{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:57:26Z","timestamp":1780437446589,"version":"3.54.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"25","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,12,22]]},"abstract":"\n BACKGROUND<\/jats:title>\n Basilar artery occlusion (BAO) is a threatening condition requiring rapid reperfusion to preserve brainstem function. Although endovascular thrombectomy is considered standard treatment, underlying pathology or limited resources may require surgical intervention. The authors performed an emergency superficial temporal artery\u2013superior cerebellar artery (STA-SCA) bypass in the hyperacute setting of BAO following elective aneurysm surgery. The bypass prevented stroke progression and dramatically improved consciousness.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case demonstrates that with early recognition, protocolized monitoring, and microsurgical capability, STA-SCA bypass is a viable effective strategy for revascularization in acute posterior circulation stroke and can prevent progression of the ischemic core.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 69-year-old man with a recent history of bilateral cerebellar infarction underwent elective microsurgical clipping of a left M1 middle cerebral artery aneurysm. The authors confirmed complete aneurysm exclusion with postoperative CTA. Eight hours later, the patient developed aphasia and deep state coma. CTA perfusion revealed BAO, with extensive cerebellar penumbra and a small core. Due to severe preexisting right vertebral and basilar intracranial atherosclerotic disease, urgent STA-SCA bypass was performed with a right subtemporal approach. Intraoperative studies confirmed graft patency reperfusion. The patient recovered consciousness and was discharged with a modified Rankin Scale score of 3.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25710<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25710","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T11:59:55Z","timestamp":1769083195000},"source":"Crossref","is-referenced-by-count":1,"title":["Emergency superficial temporal artery\u2013superior cerebellar artery bypass for hyperacute basilar artery occlusion following elective middle cerebral artery aneurysm clipping: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4256-259X","authenticated-orcid":true,"given":"Jos\u00e9 Luis","family":"Andrade Valencia","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Stroke Center, Teishinkai Hospital, Sapporo, Hokkaido, Japan"},{"name":"Department of Neurosurgery, Hospital Universitario UANL Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Nuevo Le\u00f3n, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Czy\u017cewski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Mazowieckie, Poland"},{"name":"Department of Didactics and Medical Simulation, Medical University of Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8743-4319","authenticated-orcid":true,"given":"Kohei","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stroke Center, Teishinkai Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rokuya","family":"Tanikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stroke Center, Teishinkai Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7074-1125","authenticated-orcid":true,"given":"Nakao","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stroke Center, Teishinkai Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"bib1","series-title":"Lancet Neurol","first-page":"724","article-title":"Treatment and outcomes of acute basilar artery occlusion in the basilar artery International Cooperation Study (BASICS): a prospective registry study","volume":"8","author":"Schonewille","year":"2009","unstructured":"Schonewille WJWijman CACMichel PTreatment and outcomes of acute basilar artery occlusion in the basilar artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol. 2009;8(8):724-730."},{"issue":"3","key":"bib2","series-title":"Stroke","first-page":"922","article-title":"Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis","volume":"37","author":"Lindsberg","year":"2006","unstructured":"Lindsberg PJMattle HP.Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke. 2006;37(3):922-928."},{"issue":"3","key":"bib3","series-title":"J Stroke","first-page":"394","article-title":"Prognosis of acute intracranial atherosclerosis-related occlusion after endovascular treatment","volume":"20","author":"Lee","year":"2018","unstructured":"Lee JSLee SJYoo JSPrognosis of acute intracranial atherosclerosis-related occlusion after endovascular treatment. J Stroke. 2018;20(3):394-403."},{"issue":"1","key":"bib4","series-title":"Neurosurg Rev","first-page":"49","article-title":"Microsurgical thrombectomy: where the ancient art meets the new era","volume":"47","author":"Ota","year":"2024","unstructured":"Ota NBenet AKusdiansah MMicrosurgical thrombectomy: where the ancient art meets the new era. Neurosurg Rev. 2024;47(1):49."},{"issue":"10","key":"bib5","series-title":"Neuroradiology","first-page":"2851","article-title":"Direct aspiration versus stent retriever as First-line thrombectomy techniques for acute basilar artery occlusions: an updated systematic review and Meta-Analysis","volume":"67","author":"Lee","year":"2025","unstructured":"Lee WJCorreia Maciel RAbo Kasem RDirect aspiration versus stent retriever as First-line thrombectomy techniques for acute basilar artery occlusions: an updated systematic review and Meta-Analysis. Neuroradiology. 2025;67(10):2851-2867."},{"issue":"6","key":"bib6","series-title":"JAMA Netw Open","first-page":"e2515526","article-title":"Outcomes of endovascular treatment in patients with vertebrobasilar artery occlusion beyond 24 hours","volume":"8","author":"Liu","year":"2025","unstructured":"Liu SXu YNguyen TNOutcomes of endovascular treatment in patients with vertebrobasilar artery occlusion beyond 24 hours. JAMA Netw Open. 2025;8(6):e2515526."},{"issue":"1","key":"bib7","series-title":"J Med Case Rep","first-page":"62","article-title":"Occipital artery-posterior inferior cerebellar artery bypass for anterior inferior cerebellar artery stenosis with repeated cerebellar ischemic stroke: a case report","volume":"19","author":"Eguchi","year":"2025","unstructured":"Eguchi HArai TKawamata T.Occipital artery-posterior inferior cerebellar artery bypass for anterior inferior cerebellar artery stenosis with repeated cerebellar ischemic stroke: a case report. J Med Case Rep. 2025;19(1):62."},{"key":"bib8","series-title":"Surg Neurol Int","first-page":"256","article-title":"Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection","volume":"11","author":"Hirano","year":"2020","unstructured":"Hirano YOno HInoue TSuperficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection. Surg Neurol Int. 2020;11:256."},{"issue":"4","key":"bib9","series-title":"J Neurosurg","first-page":"554","article-title":"Superficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency","volume":"72","author":"Ausman","year":"1990","unstructured":"Ausman JIDiaz FGVacca DFSadasivan B.Superficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency. J Neurosurg. 1990;72(4):554-558."},{"issue":"2","key":"bib10","series-title":"Oper Neurosurg","first-page":"279","article-title":"Microsurgical treatment of a giant thrombosed basilar artery-superior cerebellar artery aneurysm with the aid of double bypass superficial temporal artery-posterior cerebral artery and superficial temporal artery-superior cerebellar artery: 2-dimensional operative video","volume":"28","author":"Cubas Farinha","year":"2025","unstructured":"Cubas Farinha NOta NGomez-Vega JCKondo TNoda KTanikawa R.Microsurgical treatment of a giant thrombosed basilar artery-superior cerebellar artery aneurysm with the aid of double bypass superficial temporal artery-posterior cerebral artery and superficial temporal artery-superior cerebellar artery: 2-dimensional operative video. Oper Neurosurg. 2025;28(2):279-280."},{"key":"bib11","series-title":"World Neurosurg","first-page":"75","article-title":"Emergency superficial temporal artery-superior cerebellar artery bypass for the refractory vertebrobasilar insufficiency with partial mastoidectomy","volume":"118","author":"Katsuno","year":"2018","unstructured":"Katsuno MIshisaka EToyota KKawasaki KInaba I.Emergency superficial temporal artery-superior cerebellar artery bypass for the refractory vertebrobasilar insufficiency with partial mastoidectomy. World Neurosurg. 2018;118:75-80."},{"issue":"5","key":"bib12","series-title":"Oper Neurosurg","first-page":"527","article-title":"Occipital artery to extradural vertebral artery bypass for posterior circulation ischemia","volume":"16","author":"Wang","year":"2019","unstructured":"Wang XTong XShi MShang YWang H.Occipital artery to extradural vertebral artery bypass for posterior circulation ischemia. Oper Neurosurg. 2019;16(5):527-538."},{"issue":"2","key":"bib13","series-title":"Lancet Neurol","first-page":"115","article-title":"Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial","volume":"19","author":"Liu","year":"2020","unstructured":"Liu XDai QYe REndovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial. Lancet Neurol. 2020;19(2):115-122."},{"issue":"15","key":"bib14","series-title":"N Engl J Med","first-page":"1361","article-title":"Trial of endovascular treatment of acute basilar-artery occlusion","volume":"387","author":"Tao","year":"2022","unstructured":"Tao CNogueira RGZhu YTrial of endovascular treatment of acute basilar-artery occlusion. N Engl J Med. 2022;387(15):1361-1372."},{"issue":"3","key":"bib15","series-title":"J Stroke Cerebrovasc Dis","first-page":"583","article-title":"Posterior circulation hyperperfusion syndrome after superficial temporal artery-superior cerebellar artery bypass for vertebral artery dissection","volume":"23","author":"Fukuda","year":"2014","unstructured":"Fukuda KAbe HUeba TOkawa MHigashi TInoue T.Posterior circulation hyperperfusion syndrome after superficial temporal artery-superior cerebellar artery bypass for vertebral artery dissection. J Stroke Cerebrovasc Dis. 2014;23(3):583-586."},{"issue":"5","key":"bib16","series-title":"PLoS One","first-page":"e0276307","article-title":"Extravascular optical coherence tomography of cerebral vessel walls in vivo","volume":"18","author":"Hartmann","year":"2023","unstructured":"Hartmann KNeyazi BDumitru CAHaghikia ASandalcioglu IEStein KP.Extravascular optical coherence tomography of cerebral vessel walls in vivo. PLoS One. 2023;18(5):e0276307."},{"issue":"8","key":"bib1","series-title":"Lancet Neurol","first-page":"724","article-title":"Treatment and outcomes of acute basilar artery occlusion in the basilar artery International Cooperation Study (BASICS): a prospective registry study","volume":"8","author":"Schonewille","year":"2009","unstructured":"Schonewille WJWijman CACMichel PTreatment and outcomes of acute basilar artery occlusion in the basilar artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol. 2009;8(8):724-730."},{"issue":"3","key":"bib2","series-title":"Stroke","first-page":"922","article-title":"Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis","volume":"37","author":"Lindsberg","year":"2006","unstructured":"Lindsberg PJMattle HP.Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke. 2006;37(3):922-928."},{"issue":"3","key":"bib3","series-title":"J Stroke","first-page":"394","article-title":"Prognosis of acute intracranial atherosclerosis-related occlusion after endovascular treatment","volume":"20","author":"Lee","year":"2018","unstructured":"Lee JSLee SJYoo JSPrognosis of acute intracranial atherosclerosis-related occlusion after endovascular treatment. J Stroke. 2018;20(3):394-403."},{"issue":"1","key":"bib4","series-title":"Neurosurg Rev","first-page":"49","article-title":"Microsurgical thrombectomy: where the ancient art meets the new era","volume":"47","author":"Ota","year":"2024","unstructured":"Ota NBenet AKusdiansah MMicrosurgical thrombectomy: where the ancient art meets the new era. Neurosurg Rev. 2024;47(1):49."},{"issue":"10","key":"bib5","series-title":"Neuroradiology","first-page":"2851","article-title":"Direct aspiration versus stent retriever as First-line thrombectomy techniques for acute basilar artery occlusions: an updated systematic review and Meta-Analysis","volume":"67","author":"Lee","year":"2025","unstructured":"Lee WJCorreia Maciel RAbo Kasem RDirect aspiration versus stent retriever as First-line thrombectomy techniques for acute basilar artery occlusions: an updated systematic review and Meta-Analysis. Neuroradiology. 2025;67(10):2851-2867."},{"issue":"6","key":"bib6","series-title":"JAMA Netw Open","first-page":"e2515526","article-title":"Outcomes of endovascular treatment in patients with vertebrobasilar artery occlusion beyond 24 hours","volume":"8","author":"Liu","year":"2025","unstructured":"Liu SXu YNguyen TNOutcomes of endovascular treatment in patients with vertebrobasilar artery occlusion beyond 24 hours. JAMA Netw Open. 2025;8(6):e2515526."},{"issue":"1","key":"bib7","series-title":"J Med Case Rep","first-page":"62","article-title":"Occipital artery-posterior inferior cerebellar artery bypass for anterior inferior cerebellar artery stenosis with repeated cerebellar ischemic stroke: a case report","volume":"19","author":"Eguchi","year":"2025","unstructured":"Eguchi HArai TKawamata T.Occipital artery-posterior inferior cerebellar artery bypass for anterior inferior cerebellar artery stenosis with repeated cerebellar ischemic stroke: a case report. J Med Case Rep. 2025;19(1):62."},{"key":"bib8","series-title":"Surg Neurol Int","first-page":"256","article-title":"Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection","volume":"11","author":"Hirano","year":"2020","unstructured":"Hirano YOno HInoue TSuperficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection. Surg Neurol Int. 2020;11:256."},{"issue":"4","key":"bib9","series-title":"J Neurosurg","first-page":"554","article-title":"Superficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency","volume":"72","author":"Ausman","year":"1990","unstructured":"Ausman JIDiaz FGVacca DFSadasivan B.Superficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency. J Neurosurg. 1990;72(4):554-558."},{"issue":"2","key":"bib10","series-title":"Oper Neurosurg","first-page":"279","article-title":"Microsurgical treatment of a giant thrombosed basilar artery-superior cerebellar artery aneurysm with the aid of double bypass superficial temporal artery-posterior cerebral artery and superficial temporal artery-superior cerebellar artery: 2-dimensional operative video","volume":"28","author":"Cubas Farinha","year":"2025","unstructured":"Cubas Farinha NOta NGomez-Vega JCKondo TNoda KTanikawa R.Microsurgical treatment of a giant thrombosed basilar artery-superior cerebellar artery aneurysm with the aid of double bypass superficial temporal artery-posterior cerebral artery and superficial temporal artery-superior cerebellar artery: 2-dimensional operative video. Oper Neurosurg. 2025;28(2):279-280."},{"key":"bib11","series-title":"World Neurosurg","first-page":"75","article-title":"Emergency superficial temporal artery-superior cerebellar artery bypass for the refractory vertebrobasilar insufficiency with partial mastoidectomy","volume":"118","author":"Katsuno","year":"2018","unstructured":"Katsuno MIshisaka EToyota KKawasaki KInaba I.Emergency superficial temporal artery-superior cerebellar artery bypass for the refractory vertebrobasilar insufficiency with partial mastoidectomy. World Neurosurg. 2018;118:75-80."},{"issue":"5","key":"bib12","series-title":"Oper Neurosurg","first-page":"527","article-title":"Occipital artery to extradural vertebral artery bypass for posterior circulation ischemia","volume":"16","author":"Wang","year":"2019","unstructured":"Wang XTong XShi MShang YWang H.Occipital artery to extradural vertebral artery bypass for posterior circulation ischemia. Oper Neurosurg. 2019;16(5):527-538."},{"issue":"2","key":"bib13","series-title":"Lancet Neurol","first-page":"115","article-title":"Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial","volume":"19","author":"Liu","year":"2020","unstructured":"Liu XDai QYe REndovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial. Lancet Neurol. 2020;19(2):115-122."},{"issue":"15","key":"bib14","series-title":"N Engl J Med","first-page":"1361","article-title":"Trial of endovascular treatment of acute basilar-artery occlusion","volume":"387","author":"Tao","year":"2022","unstructured":"Tao CNogueira RGZhu YTrial of endovascular treatment of acute basilar-artery occlusion. N Engl J Med. 2022;387(15):1361-1372."},{"issue":"3","key":"bib15","series-title":"J Stroke Cerebrovasc Dis","first-page":"583","article-title":"Posterior circulation hyperperfusion syndrome after superficial temporal artery-superior cerebellar artery bypass for vertebral artery dissection","volume":"23","author":"Fukuda","year":"2014","unstructured":"Fukuda KAbe HUeba TOkawa MHigashi TInoue T.Posterior circulation hyperperfusion syndrome after superficial temporal artery-superior cerebellar artery bypass for vertebral artery dissection. J Stroke Cerebrovasc Dis. 2014;23(3):583-586."},{"issue":"5","key":"bib16","series-title":"PLoS One","first-page":"e0276307","article-title":"Extravascular optical coherence tomography of cerebral vessel walls in vivo","volume":"18","author":"Hartmann","year":"2023","unstructured":"Hartmann KNeyazi BDumitru CAHaghikia ASandalcioglu IEStein KP.Extravascular optical coherence tomography of cerebral vessel walls in vivo. PLoS One. 2023;18(5):e0276307."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/25\/article-CASE25710.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/25\/article-CASE25710.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/25\/article-CASE25710.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:12:14Z","timestamp":1769685134000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/25\/article-CASE25710.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,22]]},"references-count":32,"journal-issue":{"issue":"25"},"URL":"https:\/\/doi.org\/10.3171\/case25710","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,22]]}}}