Hemodynamic Evaluation of Vascular Reconstructive Surgery for Childhood Moyamoya Disease Using Single Photon Emission Computed Tomography
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概要
- 論文の詳細を見る
To evaluate the efficacy of vascular reconstructive surgery for childhood moyamoya disease, the cerebral blood flow (CBF) in 31 hemispheres of 16 patients was examined by single photon emission computed tomography (SPECT) using the ^<133>Xe inhalation method. Results were divided into two groups; 17 hemispheres with superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis [A(+) group] and 14 hemispheres without anastomosis [A(-) group]. The mean hemispheric CBF (mCBF) and regional CBF (rCBF) in the frontal, temporal, occipital, and basal ganglia regions were calculated. Pre- and postoperative SPECT on the 10 hemispheres of the A(+) group showed an increase in mCBF in 6 hemispheres, the disappearance of the low perfusion area (LPA) in all 5 hemispheres where LPA was present before surgery, and an improvement in rCBF distribution (an increase in rCBF in the frontal and temporal lobes and a decrease in the basal ganglia). This suggests that vascular reconstruction is greatly effective in treating this disease. A comparison between the A(+) group and the A(-) group by postoperative SPECT, as well as the clinical outcomes and the postoperative findings of electroencephalography and angiography, revealed that the A(+) group was superior to the A(-) group in the frequency of LPA (12% and 43%, respectively) and rCBF in the frontal region where STA-MCA anastomosis was usually performed. These results indicate that STA-MCA anastomosis with indirect synangiosis is the most effective treatment of childhood moyamoya disease.
- 日本脳神経外科学会の論文
- 1990-06-15
著者
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KAMIYAMA Hiroyasu
Department of Neurosurgery, Asahikawa Red Cross Hospital
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Abe Hiroshi
Department Of Cardiology National Cardiovascular Center
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MITSUMORI Kenji
Hokkaido Neurosurgical Memorial Hospital
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Abe Hiroshi
Department Of Neurosurgery University Of Hokkaido School Of Medicine
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Abe Hiroshi
Department Of Anatomy Akita University School Of Medicine
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Tsuru Mitsuo
Hokkaido Neurosurgical Memorial Hospital
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TAKIKAWA Shugo
Department of Neurosurgery, Hokkaido University School of Medicine
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Kamiyama Hiroyasu
Department Of Neurosurgery Hokkaido University School Of Medicine
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Kamiyama Hiroyasu
Department Of Neurosurgery University Of Hokkaido School Of Medicine
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Kamiyama Hiroyasu
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Mitsumori Kenji
Department Of Neurosurgery Hokkaido University School Of Medicine
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Takikawa Shugo
Department Of Neurosurgery Hokkaido University School Of Medicine
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Abe Hiroshi
Department Of Anatomy Akita University Graduate School Of Medicine And Faculty Of Medicine
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Abe Hiroshi
Department Of Neurosurgery Hokkaido University School Of Medicine And Sapporo Azabu Neurosurgical Ho
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Abe Hiroshi
Department Of Agricultural Chemistry Faculty Of Agriculture Tohoku University
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Kamiyama Hiroyasu
Department Of Neurosurgery Asahiakawa Red Cross Hospital
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Tsuru Mitsuo
Department Of Neurosurbery Hokkaido University School Of Medicine
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