Unexpected immediate postoperative resolution of long-standing neurological deficits following extracranial-intracranial bypass: a report of three cases
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Abstract
While intracranial ischemic insults often result in neuronal death and permanent neurological deficits, some patients may develop potentially reversible neurological dysfunction from persistent hypoperfusion, as surviving neurons remain in an “idling” state. We report a unique series of three patients with long-standing neurological deficits who underwent EC-IC bypass for repeated TIAs and demonstrated unexpected, rapid resolution of long-standing pre-existing neurological deficits. We suggest that these individuals harbored regions of underperfused, idling neurons that responded rapidly to restored cerebral reperfusion.
Keywords
Extracranial-intracranial bypass Leg plegia PerfusionNotes
Acknowledgments
We would like to acknowledge Superior Medical Experts for their editing, formatting, and research support.
Contributorship
All authors made substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; drafted the work or revised it critically for important intellectual content; provided final approval of the version to be published; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Sources of support
We received a grant from the United Hospital Foundation to support this work.
Compliance with ethical standards
Conflict of interest
Kevin Kallmes works for and holds equity in Superior Medical Experts. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
Patient consent
Consents to the public use of deidentified information were obtained from all patients prior to submission to the journal.
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