Abstract
The aim of this study was to assess the effect of superficial temporal-middle cerebral artery (STA-MCA) anastomosis, which was performed during the chronic stage of ischemic cerebrovascular disease on cerebral hemodynamics and neurologic function. Regional cerebral blood flow (CBF), and intelligence scores or intelligence quotient (IQ) were measured by the 133Xe inhalation method and the Wechsler Adult Intelligence Scale, respectively, in 45 patients before and after the surgery. There was a significant correlation between preoperative mean CBF in the affected hemisphere (mCBF) and intelligence scores, especially performance scores. Preoperative reductions in mCBF and IQ were severe in cases of major artery occlusion, regardless of infarction, and mild in cases of major artery stenosis. Reduction in IQ was greater in performance than in verbal scale. Postoperatively, mCBF and intelligence scores improved significantly in patients with major artery occlusion without infarction in the cortex. Improvement occurred soon after surgery and steadily progressed. Performance scale improved more significantly than verbal scale. In major artery stenosis, on the other hand, mCBF and intelligence scores decreased slightly shortly after surgery and then returned gradually to near preoperative levels. At least in selected cases, STA-MCA anastomosis appears to improve neurologic function as well as cerebral hemodynamics in patients with cerebrovascular ischemic disease.
