Stroke, Vol 16, 282-284, Copyright © 1985 by American Heart Association
DE Moulin, R Lo, J Chiang and HJ Barnett
The natural history of MCA occlusion has become increasingly important
since the surgical option of EC/IC bypass surgery has been available. The
clinical course of 24 patients with angiographically-demonstrated occlusion
of the MCA artery was reviewed. Eight patients presented with a major
disabling stroke and five of these died during the acute phase of this
ischemic event. The remaining 19 patients were followed for a mean of 54.2
months. There were five deaths in follow-up and two of these were due to
subsequent strokes. Fourteen patients manifested a benign course: one of
these had a further minor stroke and four had TIAs. Altogether, 3 strokes
occurred during the follow-up period (2 fatal, 1 minor) and all were in the
territory of the artery known to be occluded. Of those patients who
survived their presenting ischemic event, 12 (63%) remained completely
functional in terms of activities of daily living. MCA occlusion does not
necessarily carry a poor prognosis with medial therapy alone and the role
of bypass surgery hopefully will be clarified by the ongoing clinically
randomized trial.
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Prognosis in middle cerebral artery occlusion
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