974Google Scholar
  13. 13.
    Spetzler RF, Chater N: Occipital middle cerebral artery anastomosis for cerebral arterial occlusive disease. Surg Neurol 2:235, 1974PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1978

Authors and Affiliations

  • Philip R. Weinstein
  • Norman L. Chater
  • Roderick Lamond

There are no affiliations available

Personalised recommendations