Rescue extracranial-intracranial bypass for ischemic stroke secondary to progressive human immunodeficiency virus-associated vasculopathy

Mizushima, Makoto; Sugiyama, Taku; Eguchi, Katsuki; Tarisawa, Monami; Tokairin, Kikutaro; Ito, Masaki; Hashimoto, Daigo; Yabe, Ichiro; Fujimura, Miki

Rescue extracranial-intracranial bypass for ischemic stroke secondary to progressive human immunodeficiency virus-associated vasculopathy

Mizushima, Makoto; Sugiyama, Taku; Eguchi, Katsuki et al.

Journal of neurological surgery. Part A, central european neurosurgery, 2024, 85(1), 88-93

Permalink : https://hdl.handle.net/2115/94184

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アクセス権	open access
URI	https://hdl.handle.net/2115/94184
タイトル	Rescue extracranial-intracranial bypass for ischemic stroke secondary to progressive human immunodeficiency virus-associated vasculopathy
著者	Mizushima, Makoto ; Sugiyama, Taku ; Eguchi, Katsuki ; Tarisawa, Monami ; Tokairin, Kikutaro ; Ito, Masaki ; Hashimoto, Daigo ; Yabe, Ichiro ; Fujimura, Miki
著者名 Mizushima, Makoto
e-Rad_Researcher 70748863 著者名 Sugiyama, Taku
著者名 Eguchi, Katsuki
著者名 Tarisawa, Monami
著者名 Tokairin, Kikutaro
著者名 Ito, Masaki
著者名 Hashimoto, Daigo
e-Rad_Researcher 60372273 著者名 Yabe, Ichiro
e-Rad_Researcher 00361098 著者名 Fujimura, Miki
言語	英語
キーワード	Acquired immunodeficiency syndrome
	EC-IC bypass
	STA-MCA bypass
	Vessel wall magnetic resonance imaging
発行日	2024-01
出版者	Thieme medical publishers
収録物名	Journal of neurological surgery. Part A, central european neurosurgery
巻(号)	85(1)
ページ	88-93
抄録	Background Human immunodeficiency virus (HIV) associated vasculopathy can cause ischemic cerebral stroke; however, there is limited evidence on optimal management. Herein, we report a case of acute ischemic stroke due to progressive internal carotid artery (ICA) stenosis in an HIV-positive patient. Superficial temporal artery to middle cerebral artery (STA-MCA) bypass, in addition to the best medical treatments, prevented stroke progression. Clinical Description A 39-year-old man with HIV infection presented with a sudden onset of aphasia and right hemiparesis. Magnetic resonance imaging revealed an ischemic lesion in the left basal ganglia and concentric thickening of the vessel wall in the terminal portion of the bilateral ICAs. Despite maximal medical treatments for HIV-associated vasculopathy and possible opportunistic infections, bilateral ICA stenoses progressed, leading to a second hemodynamic stroke event. Because tissue plasminogen activator treatment failed, we performed STA-MCA bypass. A significant improvement in neurologic symptoms and cerebral blood flow was observed after surgery. No further stroke events occurred during the continuation of medical treatments. Conclusion This is the first case of STA-MCA bypass performed in a patient with recurrent ischemic stroke caused by HIV-associated vasculopathy. Although further evidence is needed, such treatment options can shed new light on the management of progressive HIV-associated vasculopathy, which is refractory to maximal medical treatment.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This is an Accepted Manuscript of an article published by Thieme in Journal Title on Publication Date, available online at http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1779-4142
PISSN	2193-6315
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1055/a-1779-4142