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ACA Territory Reinforcement

  • Chae-Yong Kim
  • Byong Cheol Kim

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.

Keywords

Anterior Cerebral Artery Moyamoya Disease Middle Cerebral Artery Territory Brain SPECT Anterior Cerebral Artery Territory 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Burke GM, Burke AM, Sherma AK et al (2009) Moyamoya disease: a summary. Neurosurg Focus 26:E11PubMedCrossRefGoogle Scholar
  2. 2.
    Kumral E, Bayulkem G, Evyapan D et al (2002) Spectrum of anterior cerebral artery territory infarction: clinical and MRI findings. Eur J Neurol 9:615–624PubMedCrossRefGoogle Scholar
  3. 3.
    Ishikawa T, Houkin K, Kamiyama H et al (1997) Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease. Stroke 28:1170–1173PubMedCrossRefGoogle Scholar
  4. 4.
    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) 105:30–34CrossRefGoogle Scholar
  5. 5.
    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 1052–1043CrossRefGoogle Scholar
  6. 6.
    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 19:316–324PubMedCrossRefGoogle Scholar
  7. 7.
    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 77:84–89PubMedCrossRefGoogle Scholar
  8. 8.
    Kuroda S, Houkin K (2008) Moyamoya disease: current concepts and future perspectives. Lancet Neurol 7:1056–1066PubMedCrossRefGoogle Scholar
  9. 9.
    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 14:444–449PubMedGoogle Scholar
  10. 10.
    Yoshioka N, Tominaga S, Suzuki Y et al (1998) Cerebral revascularization using omentum and muscle free flap for ischemic cerebrovascular disease. Surg Neurol 49:58–66PubMedCrossRefGoogle Scholar
  11. 11.
    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 58:425–429PubMedCrossRefGoogle Scholar
  12. 12.
    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 1161–1152PubMedCrossRefGoogle Scholar
  13. 13.
    Kawaguchi T, Fujita S, Hosoda K et al (1996) Multiple burr-hole operation for adult moyamoya disease. J Neurosurg 84:468–476PubMedCrossRefGoogle Scholar
  14. 14.
    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 24:147–150PubMedCrossRefGoogle Scholar
  15. 15.
    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 32:272–275PubMedCrossRefGoogle Scholar
  16. 16.
    Karasawa J, Touho H, Ohnishi H et al (1993) Cerebral revascularization using omental transplantation for childhood moyamoya disease. J Neurosurg 79:192–196PubMedCrossRefGoogle Scholar
  17. 17.
    Kinugasa K, Mandai S, Tokunaga K et al (1994) Ribbon enchephalo-duro-arterio-myo-synangiosis for moyamoya disease. Surg Neurol 41:455–461PubMedCrossRefGoogle Scholar
  18. 18.
    Kim SK, Wang KC, Kim IO et al (2002) Combined encephaloduroarteriosynangiosis and bifrontal encephalogaleo(periosteal)synangiosis in pediatric moyamoya disease. Neurosurgery 50:88–96PubMedGoogle Scholar
  19. 19.
    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 106:237–242PubMedGoogle Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  1. 1.Department of NeurosurgerySeoul National University Bundang HospitalBundang-gu, Seongnam-si, Gyeonggi-doRepublic of Korea
  2. 2.Department of NeurosurgerySeoul National University College of MedicineRepublic of Korea

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