• Fumihiro Matano, Yasuo Murai, Kojiro Tateyama, Takayuki Mizunari, Katsuya Umeoka, Kenta Koketsu, Shiro Kobayashi, and Akira Teramoto.
• Department of Neurosurgery, Nippon Medical School, Tokyo, Japan. s00-078@nms.ac.jp
• Clin Neurol Neurosurg. 2013 Jun 1;115(6):718-24.

ObjectOnly a few studies have reported the risk of ischemic complications occurring when superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is performed during surgery for complex MCA aneurysms.Subjects And MethodsThis is a retrospective study of 10 patients (age 52-73) with MCA aneurysms treated with revascularization surgery. The aneurysms were 10-50mm in size (mean: 21mm). We studied the causes and frequency of ischemic complications by analyzing postoperative magnetic resonance imaging.ResultsPostoperative diffusion-imaging confirmed ischemic complications in six of the 10 patients (in two of the five ruptured aneurysms and in four of the five unruptured). The ischemic complications that observed were infarction of the lenticulostriate artery territory in three cases, cortical infarction in two cases, and cerebral infarction that was likely to be due to cerebral vasospasm in one case. In one case, both cortical infarction and infarction of the lenticulostriate artery territory were observed. The Glasgow Outcome Scale (GOS) scores at the time of discharge indicated good recovery (GR) and moderate disability (MD) in seven cases, severe disability (SD) in two cases, and death (D) in one case.ConclusionsThe present study suggests the possibility that STA-MCA anastamosis in surgeries for MCA aneurysms can be performed with comparatively better safety. However, the temporary occlusion time with this surgery is longer than that with a temporary clipping for aneurysmal surgery; thus, we believe that adequate countermeasures are required to prevent ischemic complications.Copyright © 2012 Elsevier B.V. All rights reserved.

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