Open aortic arch replacement is a complex and challenging procedure, especially in post dissection aneurysms and in redo procedures after previous surgery of the ascending aorta or aortic root. We report our experience with the simultaneous selective perfusion of heart, brain, and remaining body to ensure optimal perfusion and to minimize perfusion-related risks during these procedures. We used...

BACKGROUND AND PURPOSE Impairment of cerebrovascular autoregulation may promote secondary brain injury in acute brain insults. Until now, only limited data are available on autoregulation in patients with spontaneous intracerebral hemorrhage. In the current study, we aimed to investigate cerebrovascular reactivity and its significance for outcome in spontaneous intracerebral hemorrhage. METHO...

BACKGROUND AND PURPOSE Global cerebral edema is common among patients with poor-grade subarachnoid hemorrhage and is associated with poor outcome. Currently no targeted therapy exists largely due to an incomplete understanding of the underlying mechanisms. METHODS This is a prospective observational study including 39 consecutive patients with poor-grade subarachnoid hemorrhage with multimoda...

BACKGROUND Animal models of focal cerebral ischemia are widely used in stroke research. The purpose of our study was to evaluate and compare the cerebral macro- and microvascular architecture of rats in two different models of permanent middle cerebral artery occlusion using an innovative quantitative micro- and nano-CT imaging technique. METHODS 4h of middle cerebral artery occlusion was per...

BACKGROUND AND PURPOSE The aim of the present study was to investigate cerebral hemodynamics in patients requiring surgical treatment for lobar intracerebral hemorrhage. METHODS Twenty patients who underwent surgery to remove a lobar spontaneous intracerebral hemorrhage were scanned before and after surgery using perfusion CT mapping. Mean transit time, time to peak of the residue function, c...

Surgical therapy for aortic arch disease involves partial or complete replacement of the aortic arch with reimplantation of the great vessels while the cerebral blood flow is temporarily altered. Patients undergoing this mandatory period of circulatory arrest during arch replacement are at an increased risk for adverse neurologic outcomes, and strategies for cerebral protection must be implemen...