title: Middle cerebral artery endarterectomy: experience with two cases.
abstract: BACKGROUND
  Atherosclerotic stenosis of the middle cerebral artery (MCA) is uncommon and long-term prognosis is not well defined. Methods of treating stenosis of the MCA range from the administration of anticoagulants to endarterectomy.
  
  
  METHODS
  We present two cases of patients with focal symptomatic stenosis of the MCA with evidence of focally decreased cerebral blood flow and compromise of cerebral blood flow reserves on xenon-enhanced computed tomography (Xe CT) scanning. Endarterectomies were performed after unsuccessful anticoagulation therapy.
  
  
  RESULTS
  Both patients underwent successful endarterectomies of the MCA. Improvement in cerebral blood flow postoperatively was documented for both patients. At last follow-up neither patient had demonstrated any additional ischemic episodes.
  
  
  CONCLUSIONS
  Atherosclerotic stenosis of the MCA may be responsible for distal emboli and compromised hemodynamics, and endarterectomy of this vessel may provide definitive therapy.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Kraus
authors.forename: J M
authors.initials: JM
authors.lastname: Herman
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.forename: R F
authors.initials: RF
authors.lastname: Spetzler
authors.forename: J L
authors.initials: JL
authors.lastname: Frey
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation; D004691:Endarterectomy; D005260:Female; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed