Journal of Korean Neurosurgical Society

  • 제62권2호
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  • Pages.136-143
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  • 2019
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Hemorrhagic Moyamoya Disease : A Recent Update

  • 투고 : 2018.05.01
  • 심사 : 2018.05.09
  • 발행 : 2019.03.01
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초록

Moyamoya disease (MMD) is a progressive cerebrovascular disease with unknown etiology, characterized by bilateral steno-occlusive changes at the terminal portion of the internal carotid artery and an abnormal vascular network formation at the base of the brain. MMD has an intrinsic nature to convert the vascular supply for the brain from internal carotid (IC) system to the external carotid (EC) system, as indicated by Suzuki's angiographic staging. Insufficiency of this 'IC-EC conversion system' could result not only in cerebral ischemia, but also in intracranial hemorrhage from inadequate collateral anastomosis, both of which represent the clinical manifestation of MMD. Surgical revascularization prevents cerebral ischemic attack by improving cerebral blood flow, and recent evidence further suggests that extracranial-intracranial bypass could powerfully reduce the risk of re-bleeding in MMD patients with posterior hemorrhage, who were known to have extremely high re-bleeding risk. Although the exact mechanism underlying the hemorrhagic presentation in MMD is undetermined, most recent angiographic analysis revealed the characteristic angio-architecture related to high re-bleeding risk, such as the extension and dilatation of choroidal collaterals and posterior cerebral artery involvement. We sought to update the current management strategy for hemorrhagic MMD, including the outcome of surgical revascularization for hemorrhagic MMD in our institute. Further investigations will clarify the optimal surgical strategy to prevent hemorrhagic manifestation in patients with MMD.

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참고문헌

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피인용 문헌

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  2. Neuro-endoscopic management of hemorrhagic moyamoya disease in the acute stage: single institute experience vol.41, pp.12, 2019, https://doi.org/10.1080/01616412.2019.1674006
  3. Predicting Decreased Activities of Daily Living in Patients with Moyamoya Disease after Revascularization: Development and Assessment of a New Predictive Nomogram vol.2021, 2019, https://doi.org/10.1155/2021/6624245
  4. Delayed Anastomotic Occlusion after Direct Revascularization in Adult Hemorrhagic Moyamoya Disease vol.11, pp.5, 2021, https://doi.org/10.3390/brainsci11050536