Superficial temporal-middle cerebral artery anastomosis (STA-MCA anastomosis) has been performed in patients with TIA (4 cases) and RIND (one case). All cases were considered to be cerebral insufficiency. Two cases of patients in TIA showed excellent results. Unfortunately one case was died because of sepsis postoperatively.
I believe that STA-MCA anastomosis has a protective effect against TIA or RIND caused by cerebral insufficiency. By-pass surgery may be benefit for patients suffering from frequent TIA attacks without confirmed vascular lesions by angiography. It is felt that rCBF measurement is important diagnostic test to decide by-pass surgery for such cases. I also pointed out hemodynamic change following by-pass surgery may cause new focal cerebral ischemic lesion.
