Zacharias and Haus Janssen were the first manufacturers of the simple microscope, 1590. After that, Anton Von Leuwenhock was a German who created an inperfected glass with magnification of 270 times. Then, Carl Zeiss introduced the principle of the tri-dimentional telescope. By the 1960s, microscopes have been used rather widely in neurosurgery. Beginning from March, 1997, Dep of neurosurgery of Cho Ray hospital has applied the microscope in cerebral vascular diseases and brain tumors
Neurosurgery ; Cerebral Revascularization ; surgery

The accidents vascular cerebral and it's severe sequelae in movements have changed a patient's gait by certain pattern. To evaluate and correct the gait disorders, the study was conducted aim to objectives: 1) Analyze the gait of normal and of stroke subjects, 2) Find out the correlation between moving balance abilities and joint angles. Method: joint angles at lower extremity in.ambulance of 33 stroke patients and 79 normal subjects of the same age and body height have been analyzed by Skelet software designed by Hanoi Polytechnics Institute authors. Results: the patient's ankle almost in dorsiflexion in walking. The knee has been limited in flexion at swinging and reduced in extension in push of. The hip has been less flexed at swinging and less extended at standing. These joint angle's changes were closely correlated to patient's balancing and moving abilities, (r = 0.67). Conclusion: In case group, the ankle is more in plantar flexion; as well as the knee's and the hip flexion is more notable in patients comparing with control group. The alterations of joint angle are correlative with patient's mobility and balance.
Cerebral Revascularization, Accidents

Through Epi-info 6, the data shows that the number of patients with nervous disease is admitted hospital increasing gradually (1%) from 1990 to 1996, especially cerebral vascular accident. The first rank is inflammatory diseases: 53,66%, cerebral vascular accident: 27,33%, sciatic nerve: 17,54% and epilepsy: 7,26%. Encephalitis, meningitis and epilepsy mainly occurs for people under the age of 20 (male: 59,17%; female: 40,83%). Sciatic nerve mainly occurs for people above the age of 20 and autonomic nervous system disorder (male and female) from 20 to 40 of age, cerebral vascular accident mainly occurs for the people above 40 : 88,30%.
Nervous System Diseases ; Cerebral Revascularization

The treatment of moya moya disease, a chronic occlusive cerebrovascular disease of unknown etiology, isn't settled ut various operative methods to maximize cerebral revascularization have been reported. Two cases in children treated surgically are presented, one with cerebroarteriosynangiosis and the other with encephalo-duro-arterio-synangiosis(EDAS). The methods of cerebral revascularization are discussed in detail.
Cerebral Revascularization ; Child* ; Humans ; Moyamoya Disease*

The benefits of extracranial-Intracranial bypass surgery have not yet been proven, but recent studies have showed the beneficial effects in selected patients. We report a 52-year-old man who underwent an emergency EC-IC bypass surgery to prevent further progression of neurological deficits after acute ICA occlusion. After overcoming the concerns of the high surgical risk involved in acute ischemic stroke, this case shows that emergency bypass surgery may be helpful in highly select patients by improving hemodynamic compromise.
Cerebral Revascularization* ; Emergencies* ; Hemodynamics ; Humans ; Middle Aged ; Stroke

OBJECTIVE: The authors evaluated the accuracies and ease of use of several commonly used microanastomosis training models (synthetic tube, chicken wing, and living rat model). METHODS: A survey was conducted among neurosurgeons and neurosurgery residents at a workshop held in 2009 at the authors' institute. Questions addressed model accuracy (similarity to real vessels and actual procedures) and practicality (availability of materials and ease of application in daily practice). Answers to each question were rated using a 5-point scale. Participants were also asked what types of training methods they would chose to improve their skills and to introduce the topic to other neurosurgeons or neurosurgery residents. RESULTS: Of the 24 participants, 20 (83.3%) responded to the survey. The living rat model was favored for model accuracy (p < 0.001; synthetic tube -0.95 +/- 0.686, chicken wing, 0.15 +/- 0.587, and rat, 1.75 +/- 0.444) and the chicken wing model for practicality (p < 0.001; synthetic tube -1.55 +/- 0.605, chicken wing, 1.80 +/- 0.523, and rat, 1.30 +/- 0.923). All (100%) chose the living rat model for improving their skills, and for introducing the subject to other neurosurgeons or neurosurgery residents, the chicken wing and living rat models were selected by 18 (90%) and 20 (100%), respectively. CONCLUSION: Of 3 methods examined, the chicken wing model was found to be the most practical, but the living rat model was found to represent reality the best. We recommend the chicken wing model to train surgeons who have mastered basic techniques, and the living rat model for experienced surgeons to maintain skill levels.
Animals ; Cerebral Revascularization ; Chickens ; Microsurgery ; Neurosurgery ; Rats ; Wings, Animal

With the development of cerebral interventional medical devices, Nitinol alloy has been widely used in clinical fields as a good biomaterial. This essay is to make brief comments on Nitinol alloy's present development, its material characteristics, medical basic researches, and applications in cerebral interventional devices.
Alloys ; Biocompatible Materials ; Cerebral Revascularization ; instrumentation ; Humans ; Stents

The role of surgical revascularization for patients with ischemic stroke remains controversial. During acute phase of large artery occlusive ischemic stroke, extracranial?intracranial (EC-IC) bypass, such as superficial temporal-middle cerebral aretery (STA-MCA) bypass sugery, has been rarely performed. We report a case of successful emergency STA-MCA bypass surgery to stop the neurologic deterioration and improve the hemodynamic compromise in a patient with acute symptomatic MCA occlusion associated with hypoperfusion.
Arteries ; Cerebral Revascularization ; Emergencies ; Hemodynamics ; Humans ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Stroke

OBJECTIVE: The aim of this study was to compare the efficacy of indirect and combined bypass surgery for treatment of adult moyamoya disease (MMD). The definition of combined bypass surgery is a combination of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and indirect anastomosis. Development of collateral circulation after surgery was investigated. METHODS: Forty three patients (58 hemispheres) with MMD were followed by cerebral angiography for at least six months after surgery, between May 2002 and July 2011. Indirect and combined revascularization surgeries were performed in 33 and 25 cases, respectively. Good outcome was defined as more than group B, in accordance with the method suggested by Matsushima. RESULTS: Development of collateral circulation was not affected by sex (p = 0.493), clinical features (p = 0.206), or Suzuki stage (p = 0.428). Based on postoperative cerebral angiography, the combined bypass surgery group showed a better angiographic outcome, than the encephaloduroarteriomyosynangiosis (EDAMS) group (p = 0.100, odds ratio [OR] 4.107, 95% confidence interval [CI] 0.700 - 24.096). The combined bypass group showed a better response than the encephaloduroarteriogaleosynangiosis (EDAGS) group (p = 0.088, OR 4.600, 95% CI 0.721 - 29.332). Similar responses were observed for EDAGS and EDAMS (p = 0.886, OR 1.120, 95% CI 0.239 - 5.251). The combined bypass group showed a better response than the indirect group (p = 0.064, OR 4.313, 95% CI 0.840 - 22.130). CONCLUSION: Results of this study demonstrate that combined bypass results in better revascularization on angiographic evaluation in adult MMD. Therefore, among surgical procedures, combined bypass is a choice that can be recommended.
Adult ; Cerebral Angiography ; Cerebral Arteries ; Cerebral Revascularization ; Collateral Circulation ; Humans ; Moyamoya Disease ; Odds Ratio

Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is often performed for the management of the patients wth chronic cerebral ischemic lesions or moyamoya disease. Postoperative aneurysm formation at the anastomosis site or its close proximity is a very rare complication. A 44-year-old female underwent bilateral STA-MCA bypass due to moyamoya disease. Approximately 2 years after bypass surgery, an aneurysm of the recipient cortical artery near the site of the anastomosis was found. Surgical exploration of the region demonstrated an 5.4 x 6.4 x 5 mm aneurysm arising near the site of the anastomosis. The aneurysm was clipped, taking care to keep the bypass flowing. This aneurysm had a thick wall and appeared to be a true saccular aneurysm caused by hemodynamic stress. The author present a case of this unusual complication and provide a brief review of literature.
Adult ; Aneurysm ; Arteries ; Cerebral Arteries* ; Cerebral Revascularization ; Female ; Hemodynamics ; Humans ; Middle Cerebral Artery* ; Moyamoya Disease