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Emergency extracranial-intracranial bypass surgery for acute ischemic stroke
Journal of Neurosurgery, 03/10/2010
Exclusive author commentary
Nussbaum ES et al. – In the authors' experience, emergency EC–IC bypass in patients with acute ischemic injury was both safe and effective. This population was characterized by relatively young patients with severely limited collateral circulation. In this series of 13 carefully selected patients, bypass was successful in arresting progression of stroke, and in some cases resulted in rapid neurological improvement.
Eric S. Nussbaum (03/10/2010) comments:
the past decade has seen a dramatic shift towards an increasingly aggressive approach to the management of acute stroke. advancing endovascular techniques have improved the efficacy and safety of mechanical and pharmaceutical thrombolytic therapy. nevertheless, there reamins a subgropu of patients who cannot be treated with these techniques, who suffer an initial mild or reversible ischemic injury, and who face a potentially devastating insult if nothing can be done to improve/restore blood flow to the territory at risk. in our experience, we have successfully treated these individuals with emergency extracranial-intracranial bypass surgery. our article details the time course, presenting findings, and ultimate favorable outcomes in this group of patients.
