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Cerebrovasc Dis. 2008;25(6):580-6. doi: 10.1159/000132205. Epub 2008 May 16.

Transient hyperperfusion after superficial temporal artery/middle cerebral artery bypass surgery as a possible cause of postoperative transient neurological deterioration.

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Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.



This study was designed to investigate the relationship between transient neurological deterioration and changes in cerebral perfusion after superficial temporal artery/middle cerebral artery (STA-MCA) bypass.


Clinical characteristics of the patients with postoperative transient neurological deterioration were analyzed in 120 STA-MCA bypass procedures for ischemic cerebral diseases, such as atherosclerotic disease and moyamoya disease. Serial brain single-photon emission computed tomography (SPECT) was performed on 25 patients before surgery and on the third and tenth postoperative days. The hemispheric perfusion on SPECT was calculated semi-quantitatively using statistical parametric mapping and a probabilistic brain atlas.


Among 120 procedures, there were 4 permanent postoperative neurological deficits (3.3%) and 20 postoperative transient neurologic deteriorations with unknown etiology (17%). In 25 patients analyzed for postoperative perfusion changes, cerebral perfusion increased on the third postoperative day and the increased perfusion negatively correlated with preoperative perfusion (correlation coefficient = -0.77; p < 0.001). Temporal changes and the location of transient hyperperfusion on SPECT correlated with the time course and neurological deficits associated with postoperative transient neurological deterioration in 3 patients.


Postoperative transient relative hyperperfusion is a common phenomenon and may be one of the causes of postoperative transient neurological deterioration after STA-MCA bypass surgery for ischemic cerebral diseases.

[Indexed for MEDLINE]

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