Basilar artery occlusion after superficial temporal artery-superior cerebellar artery anastomosis

Superficial temporal artery-superior cerebellar artery anastomosis for basilar artery stenosis was performed in a patient who had experienced recurrent nonhemispheric symptoms, and whose angiogram revealed a midbasilar stenosis. Four months after the operation he was readmitted to our hospital complaining of transient motor weakness and numbness of the left extremities. No neurological deficit was found on admission, but 1 hour later the left-sided hemiparesis occurred again and progressed. On the angiograms the upper basilar system was visualized via the superficial temporal artery, and the midbasilar artery was occluded. This conversion seemed to be a natural course rather than the influence of the hemodynamic change after the operation.