Efficacy of superficial temporal to middle cerebral artery anastomosis against hemodynamic stroke

The effect of superficial temporal artery-middle cerebral artery anastomosis on regional cerebral blood flow (rCBF) was measured on 31 patients with ischemic cerebrovascular diseases. rCBF was measured on the precentral and superior temporal gyri during surgery using the thermal diffusion technique. The mean rCBF was significantly lower than controls before anastomosis, but increased significantly after. Severer clinical symptoms were associated with lower rCBF. The rCBF increased significantly in patients with transient ischemic attack, reversible ischemic neurological deficit, and minor and major completed stroke. All 31 patients demonstrated dysautoregulation, both before and after anastomosis. However, the rCBF had increased above the ischemic threshold during hypotension, achieving a reserve capacity to prevent hemodynamic stroke.