Hemodynamic and metabolic changes following cerebral revascularization in patients with cerebral occlusive diseases

Changes in cerebral hemodynamics and metabolism following cerebral revascul arization were evaluated using positron emission tomography (PET). Ten pati ents who had received nonsurgical treatment for 3-6 months for minor comple ted stroke underwent superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery. All patients showed no extensive infarction on MR , and responsible vascular lesions were detected in the anterior circulatio n. A PET study of cerebral blood flow (CBF) oxygen extraction fraction (OEF ), cerebral metabolic rate for oxygen (CMRO2), and cerebral metabolic rate for glucose (CMRGlu) measurements was performed before and 1.5 months after surgery using a steady state technique. Angiographically, anastomotic site s were patent in all patients. Seven patients showed neurological improveme nt after surgery and the others showed no improvement. The decreases in CBF , CMRO2 and CMRGlu recovered to some extent not only on the lesion side but also on the contralateral side after surgery. The increase in OEF values o n the lesion side subsequently decreased after surgery. CMRO2 and CMRGlu sh owed parallel changes. It is concluded that the metabolic improvement affor ded by the cerebral revascularization resulted in the neurological improvem ent, and that PET study is a powerful method for evaluating patients with c erebral occlusive diseases.