Abstract
Moyamoya disease (MMD) usually involves the middle cerebral artery (MCA) and the anterior cerebral artery (ACA) territories [1]. The areas of frontal lobe supplied by ACA are cardinal for lower extremity motor function, sphincter functions, and especially neuro-cognitive development in children. It is well known that the cerebral cortex supplied by the ACA has many important roles in neuropsychological and intellectual developments in addition to lower extremity motor function and sphincter function [2]. Consequently, ischemic brain insults in the ACA territory may lead to poor intellectual outcomes and low quality of life (QoL) status as well as motor weakness or sphincter dysfunction [2– 4]. Nevertheless, many cerebral blood flow studies [4, 5] using positron emission tomography (PET) or single-photon emission computed tomography (SPECT) with acetozolamide have revealed that cerebral blood flow and metabolism in the ACA territory were significantly decreased, and were not adequately compensated by collateral flow from the external carotid arteries (ECAs), MCA, or posterior cerebral artery (PCA). The majority of previous studies have focused on the augmentation of blood flow in the MCA territory [6]. The reinforcement of the ACA territory might to be kept in mind when making the treatment plan for pediatric MMD patients.
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References
Burke GM, Burke AM, Sherma AK et al (2009) Moyamoya disease: a summary. Neurosurg Focus 26:E11
Kumral E, Bayulkem G, Evyapan D et al (2002) Spectrum of anterior cerebral artery territory infarction: clinical and MRI findings. Eur J Neurol 9:615–624
Ishikawa T, Houkin K, Kamiyama H et al (1997) Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease. Stroke 28:1170–1173
Ogawa A, Yoshimoto T, Suzuki J et al (1990) Cerebral blood flow in moyamoya disease. Part 1: Correlation with age and regional distribution. Acta Neurochir (Wien) 105:30–34
Ohtaki M, Uede T, Morimoto S et al (1998) Intellectual functions and regional cerebral haemody-namics after extensive omental transplantation spread over both frontal lobes in childhood moyamoya disease. Acta Neurochir (Wien) 140:1043–1053; discussion 1052–1043
Kim C Y, Wang KC, Kim SK et al (2003) Encephaloduroarteriosynangiosis with bifrontal encephalogaleo(periosteal)synangiosis in the pediatric moyamoya disease: the surgical technique and its outcomes. Childs Nerv Syst 19:316–324
Karasawa J, Touho H, Ohnishi H et al (1992) Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease. J Neurosurg 77:84–89
Kuroda S, Houkin K (2008) Moyamoya disease: current concepts and future perspectives. Lancet Neurol 7:1056–1066
Karasawa J, Kikuchi H, Kawamura J et al (1980) Intracranial transplantation of the omentum for cerebrovascular moyamoya disease: a two-year follow-up study. Surg Neurol 14:444–449
Yoshioka N, Tominaga S, Suzuki Y et al (1998) Cerebral revascularization using omentum and muscle free flap for ischemic cerebrovascular disease. Surg Neurol 49:58–66
Ishii R, Koike T, Takeuchi S et al (1983) Anastomosis of the superficial temporal artery to the distal anterior cerebral artery with interposed cephalic vein graft. Case report. J Neurosurg 58:425–429
Iwama T, Hashimoto N, Miyake H et al (1998) Direct revascularization to the anterior cerebral artery territory in patients with moyamoya disease: report of five cases. Neurosurgery 42:1157–1161; discussion 1161–1152
Kawaguchi T, Fujita S, Hosoda K et al (1996) Multiple burr-hole operation for adult moyamoya disease. J Neurosurg 84:468–476
Kawamoto H, Inagawa T, Ikawa F et al (2001) A modified burr-hole method in galeoduroencepha-losynangiosis for an adult patient with probable moyamoya disease — case report and review of the literature. Neurosurg Rev 24:147–150
Kawamoto H, Kiya K, Mizoue T et al (2000) A modified burr-hole method ‘galeoduroencephalo-synangiosis’ in a young child with moyamoya disease. A preliminary report and surgical technique. Pediatr Neurosurg 32:272–275
Karasawa J, Touho H, Ohnishi H et al (1993) Cerebral revascularization using omental transplantation for childhood moyamoya disease. J Neurosurg 79:192–196
Kinugasa K, Mandai S, Tokunaga K et al (1994) Ribbon enchephalo-duro-arterio-myo-synangiosis for moyamoya disease. Surg Neurol 41:455–461
Kim SK, Wang KC, Kim IO et al (2002) Combined encephaloduroarteriosynangiosis and bifrontal encephalogaleo(periosteal)synangiosis in pediatric moyamoya disease. Neurosurgery 50:88–96
Park JH, Yang S Y, Chung YN et al (2007) Modified encephaloduroarteriosynangiosis with bifrontal encephalogaleoperiosteal synangiosis for the treatment of pediatric moyamoya disease. Technical note. J Neurosurg 106:237–242
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Kim, CY., Kim, B.C. (2010). ACA Territory Reinforcement. In: Cho, BK., Tominaga, T. (eds) Moyamoya Disease Update. Springer, Tokyo. https://doi.org/10.1007/978-4-431-99703-0_34
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DOI: https://doi.org/10.1007/978-4-431-99703-0_34
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