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Superficial temporal artery — Middle cerebral artery anastomosis for acute cerebral ischemia: The effect of small augmentation of blood flow

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Summary

In order to evaluate the effectiveness of acute cerebral revascu-larisation, we conducted a review of 70 patients with acute arterial occlusion or severe stenosis. Of these, 35 underwent emergency superficial temporal artery — middle cerebral artery (STA-MCA) anastomosis (surgical group) and the other 35 were treated conservatively (non-surgical group) at different times. Statisticial analysis indicated that the two groups were homogeneous for the prognostic indicators. Seven days after admission, neurological symptoms and signs improved in 43% of patients in the surgical group and in 29% of the non-surgical group, however, this difference was not significant. The ratios of independent life at 3 months were 51% and 31%, respectively (not significant). Subgroup analyses indicated that final outcomes for patients with mild to moderate paresis on admission were significantly better in the surgical group than in the non-surgical group (94% vs. 53%, p < 0.01). The ratios of haemorrhagic infarction, neurological worsening, and mortality were comparable between the two groups. Time of ischaemia is a less important factor in the criteria for surgical selection. Acute revascularisation in selected patients does improve a natural course and could be a therapeutic option for acute cerebral ischaemia.

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  1. Neurosurgical Institute of Higashi Yokohama Hospital, Kanagawa Prefecture, Yokohama, Japan

    Y. Yoshimoto & S. Kwak

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  1. Y. Yoshimoto
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Yoshimoto, Y., Kwak, S. Superficial temporal artery — Middle cerebral artery anastomosis for acute cerebral ischemia: The effect of small augmentation of blood flow. Acta neurochir 137, 128–137 (1995). https://doi.org/10.1007/BF02187184

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