Superficial-Temporal-Artery-To-Middle-Cerebral-Artery Bypass in Cerebrovascular Occlusive Disease and Hemodynamic-Related Ischemia: Illustrative Case and Literature Review

Stroke is the third most common cause of death worldwide. About 10% to 15% of strokes related to the territory of the carotid artery are associated with its complete occlusion. There is an important subgroup of patients with cerebrovascular occlusive diseases who might benefit from an external-carotid-to-internal-carotid bypass. In the present study, we report a case of a 53-year-old male patient with stenosis of the M2 branch of themiddle cerebral artery (MCA), with a history of 20 episodes of transient ischemic accidents (TIA)s, in whom an anastomosis of the M4 branch of the superficial temporal artery-MCA was performed. The patient was discharged in three days, and in the two years of follow-up, they were no more TIAs.We also conducted a review of the literature on cerebrovascular occlusive disease and extracranial-intracranial bypass surgery. New methods to evaluate cerebral hemodynamics made it possible to classify a new subgroup of patients with symptomatic cerebrovascular disease and documented cerebrovascular compromise in whom the drug therapy fails, who can benefit from the extracranial-intracranial bypass. Our case report illustrates the advantages of revascularization in these selected patients.

Revascularización de las secuelas cerebrovasculares de tipo oclusivo con el epiplón / Revascularization of the cerebrovascular secuela of the oclusive type with the epiplon

Presentamos 25 pacientes con secuelas de enfermedad cerebro vascular de tipo oclusivo que recibieron transplante de epiplón al encéfalo. En el área de lesión se encontraron arterias con flujo sanguíneo residual centrípeta al área de infarto. La mejoría neurológica ocurrió dentro de los primeros días o semanas de la operación. Creemos que estos resultados son debidos a la revascularización y a la influencia de factores neurotróficos proporcionados por el omentum, que actuan sobre el tejido nervioso residual.