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Ⅰ.はじめに
閉塞性脳血管障害に対する外科的治療は,近年ますます普及されつつあり,その代表的なものはcarotid endarterectomyとanastomosis between the superficial temporal artery and the middle Cerebral artery(以下STA-MCA anastomosisと略す)であろう.
これらは主として,頭蓋内あるいは頭蓋外の主幹脳動脈の閉塞または狭窄に対して行われているが,最近われわれは,これら個々の手術法のみでは十分な治療効果を望みがたいと考えられる症例を経験した.
Case 1. A 65 year old male had left hemiparesis with sudden onset since 8 years ago, which gradually aggravated for these 2 years. On Sept. 27, 1973, he was admitted to the Department of Neurosurgery, Kitano Hospital.
There was left spastic hemiparesis with hemisensory disturbance and he could not walk without help for the maked spasticity. Left carotid angiogram revealed the complete occlusion of the internal carotid artery and marked stenosis of the external carotid artery at the common carotid bifurcation. External carotid endarterectomy was performed on Nov. 19, 1973, which was followed by STA-MCA anastomosis 2 months later.
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