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Reversal of focal "misery-perfusion syndrome" by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography.
Open accessAbstract
Tomographic images of cerebral blood flow (CBF) and oxygen extraction fraction (OEF) using the 15O continuous inhalation technique, and positron emission tomography, were obtained from a patient with cerebral ischemia distal to an occluded left internal carotid artery. There was a focal mismatch between CBF and oxygen metabolism in the brain supplied by the middle cerebral artery where CBF was decreased and OEF increased ("misery-perfusion syndrome" as opposed to "luxury-perfusion syndrome"). These abnormalities were most marked in the parieto-occipital watershed area. After left superficial temporal to middle cerebral artery anastomosis, the clinical attacks ceased and a repeat study did not demonstrate the previous CBF and OEF abnormalities. This suggests that this pattern of abnormalities indicates potential viable tissue. The concept of "misery-perfusion" may be of some importance in the pathophysiological mechanisms of hemodynamic cerebral ischemia and serve as a rational basis for revascularization procedures.
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Citations
Cited by
Perfusion Thresholds in Human Cerebral Ischemia: Historical Perspective and Therapeutic Implications
Baron, J.-C. (2001) · Cerebrovascular Diseases · doi:10.1159/000049119 · Cited by 352
Self-citationPredictors and assessment of cognitive dysfunction resulting from ischaemic stroke.
Gottesman, R. F., & Hillis, A. E. (2010) · The Lancet Neurology · doi:10.1016/s1474-4422(10)70164-2 · Cited by 319
Cerebral Hemodynamics and Vascular Risk Factors: Setting the Stage for Alzheimer's Disease
de la Torre, J. C. (2012) · Journal of Alzheimer's Disease · doi:10.3233/jad-2012-120793 · Cited by 219
Heiss, W.-D., Graf, R., Löttgen, J., Ohta, K., Fujita, T., Wagner, R., Grond, M., & Weinhard, K. (1997) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1097/00004647-199704000-00004 · Cited by 132
Cerebral hemodynamics and cognitive impairment: Baseline data from the RECON trial
Marshall, R. S., Festa, J. R., Cheung, Y. K., Chen, R., Pavol, M. A., Derdeyn, C. P., Clarke, W. R., Videen, T. O., Grubb, R. L., Adams, H. P., et al. (2012) · Neurology · doi:10.1212/wnl.0b013e31824365d3 · Cited by 124
Metadata
- Authors
- Baron, J. C., Bousser, M. G., Rey, A., Guillard, A., Comar, D., & Castaigne, P.
- Venue
- Stroke
- Published
- 1981-07
- Volume
- 12
- Issue
- 4
- Pages
- 454-459
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2035809927
- Cited by
- 724
- References
- 0
- FWCI
- 12.40
- Type
- journal article
- Language
- en
- Open access
- bronze
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- CoChat. (2026). Citation check: Reversal of focal "misery-perfusion syndrome" by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography. https://app.cochat.ai/papers/10.1161/01.str.12.4.454
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- Baron, J. C., Bousser, M. G., Rey, A., Guillard, A., Comar, D., & Castaigne, P. (1981). Reversal of focal "misery-perfusion syndrome" by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography. Stroke. https://doi.org/10.1161/01.str.12.4.454
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