Reason and prospects of surgery by transposition of omentum on the brain in patients after ischemic stroke on the basis of 50 cases operated upon

ABSTRACT

The results of surgery by transposition of omentum on the surface of ischemic brain in 50 patients have been presented and discussed. The reason of such operation is 1) recent discoveries in omentum biologically active substances taking part in angiogenesis what allows new vascular connections to develop from omentum to the brain and by this way to augment CBF in low perfused areas. 2) the idea that neurons way survive even by long period of time in condition of lowering metabolism provided perfusion in maintained above critical threshold and in condition of increased CBF the normal matabolic and synaptic functions may be restored. 3) encouraging results of such operations perfomed for the first time by Goldsmith in 1978. 4) results of EC-IC Bypass Study Group suggesting failure of arterial bypass to reduce the risk of ischemic stroke. 5) results of catamnestic investigation of 300 patients treated by STA-MCA anastomosis in our Clinic in Bytom in the period 1979-1990 suggesting that in the region of ischemia specially in patients with deep neurological deficit rather creation the new vascular network than bypass formation in reasonable. Patients in the age from 33 to 66 years old were operated upon in the years 1989-1992. They were characterized mainly by deep and stable neurological deficit and in the majority of cases the surgery was pèrfomed 1-4 months after stroke. In postoperative period 4 patients died, 8 were clinically unchanged, 38 regained varying degree, in some patients suprisingly high motor improvement and in lesser degree the speech improvement was observed