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Moyamoya Bypasses

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Pediatric Vascular Neurosurgery

Abstract

Moyamoya disease/syndrome is a rare disease involving chronic, slowly progressive stenosis of bilateral internal carotid arteries and/or proximal anterior and middle cerebral arteries, with formation of collateral vessels that resemble a “puff of smoke” on angiography. Younger patients usually present with ischemia while older ones present with hemorrhage. There is no proven medical treatment for this pathology. Surgical treatment involves revascularization either via an indirect method such as dural inversion, a direct method such as external carotid to internal carotid artery bypass or both. In this chapter, we discuss briefly the technique for indirect and direct revascularization used at our institution.

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References

  1. Smith E, Scott RM. Revascularization techniques in pediatric cerebrovascular disorders. In: Alfredo Q-H, editor. Schmidek & Sweet operative neurosurgical techniques: indications, methods and results, vol. I. 6th ed. Philadelphia: Elsevier Saunders; 2012.

    Google Scholar 

  2. Arias EJ, Derdeyn CP, Dacey Jr RG, Zipfel GJ. Advances and surgical considerations in the treatment of moyamoya disease. Neurosurgery. 2014;74(2):S116–25.

    Article  Google Scholar 

  3. Suzuki J, Kodama N. Moyamoya disease: a review. Stroke. 1983;14(1):104–9.

    Article  CAS  PubMed  Google Scholar 

  4. Suzuki J, Takaku A. Cerebrovascular “moyamoya” disease: a disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288–99.

    Article  CAS  PubMed  Google Scholar 

  5. Matsushima T, Inoue T, Suzuki SO, Fujii K, Fukui M, Hasuo K. Surgical treatment of moyamoya disease in pediatric patients – comparison between the results of indirect and direct revascularization procedures. Neurosurgery. 1992;31(3):401–5.

    Article  CAS  PubMed  Google Scholar 

  6. Matsushima T, Fujiwara S, Nagata S, Fujii K, Fukui M, Kitamura K, Hasuo K. Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS). Acta Neurochir (Wien). 1989;98:135–40.

    Article  CAS  Google Scholar 

  7. Donaghy RM, Yasargil G. Microangeional surgery and its techniques. Prog Brain Res. 1968;30:263–7.

    Article  CAS  PubMed  Google Scholar 

  8. Fung L-W E, et al. Revascularisation surgery for paediatric moyamoya: a review of the literature. Childs Nerv Syst. 2005;21:358–64.

    Article  PubMed  Google Scholar 

  9. Sato K, Shirane R, Kato M, et al. Effect of inhalational anesthesia on cerebral circulation in moyamoya disease. J Neurosurg Anesthesiol. 1999;11(1):25–30.

    Article  CAS  PubMed  Google Scholar 

  10. Amin-Hanjani S, Du X, Mlinarevich N, et al. The cut flow index: an intra-operative predictor of the success of extracranial-intracranial bypass for occlusive cerebrovascular disease. Neurosurgery. 2005;56 Suppl 1:75–85; discussion 75–85.

    PubMed  Google Scholar 

  11. Lee M, Guzman R, Bell-Stephens T, et al. Intra-operative blood flow analysis of direct revascularization procedures in patients with moyamoya disease. J Cereb Blood Flow Metab. 2011;31(1):262–74.

    Article  PubMed  Google Scholar 

  12. Choi JU, Kim DS, Kim EY, Lee KC. Natural history of moyamoya disease: comparison of activity of daily living in surgery and non surgery groups. Clin Neurol Neurosurg. 1997;99 Suppl 2:S11–8.

    Article  PubMed  Google Scholar 

  13. Ezura M, Yoshimoto T, Fujiwara S, Takahashi A, Shirane R, Mizoi K. Clinical and angiographic follow-up of childhood-onset moyamoya disease. Childs Nerv Syst. 1995;11:591–4.

    Article  CAS  PubMed  Google Scholar 

  14. Kurokawa T, Tomita S, Ueda K, Narazaki O, Hanai T, Hasuo K, Matsushima T, Kitamura K. Prognosis of occlusive disease of the circle of Willis (moyamoya disease) in children. Pediatr Neurol. 1985;1:274–7.

    Article  CAS  PubMed  Google Scholar 

  15. Ikezaki K, et al. Rational approach to treatment of moyamoya disease in childhood. J Child Neurol. 2000;15:350–6.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Gavin W. Britz MD .

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© 2016 Springer International Publishing Switzerland

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Desai, V.R., Scranton, R.A., Britz, G.W. (2016). Moyamoya Bypasses. In: Agrawal, A., Britz, G. (eds) Pediatric Vascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43636-4_17

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  • DOI: https://doi.org/10.1007/978-3-319-43636-4_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43634-0

  • Online ISBN: 978-3-319-43636-4

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