Abstract
We describe the case of a 47-year-old female with symptomatic right MCA stenosis who had undergone cerebral revascularization through a superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass. Despite clear patency in the operating room, post-operative angiography showed no flow in the bypass. Her ipsilateral internal carotid artery (ICA) was widely patent. She remained asymptomatic and follow-up angiography four years later showed a widely patent bypass graft in the setting of critical stenosis of the ipsilateral ICA. That the graft was found opened up and supplying the hemisphere was presumably stimulated by an increased "demand" and flow gradient promoting its patency.
MeSH terms
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Blood Pressure / physiology
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Brain / blood supply
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Brain / physiopathology
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Carotid Artery, Internal / diagnostic imaging
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Carotid Artery, Internal / pathology
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Carotid Artery, Internal / physiopathology
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Carotid Stenosis / diagnostic imaging
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Carotid Stenosis / pathology
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Carotid Stenosis / physiopathology*
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Cerebral Angiography
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Cerebral Revascularization / adverse effects*
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Cerebrovascular Circulation / physiology
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Female
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Humans
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Infarction, Middle Cerebral Artery / diagnostic imaging
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Infarction, Middle Cerebral Artery / pathology*
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Infarction, Middle Cerebral Artery / surgery*
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Middle Aged
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Middle Cerebral Artery / diagnostic imaging
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Middle Cerebral Artery / pathology
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Middle Cerebral Artery / physiopathology
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Postoperative Complications / etiology*
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Postoperative Complications / physiopathology*
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Time Factors