[The usefulnessof STA-MCA anastomosis in trapping vascular disorder (author's transl)]

Huge aneurysm taking place within the cavernous sinus or at the junction of the internal carotid artery with the ophthalmic artery must be treated by intra- and extracranial ligation of the internal carotid artery because of its anatomical specificity, if it is to be radically treated. Carotid-cavernous fistula which cannot be cured by embolization must also be treated by ligation of the internal carotid artery. However, if there is only a poor collateral circulation over the area distal to ligated portion, the operation surely incurs severe neurological deficit, so that trapping must be abandoned in such cases. Nevertheless, by establishing a bypass through anastomosis between the superficial temporal artery and the middle cerebral artery, the operation can be done safely. Further, even in cases of aneurysm taking place on the cerebral main vessel in which the aneurysm must be extirpated despite the presence of an important branch shooting-off from the aneurysm, or in some other cases (sphenoidal ridge meningioma, for instance) in which total extirpation of the tumor must necessarily be associated with sacrifice of the main vessel because it is involved in the brain tumor, we think that the operation can be performed rather safely through anastomosis with the vessel to be sacrificed. Some representative examples of such cases are described, and the usefulness of anastomosis between the superficial temporal artery and the middle cerebral artery in trapping of vascular disorders.