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Early surgical treatment benefits early staged pediatric moyamoya disease—single case report

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Abstract

Purpose

Surgical revascularization for pediatric moyamoya disease improves cerebral blood flow (CBF) and consequently may prevent further ischemic events. However, the timing of the treatment is controversial especially for patients with no ischemic symptom and normal CBF. The purpose of this case report is to inform and infer the surgical treatment timing for pediatric moyamoya disease patients.

Case report

A 10-year-old female patient with unilateral moyamoya disease complaining of only headache as a symptom and whose Suzuki stage was II or in transition to III by angiography and CBF was almost normal was admitted to Tokyo Women’s Medical University Hospital. We performed superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses for the patient because we estimated her headache was derived from low perfusion in the brain. STA-MCA bypass surgery was not only effective for relief of her severe headache but also valid for her cerebral perfusion. Her angiography showed much supply from external carotid artery to intracranial arteries via bypass grafts in 7 months.

Conclusion

Our case showed early surgical treatment was beneficial for relief of severe headache even for early staged pediatric moyamoya disease patients by improving perfusion pressure and cerebral circulation.

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Acknowledgments

We thank David Huang for their guidance and staff of the Department of Neurosurgery, Tokyo Women’s Medical University, in preparing this paper.

Declaration of funding source

This study was supported by research funds of the Department of Neurosurgery, Tokyo Women’s Medical University.

Conflict of interest

The authors have no personal financial or institutional interest in any of the materials or devices described in this article.

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Authors and Affiliations

  1. Department of Neurosurgery, Tokyo Women’s Medical University Hospital, 8-1 Kawada-cho Shinjuku-ku, Tokyo, 162-8666, Japan

    Go Matsuoka, Yasuo Aihara, Koji Yamaguchi, Tatsuya Ishikawa, Akitsugu Kawashima, Takakazu Kawamata & Yoshikazu Okada

Authors
  1. Go Matsuoka
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  2. Yasuo Aihara
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  3. Koji Yamaguchi
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  4. Tatsuya Ishikawa
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  5. Akitsugu Kawashima
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  6. Takakazu Kawamata
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  7. Yoshikazu Okada
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Corresponding author

Correspondence to Yasuo Aihara.

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Matsuoka, G., Aihara, Y., Yamaguchi, K. et al. Early surgical treatment benefits early staged pediatric moyamoya disease—single case report. Childs Nerv Syst 31, 1195–1199 (2015). https://doi.org/10.1007/s00381-015-2709-3

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  • DOI: https://doi.org/10.1007/s00381-015-2709-3

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