Eur J Cardiothorac Surg 2005;28:771
© 2005 Elsevier Science NL
Images in cardio-thoracic surgery |
MRI image on hyperperfusion syndrome following aorto-bicarotid and aorto-biaxillary bypass for Takayasu's arteritis
Hee Jae Jun
*
,
YangHaeng Lee,
Youn Ho Hwang,
Kwang Hyun Cho
Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, College of Medicine, Inje University, 633-165, Gaegeum-dong, Busanjin-gu, Busan, South Korea
Received 14 February 2005;
received in revised form 13 July 2005;
accepted 15 July 2005.
* Corresponding author. Tel.: +82 51 890 6123; fax: +82 51 891 1297. (Email: cs523{at}inje.ac.kr).
Key Words: Takayasu's arteritis • Carotid bypass surgery • Hyperperfusion • T2-weighted MRI
A 26-year-old woman was admitted for postural dizziness and progressive loss of vision. An aortogram revealed complete occlusion of arch vessels (Fig. 1
). We report the patient with hyperperfusion symptoms, who has abnormal T-2 weighted MRI image and normal diffusion-weighted image (DWI) after aorto-bicarotid and aorto-biaxillary bypass operation (Fig. 2
).
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Fig. 1. A preoperative aortogram revealed complete occlusion of innominate artery, both common carotid arteries and both subclavian arteries, and well developed collateral circulation at the chest and neck (A). On postoperative 40 days aortogram, the patency of 4 graft branches were good (B).
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Fig. 2. A magnetic resonance imaging (MRI) scan revealed diffuse abnormal hyperintensity on a T2-weighted image in bilateral occipital, parietal-temporal, and frontal area (A) with no signal change upon a diffusion-weighted image and no abnormal enhancement after contrast injection (B) on 5th postoperative day. On the 14th postoperative day, MRI findings were completely normal (T2-weighted image (C), diffusion-weighted image (D))
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