Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Indirect revascularization surgery for moyamoya disease in children and its special considerations

  • Wang, Kyu-Chang (Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital) ;
  • Phi, Ji Hoon (Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital) ;
  • Lee, Ji Yeoun (Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital) ;
  • Kim, Seung-Ki (Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital) ;
  • Cho, Byung-Kyu (Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital)
  • Received : 2012.06.29
  • Accepted : 2012.08.18
  • Published : 2012.11.15
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Abstract

Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

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References

  1. Veeravagu A, Guzman R, Patil CG, Hou LC, Lee M, Steinberg GK. Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions. Neurosurg Focus 2008;24:E16.
  2. Lee SB, Kim DS, Huh PW, Yoo DS, Lee TG, Cho KS. Long-term followup results in 142 adult patients with moyamoya disease according to management modality. Acta Neurochir (Wien) 2012;154:1179-87.
  3. Matsushima Y, Fukai N, Tanaka K, Tsuruoka S, Inaba Y, Aoyagi M, et al. A new surgical treatment of moyamoya disease in children: a preliminary report. Surg Neurol 1981;15:313-20.
  4. Scott RM, Smith JL, Robertson RL, Madsen JR, Soriano SG, Rockoff MA. Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis. J Neurosurg 2004;100(2 Suppl Pediatrics):142-9.
  5. Kinugasa K, Mandai S, Tokunaga K, Kamata I, Sugiu K, Handa A, et al. Ribbon enchephalo-duro-arterio-myo-synangiosis for moyamoya disease. Surg Neurol 1994;41:455-61.
  6. Kim SK, Wang KC, Kim IO, Lee DS, Cho BK. Combined encephaloduroarteriosynangiosis and bifrontal encephalogaleo(periosteal) synangiosis in pediatric moyamoya disease. Neurosurgery 2002;50:88-96
  7. Endo M, Kawano N, Miyaska Y, Yada K. Cranial burr hole for revascularization in moyamoya disease. J Neurosurg 1989;71:180-5.
  8. Fujimura M, Kaneta T, Mugikura S, Shimizu H, Tominaga T. Temporary neurologic deterioration due to cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with adult-onset moyamoya disease. Surg Neurol 2007;67:273-82.
  9. Kim JE, Oh CW. Moyamoya disease in adult: post-bypass symptomatic hyperperfusion. In: Cho BK, Tominaga T, editors. Moyamoya disease update. Tokyo: Springer, 2010:306-17.
  10. Fung LW, Thompson D, Ganesan V. Revascularisation surgery for paediatric moyamoya: a review of the literature. Childs Nerv Syst 2005; 21:358-64.
  11. Kim SK, Seol HJ, Cho BK, Hwang YS, Lee DS, Wang KC. Moyamoya disease among young patients: its aggressive clinical course and the role of active surgical treatment. Neurosurgery 2004;54:840-4.
  12. Im SH, Oh CW, Kwon OK, Kim JE, Han DH. Moyamoya disease associated with Graves disease: special considerations regarding clinical significance and management. J Neurosurg 2005;102:1013-7.

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