Temporo-Sylvian anastomosis in the management of internal carotid system occlusions: Patient series

Abstract

Background: Extracranial-intracranial bypass (EC-IC) procedures have played an important role in the treatment of cerebrovascular disease since their development in the 1960s.The aim of our work is to evaluate the results of temporo-sylvian anastomosis in internal carotid occlusions in a retrospective study of a series of six descriptive cases. Observation(s): The mean age of our patients was 55.16 years. An arterial hypertension was found in 4 cases and atherosclerosis in 3 cases. An embolization of an arteriovenous malformation of the oral floor was reported in one patient. Likewise, a cavernous sinus meningioma had been the subject of radiotherapy in 02 other patients. The symptomatology leading to the diagnosis consisted of a recurrent TIA (transient ischemic attack) or minor stroke in all of our patients. An asymmetry of the cerebral perfusion was objectified on the perfusion MRI (Magnetic resonance imaging) in all our patients. The follow-up was favorable, with an mRS (modified Rankin score) between 0 and 2 at three months. A control perfusion MRI was performed in all patients, showing better perfusion in the affected area. Lessons: Temporal-sylvian anastomosis is a surgical technique that is effective in the short and medium term in carotid occlusions responsible for ischemic hemodynamic attacks.

Keywords

• Internal carotid occlusion
• Temporo-sylvian anastomosis
• Bypass