Andrew John Gauden

All Publications

• Direct and indirect microvascular revascularization in the setting of moyamoya disease. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia Gauden, A. J., Steinberg, G. K. 2023; 119: 112

  View details for DOI 10.1016/j.jocn.2023.10.022

  View details for PubMedID 37995408

• High flow bypass for revascularization in occlusive atherosclerotic cerebrovascular disease. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia Gauden, A. J., Steinberg, G. K. 2023; 118: 176

  View details for DOI 10.1016/j.jocn.2023.10.021

  View details for PubMedID 37967501

• Combined high-flow bypass and endovascular sacrifice for dysplastic cavernous internal carotid artery aneurysm for recurrent epistaxis. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia Gauden, A. J., Dodd, R., Steinberg, G. K. 2023; 118: 175

  View details for DOI 10.1016/j.jocn.2023.10.023

  View details for PubMedID 37956500

• Microsurgical disconnection of a T12/L1 ventral intradural perimedullary arteriovenous fistula (type IV) via instrumented trans-pedicular approach JOURNAL OF CLINICAL NEUROSCIENCE Kam, J., Toomey, F., Tan, D., Castle-Kirszbaum, M., Gauden, A., Taniguchi, S., Slater, L., Lai, L. 2023; 118: 79-80

  Abstract

  We present a case of microsurgical disconnection of a PMAVF supplied by the artery of Adamkiewicz with fistulation at the ventral spinal cord.

  View details for DOI 10.1016/j.jocn.2023.09.033

  View details for Web of Science ID 001105336600001

  View details for PubMedID 37890197

• Modern Imaging of Aneurysmal Subarachnoid Hemorrhage. Radiologic clinics of North America Levinson, S., Pendharkar, A. V., Gauden, A. J., Heit, J. J. 2023; 61 (3): 457-465

  Abstract

  In this review, we discuss the imaging of aneurysmal subarachnoid hemorrhage (SAH). We discuss emergency brain imaging, aneurysm detection techniques, and the management of CTA-negative SAH. We also review the concepts of cerebral vasospasm and delayed cerebral ischemia that occurs after aneurysm rupture and their impact on patient outcomes. These pathologies are distinct, and the use of multimodal imaging modalities is essential for prompt diagnosis and management to minimize morbidity from these conditions. Lastly, new advances in artificial intelligence and advanced imaging modalities such as PET and MR imaging scans have been shown to improve the detection of aneurysms and potentially predict outcomes early in the course of SAH.

  View details for DOI 10.1016/j.rcl.2023.01.004

  View details for PubMedID 36931762

• Revascularization improves vascular hemodynamics - a study assessing cerebrovascular reserve and transit time in Moyamoya patients using MRI. Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Zhao, M. Y., Armindo, R. D., Gauden, A. J., Yim, B., Tong, E., Moseley, M., Steinberg, G. K., Zaharchuk, G. 2022: 271678X221140343

  Abstract

  Cerebrovascular reserve (CVR) reflects the capacity of cerebral blood flow (CBF) to change. Decreased CVR implies poor hemodynamics and is linked to a higher risk for stroke. Revascularization has been shown to improve CBF in patients with vasculopathy such as Moyamoya disease. Dynamic susceptibility contrast (DSC) can measure transit time to evaluate patients suspected of stroke. Arterial spin labeling (ASL) is a non-invasive technique for CBF, CVR, and arterial transit time (ATT) measurements. Here, we investigate the change in hemodynamics 4-12 months after extracranial-to-intracranial direct bypass in 52 Moyamoya patients using ASL with single and multiple post-labeling delays (PLD). Images were collected using ASL and DSC with acetazolamide. CVR, CBF, ATT, and time-to-maximum (Tmax) were measured in different flow territories. Results showed that hemodynamics improved significantly in regions affected by arterial occlusions after revascularization. CVR increased by 16 ± 11% (p < 0.01) and 25 ± 13% (p < 0.01) for single- and multi-PLD ASL, respectively. Transit time measured by multi-PLD ASL and post-vasodilation DSC reduced by 13 ± 7% (p < 0.01) and 9 ± 5% (p < 0.01), respectively. For all regions, ATT correlated significantly with Tmax (R2  =  0.59, p < 0.01). Thus, revascularization improved CVR and decreased transit times. Multi-PLD ASL can serve as an effective and non-invasive modality to examine vascular hemodynamics in Moyamoya patients.

  View details for DOI 10.1177/0271678X221140343

  View details for PubMedID 36408536

• Application of FLOW 800 in extracranial-to-intracranial bypass surgery for moyamoya disease. Neurosurgical focus: Video Yim, B., Gauden, A. J., Steinberg, G. K. 2022; 6 (1): V16

  Abstract

  The surgical treatment of moyamoya disease is heavily reliant upon a real-time understanding of cerebral hemodynamics. The application of FLOW 800 allows the surgeon to semiquantify the degree of perfusion to the cerebral cortex following extracranial-to-intracranial (EC-IC) bypass surgery. The authors present three illustrative cases demonstrating common intraoperative findings prior to and following anastomosis using FLOW 800. All patients were diagnosed by catheter angiogram with moyamoya disease and noninvasive imaging demonstrating hemispheric hypoperfusion. Superficial temporal artery (STA)-to-middle cerebral artery (MCA or M4) bypasses were performed to augment intracranial perfusion. The patients tolerated the procedures well and were discharged without event in stable neurological condition. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21191.

  View details for DOI 10.3171/2021.10.FOCVID21191

  View details for PubMedID 36284597

  View details for PubMedCentralID PMC9555355