Pregnancy and Delivery in Moyamoya Disease
Moyamoya disease is more prevalent in females than in males . Moreover, this disease occurs most frequently during childhood and early adulthood; thus, it is not uncommon for patients to become pregnant and give birth. Although serious vascular events in pregnant patient of moyamoya disease have been reported, no guidelines have been established on managing the pregnancies of such patients (Fig. 1). In this chapter, this problem is discussed in light of a review of the literature and a recent nationwide survey on pregnancy, delivery, and moyamoya disease.
KeywordsCerebral Ischemia Vaginal Delivery Intracranial Hemorrhage Epidural Anesthesia Pregnant Patient
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.
Handa H, Yonekawa Y (1985) The occlusion of the circle of Willis: 1,500 case files including 200 long follow-up cases [in Japanese]. No Socchu 7:477–480Google Scholar
Jennett WB, Cross JN (1967) Influence of pregnancy and oral contraception on the incidence of strokes in women of childbearing age. Lancet 1:1019–1023PubMedCrossRefGoogle Scholar
Wiebers DO (1985) Ischemic cerebrovascular complications of pregnancy. Arch Neurol 42:1106–1113PubMedCrossRefGoogle Scholar
Kittner SJ, Stern BJ, Feeser BR et al (1996) Pregnancy and the risk of stroke. N Engl J Med 335:768–774PubMedCrossRefGoogle Scholar
Sameshima H (1999) Ninshin,bunbenji no nousyukketu (cerebral hemorrhage during pregnancy and delivery) [in Japanese]. Perinat Med 29:205–209Google Scholar
Komiyama M, Yasui, T, Kitano S et al (1998) Moyamoya disease and pregnancy: case report and review of the literature. Neurosurgery 43:360–368PubMedCrossRefGoogle Scholar
Takahashi JC, Ikeda T, Iihara K et al (2009) A nationwide survey on the management of pregnancy and delivery in association with moyamoya disease [in Japanese]. Jpn J Neurosurg (Tokyo) 18:367–375Google Scholar
Kawaguchi S, Okuno S, Sakaki T (2000) Effect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease. J Neurosurg 93:397–401PubMedCrossRefGoogle Scholar
Miyamoto S (2004) Study design for a prospective randomized trial of extracranial-intracranial bypass surgery for adults with moyamoya disease and hemorrhagic onset –the Japan Adult Moyamoya Trial Group. Neurol Med Chir (Tokyo) 44:218–219CrossRefGoogle Scholar
Yoshida Y, Yoshimoto T, Shirane R et al (1999) Clinical course, surgical management, and long-term outcome of moyamoya patients with rebleeding after an episode of intracerebral hemorrhage: an extensive follow-up study. Stroke 30:2272–2276PubMedCrossRefGoogle Scholar
Ikeda T, Neki R, Suga S et al (2009) Intrapartum epidural analgesia for patients with moyamoya disease. Jpn J Neurosurg (Tokyo) 18:376–382Google Scholar