Superficial temporal artery--middle cerebral artery anastomosis for acute cerebral ischemia: the effect of small augmentation of blood flow

Acta Neurochir (Wien). 1995;137(3-4):128-37, discussion 137. doi: 10.1007/BF02187184.


In order to evaluate the effectiveness of acute cerebral revascularisation, 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. Statistical 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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Blood Flow Velocity / physiology
  • Brain / blood supply*
  • Brain Ischemia / mortality
  • Brain Ischemia / physiopathology
  • Brain Ischemia / surgery*
  • Cerebral Angiography
  • Cerebral Infarction / mortality
  • Cerebral Infarction / physiopathology
  • Cerebral Infarction / surgery*
  • Cerebral Revascularization / methods*
  • Collateral Circulation / physiology
  • Emergencies*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurologic Examination
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Regional Blood Flow / physiology
  • Survival Rate
  • Tomography, X-Ray Computed
  • Treatment Outcome