Cutting off blood aids brain surgery.

• Position: Basilar artery occlusion

When British surgeon John Hunter cut the blood flow feeding deer antlers in 1785, he made a discovery that ultimately led contemporary researchers to a study documehting that a usually fatal brain disorder in humans can be treated by cutting off selected blood flow to the brain. Gary K. Steinberg, associate, professor of neurosurgery, Stanford University, and colleaques followed 201 patients at two North American medical centers who received an innovative surgery based on Hunter's observation that, when critical blood flow is cut off, the body will compensate by rapidly developing new blood vessels (called collateral circulation) to pick up the slack. In the deer, new blood vessel developed within a few weeks to feed the antlers, which resumed growth.

Survival and quality of life improved dramatically for human patients who underwent an operation that blocked arteries leading to areas with weakened arterial walls - called aneurysms - deep within the brain. According to Steinberg, research results clearly document that the admittedly tricky procedure is the best hope for appropriate patients. Even though such surgery - called basilar or vertebral artery occlusion - has been performed sporadically at a variety of institutions worldwide since 1962, this study is the first large-scale analysis of results.

Sixty-eight...