Dramatic improvement with superficial temporal artery and middle cerebral artery bypass in acute ischemic stroke in a rural area without MRI and angiography

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Stroke is a major cause of mortality and morbidity. The best therapeutic modality is the early identification of patients with stroke symptoms, correct interpretation of different neuroimaging techniques, and immediate provision of reperfusion therapy. Apart from conventional treatments, superficial temporal artery-middle cerebral artery (STA-MCA) bypass should be considered a treatment modality for acute ischemic stroke, with good results and early improvement in cerebral perfusion and neurological status. In the present case, in a patient clinically diagnosed with MCA infarction, early STA-MCA bypass 45 min after symptom onset resulted in rapid neurological recovery, and contrast-enhanced computed tomography showed that the anastomosis was functioning.