TRANSCRANIAL REVASCULARIZATION IN CHILDHOOD AND ADOLESCENCE

Fifteen patients under the age of 20 years underwent transcranial reva scularisation surgery: 13 presented with acute strokes or recurrent tr ansient neurological events, one with progressive dementia and one wit h recurrent syncope. Five underwent unilateral and seven bilateral ana stomosis of the superficial temporal artery to a branch of the middle cerebral artery (STA-MCA bypass). One patient aged 22 months underwent bilateral encephaloduroarterisynangiosis (EDAS). Three patients deter iorated postoperatively: one died from a probable cardiac cause, one h ad subarachnoid haemorrhage and the patient who underwent EDAS suffere d further permanent ischaemic damage. No further permanent ischaemic e vents occurred following STA-MCA bypass (median follow-up 41 months). Transient ischaemic events persisted postoperatively in four cases, bu t with reduced severity. The results suggest that STA-MCA bypass may b e effective in protecting young patients from further permanent ischae mic events in the treated vascular territory.