Indications and results of extra-intracranial arterial bypasses.

410 patients with transient ischemic attacks (TIA), prolonged reversible neurologic deficits (PRIND), progressive and completed strokes were treated surgically with a superficial temporal artery-middle cerebral artery-extra-intracranial arterial bypass (STAMCA EIAB). Angiography and echo-flow-scans showed 92% of these grafts to be patent. Ninety-three patients suffered from TIA's, 57 from PRIND, 21 from progressive strokes, and 239 from completed strokes. In 53-70% of the 239 patients with completed strokes, there was improvement or complete regression of the neurological symptoms, following an EIAB. The mortality and morbidity rates were low. We believe that the clinical indications for EIAB include: TIA, PRIND and completed strokes (at an appropriate time after the event). Contraindications are: cerebral ischemia at the acute edema stage, advanced intracranial small vessel occlusive disease, completed stroke without any tendency to improvement, multiple vascular processes, severe static neurological deficits of long duration, serious cardio-vascular and pulmonary diseases, including long-standing hypertension.