Abstract
A patient with traumatic occlusion of the right internal carotid artery (ICA) was treated by a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. This 10-year-old girl had cervical hyperextension in a fall. Six hours later, she suffered progressive left hemiparesis. After 24 hours from the trauma, she was admitted to our hospital.
Neurological examination revealed mild disturbance of consciousness and left hemiparesis. Computed tomography showed a small low density area in right frontal lobe. Angiography demonstrated a postsinus tapering stenosis of the right cervical ICA, and occlusion of the anterior clinoid portion of the right ICA. By the fifth hospital day, left hemiparesis disappeared with conservative treatments. However, she repeated still transient motor weakness of the left upper extremity. Four weeks later, a right STA-MCA anastomosis was performed. After the operation, transient motor weakness quickly disappeared. Postoperative angiography showed good filling of the middle cerebral arteries from the STA.
The patient has had no recurrence of transient motor weakness for 3 years since the operation. This result suggested that transient motor weakness was related to hypoperfusion.
