Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease

Stroke; a Journal of Cerebral Circulation
T IshikawaH Abe

Abstract

We reviewed surgically treated patients with pediatric moyamoya disease and examined whether vasoreconstructive surgeries reduced the risk of recurrent ischemic attacks and changed overall outcomes in terms of the patients' performance and intellectual status. Sixty-four hemispheric sides in 34 pediatric moyamoya disease patients who received surgical treatment were examined. We performed superficial temporal artery to middle cerebral artery (STA-MCA) bypass and encephalo-duro-arterio-myo-synangiosis (EDAMS) on 48 sides (combined group) and indirect bypass surgery such as EDAMS on 16 sides (indirect group). These 34 patients were observed postoperatively from 1 to 14 years (mean +/- SD, 6.6 +/- 3.8 years) and were examined for the incidence of recurrent ischemic attack. Of the 34 patients, 23 were followed up for > 5 postoperative years, and their overall outcomes in terms of their performance and intellectual status were determined. Perioperative ischemic events (< or = 2 weeks after surgery) occurred in 5 surgeries (31%) of the indirect group and in 6 (13%) of the combined group (P = NS). The incidence of postoperative ischemic events (> 2 weeks after surgery) was significantly reduced in the combined group (10%) compared wit...Continue Reading

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Citations

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