The Potential Factors For Perioperative Complications And The Association Between Intracranial Hemorrhage And Cerebral Hyperperfusion Syndrome After Combined Bypass In Adult Moyamya Patients

Objective To analyse the potential factors of perioperative complications for adult moyamoya patients who underwent combined bypass,and also figure out the association between postoperative intracranial hemorrhage and cerebral hyperperfusion syndrome.Methods Clinical data of patients who underwent combined bypass in Department of Neurosurgery,Zhongnan Hospital of Wuhan University are collected and the association between sex,age,operation timing,Suzuki stage,ect and perioperative complications are analyzed respectively using univariate analysis by SPSS 22.0 software.And also,the association between postoperative intracranial hemorrhage and cerebral hyperperfusion syndrome are analyzed.Results 125 adult patients underwent altogether 142 combined bypass are included,in which perioperative complication occurred in 14 cases,cerebral hyperperfusion syndrome occurred in 10 cases and postoperative cerebral hemorrhage occurred in 7 cases.The results of statistical analysis showed that:(1)There is a higher perioperative complication rate in the early surgery group(P=0.012),with significant statistic differences.(2)We also observed a higher postoperative cerebral hemorrhage rate in the early surgery group(P =0.004),with significant statistic differences.(3)And there is definitely a strong association between cerebral hyperperfusion symdrome and postoperative cerebral hemorrhage(P < 0.001),with significant statistic differences.Conclusion In treating adult MMD,if we perform combined bypass 90 days after the initial onset,it will be much safer with lower perioperative complication rate.So we recommend a late surgery rather than early ones.Postoperative cerebral hemorrhage is closely related to cerebral hyperperfusion symdrome,so it’s crucial to regularly monitor patients’ CBF in order to observe and deal with possible cerebral hyperperfusion syndrome in case of a more severe consequence.