Effect of STA-MCA Anastomosis on Ischemic Cerebrovascular Disease

The long-term effect of superficial temporal-middle cerebral artery (STA-MCA) anastomosis on cerebral hemodynamics and neurologic function was evaluated in patients with ischemic cerebrovascular disease. Regional blood flow (r-CBF) by Xe-133 inhalation and intelligence quotient (IQ) by the Wechsler Adult Intelligence Scale were measured in 60 and 45 patients, respectively, before and after the surgery. There was a significant correlation between mean CBF in the affected hemisphere (mCBF) and IQ, especially performance IQ. Preoperative reduction in mCBF and IQ was severe in patients with occlusion of the major artery, regardless of the presence and the size of infarction. mCBF and IQ improved significantly postoperatively in patients with occlusion of the major artery without infarction in the cortex. These improvements occurred soon after the surgery and were sustained for up to 3 years. Performance IQ improved more significantly than verbal IQ. On the other hand, mCBF and IQ decreased slightly shortly after the surgery and then returned gradually to the preoperative levels in patients with stenosis of the major artery. From these findings, STA-MCA anastomosis appears to improve neurologic function as well as cerebral hemodynamics in the selected patients with ischemic cerebrovascular disease