内頸動脈閉塞症における主要側副血行路狭窄例のSTA-MCA吻合術

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Occlusion of the internal carotid artery is accompanied by various symptoms which are related directly to the adequecy of the external and internal collateral circulation. We have experienced STA-MCA anastomosis in two cases of complete occlusion of the internal carotid artery, followed by severe stenosis of collateral circulation.<BR>Case. 1. A 60 year old man had a severe headache and his left extremities were rendered weak. These symptoms of TIA appeared several times in succession and progressed to a complete stroke. Right carotid angiography demonstrated a complete occlusion of the right internal carotid artery and at the origin of the middle meningeal artery of collateral circulation severe stenosis occurred.<BR>Case 2. A 55 year old man suffered from a complete stroke with left hemiparesis, total aphasia and mental disturbance after several reoccurrences of TIA. The symptoms of these two cases were remarkably improved, when STA-MCA anastomosis were performed at the stage of a complete stroke in both cases. It may be concluded that the symptoms of both cases followed the stenosis of collateral circulation. In such cases, STA-MCA anastomosis seems to be effective in improving the symptoms even at the stage of a complete stroke. And also, we tried to show the indication of STA-MCA anastomosis for occlusion of the internal carotid artery based on the follow-up study results of cases treated conservatively. Occlusion of the contralateral internal carotid artery occurred in 3 cases of good prognosis, which caused a miserable state of death or vegetative state in later days. Therefore, we emphasize that STM-MCA anastomosis should be performed to prevent this miserable state in suitable cases even if they have a good prognosis.
The Japanese Society on Surgery for Cerebral Strokeの論文

内頸動脈閉塞症における主要側副血行路狭窄例のSTA-MCA吻合術

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