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Superficial temporal-middle cerebral artery anastomosis

Effects on vascular, neurologic, and neuropsychological functions

Cerebrovascular Research Center and the Departments of Neurology, Neurosurgery, Radiology, and Psychiatry, University of Pennsylvania, Philadelphia, PA.

In 44 patients, we studied the effects of superficial temporal-middle cerebral artery anastomosis on cerebral blood flow (CBF), neurologic examination, and cognitive functions. At 3 months, there was significant improvement in all variables. At 9 months, CBF was no longer significantly greater, but neurologic examination and cognitive functions had further improved. Patients with TIA had significant postoperative decreases in TIA frequency and did not progress to stroke, but had no significant changes in any variable. In stroke patients, we could not separate the effects of surgery from the natural evolution of changes in CBF and examination after stroke. None of the preoperative measurements predicted postoperative clinical improvement.

Address correspondence and reprint requests to Dr. Younkin, Cerebrovascular Research Center, 429 Johnson Pavilion, 36th and Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104.

Supported in part by a grant from the National Institutes of Health (NS 10939–11). Dr. Younkin is the recipient of Teacher-Investigator Award NS 00774–01 from the National Institute of Neurological and Communicative Disorders and Stroke.

Presented in part at the thirty-fourth annual meeting of the American Academy of Neurology, Washington, DC, May 1982.

Accepted for publication August 6, 1984.

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