Multiple burr-hole operation for adult moyamoya disease
| Autor: | Kohkichi Hosoda, Seiji Hamano, Shigekiyo Fujita, Yoshiteru Shose, Norihiko Tamaki, Masaki Iwakura, Tetsuro Kawaguchi |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Middle meningeal artery Neovascularization Physiologic medicine.artery Trephining medicine Humans Moyamoya disease Subdural effusion Tomography Emission-Computed Single-Photon Cerebral Revascularization medicine.diagnostic_test Cerebral infarction business.industry Brain Middle Aged Superficial temporal artery medicine.disease Cerebral Angiography Surgery Intraventricular hemorrhage Cerebral blood flow Cerebrovascular Circulation Female Moyamoya Disease business Follow-Up Studies Cerebral angiography |
| Zdroj: | Journal of Neurosurgery. 84:468-476 |
| ISSN: | 0022-3085 |
| DOI: | 10.3171/jns.1996.84.3.0468 |
| Popis: | ✓ Excellent results from multiple burr-hole operations for adult moyamoya disease are reported in this study. Ten patients had between one and four burr holes (mean 2.1) drilled in each hemisphere. In four patients new burr holes were added on the opposite side after depression of cerebral blood flow (CBF) was detected by follow-up single-photon emission computerized tomography imaging of the brain with N-isopropyl-p-[123I]iodoamphetamine. The postoperative follow-up period ranged from 6 to 62 months (mean 34.7 months). Beginning at 6 months postsurgery, angiograms disclosed rich neovascularization at 41 of 43 burr holes, first from the middle meningeal artery, then from the superficial temporal artery. Neovascularization did not occur at two burr holes at which there was subdural effusion and local cerebral atrophy, respectively. Progression of stenosis of the major vessels was seen in six patients. Moyamoya vessels were decreased at six sites in four patients. The CBF study revealed that the reactivity to acetazolamide improved in all six patients tested. Transient ischemic attacks disappeared in all six patients presenting with this symptom, and preoperative symptoms improved in both of the patients who presented with cerebral infarction and in both patients with intraventricular hemorrhage. There was no mortality or morbidity, and no new neurological deficits or rebleeding developed during the follow-up period. The authors strongly recommend the multiple burr-hole operation as the surgical treatment of choice for adult moyamoya disease because of its safety and effectiveness. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|