Reversal of the reversed 'Robin Hood syndrome' after superficial temporal-Middle cerebral artery bypass for severe intracranial stenosis. (1st November 2020)

• Record Type: Journal Article
• Authors: Sharma, Vijay K.; Chou, Ning; Sinha, Arvind K.
• Is Part Of: British journal of neurosurgery. Volume 34:Number 6(2020)
• Page Start: 626
• Page End: 627
• Publication Date: 2020-11-01
• Subjects: Intracranial stenosis -- superficial temporal-middle cerebral artery bypass -- vasodilatory reserve -- SPECT; Nervous system -- Surgery -- Periodicals; 617.48
• DOI: 10.1080/02688697.2019.1645299
• Languages: English
• ISSNs: 0268-8697

Abstract

Abstract: Background: Intracranial arterial stenosis is a common cause of ischemic stroke. Recent attempts with intracranial stenting and superficial temporal-middle cerebral artery (STA-MCA) bypass failed to show benefit. Perhaps, better strategies are needed for selecting suitable patients. Acetazolamide-challenged single photon emission computed tomography (SPECT) can demonstrate reversed Robin Hood syndrome (RRHS) due to intracranial steal phenomenon and identify high-risk patients. Methods : We describe the clinical and SPECT findings of RRHS. Results : In our patient with severe and symptomatic severe stenosis of the right MCA, STA-MCA bypass resulted in complete resolution of RRHS. Conclusion: STA-MCA bypass surgery should be considered a possible option in patients with severe stenosis of intracranial internal carotid artery or MCA in carefully selected patients.