De Novo Aneurysm Associated with Superficial Temporal Artery to Middle Cerebral Artery Bypass: Report of Two Cases and Review of Literature.
BACKGROUND
De novo aneurysm formation has been reported as a rare complication of superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery.


METHODS
The first patient with intracerebral hemorrhage had a ruptured de novo aneurysm arising from the recipient MCA at 6 years after undergoing STA-MCA bypass for hemispheric hemodynamic insufficiency. In the second case, an enlarging unruptured STA aneurysm was detected by follow-up magnetic resonance angiography at 8 years after the patient underwent STA-MCA bypass for moyamoya disease. Both patients were successfully treated by surgical clipping.


CONCLUSIONS
Persistent hemodynamic stress with hypertension in an artificial T-shaped vasculature and traumatic injury during surgical manipulation are the most important causes for de novo aneurysms after STA-MCA bypass. Follow-up magnetic resonance and computed tomography angiography examinations, along with appropriate blood pressure control, are recommended for patients who have undergone STA-MCA bypass surgery.
Department of Neurosurgery, Higashiosaka City General Hospital, Osaka, Japan. Electronic address: hyokota0001@gmail.com.
Hiroshi
H
Yokota
Department of Neurosurgery, Higashiosaka City General Hospital, Osaka, Japan.
Kazuhiro
K
Yokoyama
Department of Neurosurgery, Higashiosaka City General Hospital, Osaka, Japan.
Hiroshi
H
Noguchi
D002543:Cerebral Hemorrhage / Q000601:surgery; D002548:Cerebral Revascularization / Q000009:adverse effects*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D009072:Moyamoya Disease / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D013699:Temporal Arteries / Q000601:surgery; D014057:Tomography, X-Ray Computed
De novo aneurysm; Intracerebral hemorrhage; Moyamoya disease; Superficial temporal artery to middle cerebral artery bypass