Additional surgery for postoperative ischemic symptoms in patients with moyamoya disease: the effectiveness of occipital artery-posterior cerebral artery bypass with an indirect procedure: technical case report

Neurosurgery
Toshiaki HayashiTeiji Tominaga

Abstract

In patients with moyamoya disease, surgery to revascularize the ischemic brain is a recommended treatment. However, there are a few patients who require additional revascularization surgery because of progression of the disease. Even patients who show no postoperative ischemic symptoms at first may experience late deterioration. We performed additional surgery for such lesions using occipital artery (OA)-posterior cerebral artery (PCA) bypass with indirect revascularization. The efficacy of the procedure is reported. We treated 3 patients with moyamoya disease who showed a transient ischemic attack after revascularization surgery. Three female patients, ranging in age from 6.0 to 35.2 years (mean age, 23.8 years) at the time of surgery, with ischemic symptoms (leg monoparesis in 2, visual impairment in 1) underwent the additional revascularization procedure. Preoperatively, all patients underwent indirect and/or direct revascularization surgery for initial treatment. All patients showed progression of the disease, especially in the PCA. OA-PCA bypass with encephalogaleodurosynangiosis and burr hole surgery were performed for postoperative ischemic symptoms. All patients showed clinical and radiological improvement. The transien...Continue Reading

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Citations

May 9, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ji Yeoun LeeKyu-Chang Wang
Jul 3, 2010·Journal of Neurosurgery. Pediatrics·Toshiaki HayashiTeiji Tominaga
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