@article{oai:sapmed.repo.nii.ac.jp:00008000,
 author = {武田, 利兵衛 and 中川原, 譲二 and 松崎, 隆幸 and 田中, 靖通 and 中村, 順一 and 末松, 克美},
 issue = {1},
 journal = {北海道脳神経疾患研究所医誌 = Journal of Hokkaido Brain Research Foundation},
 month = {Aug},
 note = {In the past two years we have performed surgical revascularization for the secondary trunk occlusion of the middle cerebral artery (MCA) in order to prevent the evolution of ischemic infarction in the acute stage. The effects of surgical therapy in the acute stage were analyzed in consecutive patients, in comparison with another fifteen patients, admitted within the same period, upon whom conservative therapy was performed. We compared in the two groups clinical features, neuroradiological findings, and clinical outcome. The results were as follows: 1) The non-surgical group (a group of eleven males and four females) Clinical presentation included progressive neurological dysfunction in four cases and complete nonfluctuating deficits in eleven cases. Angiographic findings for all these cases showed poor or fair leptomeningeal collateral flow. Low density areas (LDA) over the whole territory fed by MCA trunk were noted in all cases seven days from onset. Although eight patients (53%) showed clinical improvement three months from onset, only one patient (7%) showed an excellent result. 2) The surgical group ( a group of six males and four females) Clinical presentation included progressive neurological dysfunction in all ten cases. In preoperative state, these patients had good collateral flow judged from angiogram and high value of residual flow by iXe cerebral blood flow measurement. The average time until revascularization was thirty four hours. The clinical picture for six patients was re-solved after surgery and five patients (50%) showed an excellent result. No extension into cortex of LDA was noted. In conclusion, in this prospective nonrandomized study, acute revascularization of secondary trunk occlusion of MCA by bypass operation was performed safely, had limited risks, and offerd the potential to help some patients. Further controlled randomized studies are indicated.},
 pages = {30--38},
 title = {中大脳動脈 secondary trunk occlusionに対する急性期治療 : 特に急性期血行再建術の意義},
 volume = {1},
 year = {1988}
}