Niijima K H, Handa H, Yonekawa Y, Taki W, Miyake H, Kobayashi A, Gotoh Y, Moritake K
No Shinkei Geka. 1986 Mar;14(3 Suppl):331-7.
Out of 12 cases of bilateral stenosis of the internal carotid (IC) system underwent unilateral STA-MCA anastomosis on the symptomatic side, no ischemic signs recurred in 8 cases, while, in the remaining 4, symptoms appeared postoperatively, requiring the anastomosis of the contralateral side. Preoperative findings of CT scan, CAG and r-CBF were reviewed and compared. It has, consequently, become evident that, in the latter 4 cases, angiography showed stenotic lesion of over 50% of the ICA lumen, between the mastoid-mandibular line (MML) and the circle of Willis, on the initially asymptomatic side. Furthermore, in the same 4 cases, multiple thrombotic foci were more liable to be demonstrated on the CT scans and r-CBF was lowered in both hemispheres without significant difference in laterality. In additional 7 cases presenting such characteristics as stated above, one-stage bilateral STA-MCA anastomosis was carried out with a successful result.
在12例因颈内动脉（IC）系统双侧狭窄而在症状侧接受单侧颞浅动脉-大脑中动脉（STA-MCA）吻合术的病例中，8例未再出现缺血症状，而其余4例术后出现症状，需要进行对侧吻合术。回顾并比较了术前CT扫描、脑血管造影（CAG）和区域脑血流量（r-CBF）的检查结果。结果发现，在后4例中，血管造影显示最初无症状侧的颈内动脉管腔在乳突-下颌线（MML）与 Willis 环之间有超过50%的狭窄病变。此外，在同样的4例中，CT扫描更易显示多个血栓形成灶，且双侧半球的r-CBF均降低，两侧无显著差异。另外7例具有上述特征的病例，进行了一期双侧STA-MCA吻合术，结果成功。
