Anastomosis of the Superficical Temporal Artery to the Middle Cerebral Artery (STA-MCA bypass) for Vascular Dementia

Anastomosis of the superficial temporal artery to a cortial branch of the middlecerebral artery　(STA-MCA　bypass) was useful in three cases with vascular dementia.　The ages of the patients were 27, 61 and 53 years, respectively. The main clinical symptoms in these patients were impairment of memory, dyscalculia and urinary incontinence following ischemic insults. The grade of dementia was mild in all cases by the Wechsler Adult Intelligence Scale, Hasegawa's Dementia Scale and Kohs' Block Design Test. Computerized tomography scans demonstrated multiple small infacts in all patients and angiogram showed moya-moya like features in case 1 and occlusion of both the internal carotid arteries in the others. A study of the regional cerebral blood fiow (r-CBF) showed diffuse hypoperfusion in both hemispheres in all patients. Cognitive function as revealed by tests showed remarkable improvement with increased CBF after the STA-MCA bypass. It is concluded that STA-MCA bypass is a promising treatment for vascular dementia caused by diffuse hypoperfusion.

Alzhimer's disease

Vascular dementia

STA-MCA bypass

hypoperfusion