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Child's Nervous System

, Volume 12, Issue 2, pp 69–75 | Cite as

The effectiveness of O2 administration for transient ischemic attacks in moyamoya disease in children

  • Junko Fujiwara
  • Satoko Nakahara
  • Takao Enomoto
  • Yoshitaka Nakata
  • Hitoshi Takita
Original Paper

Abstract

Moyamoya disease is a cerebrovascular obstructive disease of unknown etiology. The rebuild-up phenomenon, slowing of waves on electroencephalogram (EEG) seen after cessation of hyperventilation (HV), is one of the characteristic phenomena of the disease and is though to be related to a development of its symptoms. Therefore, we investigated the mechanism involved in the rebuild-up phenomenon to clarify the mechanism of development of transient ischemic attack (TIA) in moyamoya disease. Ten patients with moyamoya disease were studied; they ranged in age from 7 to 17 years. The power spectra of the EEGs in the occipital region were obtained with a Berg Fourier EEG analyzer for quantitative analysis. Arterial blood gas change (pH,PaO2,PaCO2), respiratory pattern (abdominal and nasal), tidal volume and respiratory rate were analyzed simultaneously every 30 s-1 min before, during, and after HV. The slow wave power spectrum (rebuild-up) increased and symptoms of TIA developed as a result of the sharp decrease inPaO2 (PaO2 60.5±15.4 mmHg) after cessation of HV. Based on the fact that hypoxemia was playing a main role, 100% oxygen was administered at a rate of 0.5 l/min in 4 cases where the rebuild-up phenomenon was clear. The EEG power spectra and arterial blood gas were analyzed during rebuild-up with and without O2 administration. The effectiveness of O2 administration at the beginning of rebuild-up as measure to prevent the symptoms was checked by a recovery rate of slow wave power percentage, a recovery time of slow wave power percent and by clinical observation. The recovery rates were 11.8±4.2% min and 5.5±4.0% min with and without O2 inhalation, respectively (P< 0.001). Recovery times of slow wave power percentage were 4.3±1.8 min and 8.1±1.2 min with and without O2 inhalation, respectively (P< 0.01). Thus, oxygen administration soon after the cessation of HV was shown to be effective in eliminating the rebuild-up phenomenon and hence in abolishing its symptoms.

Key words

Moyamoya disease EEG power spectrum O2 administration Rebuild-up phenomenon 

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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Junko Fujiwara
    • 1
  • Satoko Nakahara
    • 2
  • Takao Enomoto
    • 3
  • Yoshitaka Nakata
    • 4
  • Hitoshi Takita
    • 5
  1. 1.Division for the Visually Impaired (Clinical Medicine, Pediatrics)Tsukuba College of TechnologyTsukuba, IbarakiJapan
  2. 2.Kensci General HospitalTsukubaJapan
  3. 3.Department of Neurosurgery, Institute of Clinical MedicineUniversity of TsukubaTsukubaJapan
  4. 4.Tsukuba Medical HospitalTsukubaJapan
  5. 5.Department of PediatricsUniversity of TsukubaTsukubaJapan

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