Abstract
Moyamoya disease is a unique disease of unknown etiology characterized by progressive occlusion of the supraclinoid portion of bilateral internal carotid arteries (IC), and the proximal portions of anterior (ACA) and middle cerebral arteries (MCA). Occlusion of the posterior circulation is also involved in 30–40% of patients. In most of the recommended procedures till date, either direct and/or indirect bypass surgery has been advocated to improve cerebral perfusion. In the present study, we performed combined surgery that included both the direct bypass procedures as well as the indirect ones [1,2]. The combination of procedures ensured perfusion of a wider ischemic zone and salvaging of the penumbric area. Indirect procedures like encephalo-duro-arterio-synangiosis (EDAS), encephalo-myo-synangiosis (EMS) or galeal flaps are safe and easy. Direct bypass surgery, however, is more reliable in providing adequate cerebral blood flow but is technically difficult as the recipient artery running on the cortical surface is usually fine and fragile in moyamoya disease.
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References
Suzuki Y, Negoro M, Shibuya M, et al (1997) Surgical treatment for pediatric moyamoya disease: use of th3 superior temporal artery for both areas supplied by the anterior and middle cerebral arteries. Neurosurgery 40:324–330
Suzuki Y, Fujita M, Mizutani N, et al (2000) Role of nitric oxide in the control of cerebral microcirculation under physiological and pathological condition. Clin Hemorheol Microcirc 23:307–312
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© 2006 Springer-Verlag Tokyo
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Suzuki, Y., Hatano, N., Takasu, S., Matsubara, N., Kishida, Y., Mizutani, N. (2006). Direct Cerebral Bypass Supplements Indirect Bypass Procedures in Moyamoya Disease. In: Kanno, T., Kato, Y. (eds) Minimally Invasive Neurosurgery and Multidisciplinary Neurotraumatology. Springer, Tokyo. https://doi.org/10.1007/4-431-28576-8_14
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DOI: https://doi.org/10.1007/4-431-28576-8_14
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-28551-9
Online ISBN: 978-4-431-28576-2
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