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Surgical Revascularisation of the Brain: A rare operation for unusual
circumstances
Case
Examples:
A 30 year-old woman suffered an injury to both carotid arteries,
which are the blood vessels that supply most of the blood flow to
both sides of the brain. The right carotid artery, although injured,
was still patent (allowing blood to flow), but the left was
completely occluded. The patient was becoming progressively
paralyzed on the right side of her body, and was unable to speak.
Pre-Treatment:
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Angiogram of the left carotid artery in the neck
(left panel) and the head (right panel), showing that the internal
carotid artery is blocked (arrow), allowing no blood to get to the
brain.
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Angiogram of the right carotid artery showing the
injured segment in the neck (arrow; left panel). The right panel
shows that the blood flow gets to the right side of the brain, but
less so to the left side.
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Intra-Treatment:
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Surgeon's view of the operative site. There are two
clips on the middle cerebral artery, and the vein has been sown into
place.
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All of the clips have now been removed, and the vein
is filling with blood. Blood flow has been restored.
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Treatment consisted of obtaining a vein from the
patient's leg, and connecting one end of it to the left middle
cerebral artery, one of the main arteries of the brain. The
other end of the vein was connected to the patient's caroted
artery below the level of the injured segment.
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Post-Treatment:
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Angiogram of the left carotid artery showing blood
flowing into the vein graft (arrow).
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Angiogram of the blood vessels on the left side of
the patient's brain, showing that they fill with blood through the
vein graft (arrow)
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