22. Dolichoectasiaに対するSTA-MCA吻合術の経験

概要

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The authors reported two cases of dolichoectasia surgically treated by STA-MCA anastomosis. Case 1: A 50-year-old woman noticed right motor and sensory disturbances. CT scan revealed a mass lesion showing high density with some contrast enhancement located at the left frontal lobe to the ambient cistern. Angiography demonstrated an abnormally tortuous and dilated left internal carotid artery at the C1 to C3 portion and extremely delayed circulation time. The operation was performed to clip the proximal portion of the internal carotid artery after STA-MCA anastomosis. The postoperative course was excellent, and the angiogram demonstrated good functional anastomosis and obliteration of the dolichoectasia. Case 2: A 53-year-old men had experienced left hemiparesis in 1978. In 1981, he again no-ticed deteriorated right motor and sensory function. CT scan showed a mass lesion having contrast enhancement by the clivus. Angiography demonstrated the tortuous and dilated vertebrobasilar artery and the dilated internal carotid and middle cerebral (M1) arteries. Emission tomography (Tomomatic 32) revealed diffuse low perfusion of the cerebrum, especially at the right frontoparietal area. STA-MCA anastomosis was performed to improve the cerebral blood flow and left hemiparesis. These two cases suggested a possibility of surgical treatment of dolichoectasia by STA-MCA anastomosis.
The Japanese Society on Surgery for Cerebral Strokeの論文