1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-6-66 10.15844/pedneurbriefs-6-9-2 Vascular Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Moyamoya Disease: Results of Surgery http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 09 1992 01 07 2016 6 9 66 67 Copyright: © 1992 The Author(s) 1992 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Childhood moyamoya disease before and after encephalo-duro-arterio-synangiosis: an angiographic study

An angiographic study of the effects of encephalo-duro-arterio-synangiosis (EDAS) in 27 children with moyamoya disease is reported from the Departments of Radiology and Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.

 Moyamoya Disease Preoperative Angiograms Hyperventilation

An angiographic study of the effects of encephalo-duro-arterio-synangiosis (EDAS) in 27 children with moyamoya disease is reported from the Departments of Radiology and Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan. Comparing pre- and post-operative angiograms, the development of collaterals from the external carotid arterial system into the middle cerebral artery territory was excellent in 16 of 54 cerebral hemispheres after EDAS, good in 25 and poor in 13. The development of collateral vessels from the ECA to the MCA territory increased with the severity of the stenosis of the ICA on preoperative angiograms, but in most advanced stages the development of collateral supply was less marked. The development of collateral vessels was associated with a decrease of abnormal net-like vessels. Stenosis in the ICA had progressed on 12 of the 54 cerebral hemispheres as compared with preoperative angiograms. [1]

COMMENT. This study suggests that EDAS for childhood moyamoya disease should be performed as early as possible so that the development of irreversible ischaemia and permanent neurological defects may possibly be prevented.

Cerebral blood flow reactivity to hyperventilation in children with moyamoya disease was studied at the Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan [2]. CBF was measured by single photon emission CT (SPECT) in 11 children divided into bypass and non-bypass groups. There was some hemodynamic insufficiency in the frontal lobes of the non-bypass group who underwent procedures such as EDAS. The reduction of CBF was less after hyperventilation, especially in the frontal lobes of the bypass group in which a much better collateral blood flow occurs.

 Yamada I Matsushima Y Suzuki S Childhood moyamoya disease before and after encephalo-duro-arterio-synangiosis: an angiographic study Neuroradiology 1992 34 4 318 322 10.1007/BF00588191 1528443 Isobe M Neurol Surg 1992 April 20 407