1984 Volume 24 Issue 11 Pages 881-885
A case with brain ischemia induced by the absence of bilateral internal carotid arteries, in which a superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed is reported. No similar case has been reported before.
The patient was a 27-year-old female who had suffered from syncope and right hemiconvulsion since the age of 15. After the first delivery hemiparesis occurred on the right side. The plain skull Xray films including tomograms showed no carotid canal. The aortograms showed a right aortic arch and an aberrant left subclavian artery. The angiograms demonstrated no bifurcation of either common carotid arteries and absence of bilateral internal carotid arteries, except for the cavernous sinus portion and the supraclinoid portion of the right internal carotid artery. The intracranial blood was supplied mainly by the dilated right vertebral artery and the enlarged collateral artery from the right maxillary artery to the cavernous sinus portion of the right internal carotid artery. The supraclinoid portion of the right internal carotid artery was dilated in fusiform. STA-MCA anastomosis was carried out on the left side. Symptoms and the regional cerebral blood flow improved postoperatively.
