Abstract
To evaluate a functional reversibility of ischemic brain and CT-findings, correlative studies for CT-scan and cerebral angiography or drug-induced EEG or somato-sensory evoked potential test (DEE-test) or clinical results has been performed on 65 cases of middle cerebral artery trunk occlusion.
Fifteen out of 52 cases with conservative treatment were confirmed as spontaneous recanalization of occluded artery by angiography.
External-Internal Arterial Bypass (EIAB) were carried out in 9 cases, EIAB with external decompression in 3 cases and external decompression in one case.
Based on the localization and extent of infarction, three cases were classified to four groups concerning CT-abnormalities such as total type (32 cases), cortical or subcortical type (14 cases), basal ganglionic type (18 cases) and normal type (1 case).
Angiographical findings such as occluded sites, collateral circulation via leptomeningeal anastomosis and filling of lenticulostriate arteries were roughly corresponded to the CT-abnormalities.
Clinical results of conservatively treated cases show that good functional recovery was gotten in the normal, cortical or subcortical and basal ganglionic type. Except 2 cases prognosis was very poor in the total type. Good effects after spontaneous recanalization of occluded artery were obtained in some cases of cortical or subcortical and basal ganglionic type infarction.
When the activation of SEP after induced hypertension was recognized, good surgical results has been led in both acute and chronic stage except total type infarction. If the SEP is activated by glycerol., external decompression will be recommended with or without EIAB in the acute stage.
