Neurosurgical extracranial-intracranial bypass for stroke: with 400 cases.

An update of the current status of neurosurgical microvascular bypass for problems of cerebrovascular occlusive disease is presented. In 400 patients who have undergone operations by one surgeon, the results are encouraging in cases of transient ischemic attacks with hemodynamic lesions previously considered inoperable or inaccessible in the cerebral vasculature. The permanent neurological morbidity rate is 2% and the present operative mortality rate is 2.5%. The incidence of stroke to date on the side of a functioning bypass is 0.9% per year. Average follow-up is 55 months.