J Korean Neurosurg Soc.
1980 Sep;9(2):357-368.
Experimental Microneurosurgical Cerebral Embolectomy:A Time Limit for Cerebral Embolectomy
- Affiliations
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- 1Department of Neurological Surgery, Ewha Womans University College of Medicine, Seoul, Korea.
Abstract
- Acute cerebral embolism continues to be a major cause of stroke morbidity in children and young adults. A variety of drugs including steroids, dextran, barbiturates, and anticoagulants are used in the management of cerebral ischemia, despite controversy over their benefits in clinical and experimental situations. The operative treatment includes microsurgical cerebral embolectomy and cerebral revascularization. Middle cerebral artery embolectomies which have been carried out in human with variable results, have been reported by different authors. In order to define a time limit for cerebral embolectomies before irreversible brain damage has been incurred, the canine middle cerebral artery was embolized by means of a gutta percha cylinder, 4 mm long by 1.5 mm in diameter, via the internal carotid artery. It was observed that embolectomy of the middle cerebral artery performed between 4 and 5 hours postembolism could prevent the expected cerebral infarction effectually. Middle cerebral artery embolectomy beyond 5-hour periods invariably resulted in severe hemorrhagic infarction with concomitant neurological impairment.