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Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report

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Author(s): Marcondes Jorge | Aversa Antônio | Peçanha Marcio | Domingues Flávio | Nascimento Fernanda | André Charles | Freitas Gabriel | Azevedo Feliciano | Exposito Maria

Journal: Arquivos de Neuro-Psiquiatria
ISSN 0004-282X

Volume: 59;
Issue: 3B;
Start page: 797;
Date: 2001;
Original page

Keywords: giant intracavernous aneurysm | cerebral revascularization | carotid artery occlusion | saphenous vein graft | SPECT

ABSTRACT
Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.
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