ISOLATED SYMPTOMATIC STENOSIS OF THE MIDDLE CEREBRAL-ARTERY IN YOUNGER ADULTS - A CLINICAL AND ULTRASONIC FOLLOW-UP-STUDY OF 8 PATIENTS

We studied 8 symptomatic patients aged 32-56 years with isolated steno sis of the middle cerebral artery who had TIAs or minor strokes. Angio graphy showed MCA stenosis in the M1 segment in 7 patients, and proxim al M1 occlusion that later recanalized with persistent stenosis in 1 p atient, without evidence of more widespread atherosclerotic disease. A potential cardiac source of embolism was detected in only 2 patients with mitral valve prolapse. During follow-up for 39-82 months, no furt her ischemic events occurred, and transcranial Doppler showed unchange d or decreased stenosis in 6 patients. We conclude that isolated MCA s tenosis in younger patients may be a unique pathologic entity with a b enign long-term course, although previous embolism with partial recana lization appears possible in some patients.