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Cerebral revascularisation: where are we now?

¹ University Department of Neurosurgery, Addenbrooke’s Hospital, Cambridge, UK
² Department of Neurosurgery (TTSH Campus), National Neuroscience Institute, Singapore

Correspondence to:
Correspondence to:
Mr P J Kirkpatrick
University Department of Neurosurgery, Block A Level 4, Addenbrooke’s Hospital, Cambridge CB2 2QQ, UK; pjk21@medschl.cam.ac.uk

Keywords: cerebral blood flow; cerebrovascular reactivity; ec-ic bypass

The first 150 words of the full text of this article appear below.

Enthusiasm for delivering an alternative blood supply to the brain by surgical means has waxed and waned for over three decades. In situations where a major cerebral vessel is sacrificed for removal of macroscopic pathology (such as a skull base tumour or giant intracranial aneurysm), the need to replace lost cerebral blood flow (CBF) is obvious and often required as part of a staged surgical procedure.^1,2 In such cases, the need and type of surgical bypass graft (high or low flow) is dictated by the presence or absence of adequate collateral vascular pathways, the design of the circle of Willis, and any extracranial to intracranial (EC-IC) vascular connections.³ Detailed cranial angiography and observation of the clinical and physiological responses to temporary test occlusion of parent vessels provide the relevant information. When reliably practised, daunting cervical and cranial pathologies can be approached confidently with acceptable morbidity.⁴ Although simple in . . . [Full text of this article]