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The extra-intracranial bypass has been used in the treatment of patients with chronic cerebrovascular insufficiency. More recent studies have demonstrated the benefit of this technique to patients with arterial occlusion in the acute phase. We relate the case of a 19-year-old patient, victim of cervical trauma, who presented evidence of intra- and extracranial internal carotid artery (ICA) occlusion and progressive intra hospital clinical worsening. He underwent a high-flow bypass surgery with NIHSS at 17, progressing with progressive intra hospital improvement and in the outpatient segment achieved a NIHSS of 2 in 6 months of follow-up. We discuss the role of high- and low-flow bypass in chronic occlusive arterial disease, based on a review of the literature. We conclude that in spite of there being a divergence as to the indication for, and benefits of, these techniques in chronic occlusive arterial disease, in the acute phase, there appears to be a more evident benefit mainly in the young patients, whose etiology is the dissection of the ICA.

arquivos brasileiros de neurocirurgia

Role of the emergency extra-intracranial bypass in acute occlusive arterial disease: evidence in the literature as to the benefit to young patients and an illustrative case of a patient with extra- and intracranial traumatic internal carotid artery occlusion