Neurosurgery in Brain Ischemic Stroke
Pp. 170-184 (15)
Paolo Missori and Cristina Mancarella
Ischemic strokes caused by the complete occlusion of an intracranial artery
are associated with poor outcomes overall, and high mortality rates. To improve the
survival and the outcome otherwise not afforded by the available medical and
interventional therapies a neurosurgical approach must be considered. In selected
patients a microsurgical embolectomy and a decompressive craniectomy are effective
therapies with which to treat occlusions of the middle cerebral artery or other territories
when thrombolysis or an interventional endovascular embolectomy does not restore the
vascular flow. A bypass procedure that employs a superficial temporal artery-to-middle
cerebral artery (STA-to-MCA) surgical anastomosis can be performed to improve the
blood flow in a deficient artery chronic angiopathic disorder.
Bypass, Decompressive craniectomy, Encephalo-myo-synangiosis,
Ischemia, Intracranial pressure, Microsurgical embolectomy, Middle cerebral
artery, Neurosurgery, Stroke.
Department of Neurology and Psychiatry, Neurosurgery, Policlinico Umberto I, “Sapienza” University of Rome, Italy.