小児および成人もやもや病に対する脳血行再建術の長期効果

概要

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We analyzed overall outcome after surgical revascularization in 149 patients with moyamoya disease. Of 61 childhood patients, 58 (95.1%) have not experienced further ischemic episode during follow-up periods. Postoperative angiograms showed well-developed collaterals via STA-MCA anastomosis and indirect synangiosis. Total IQs were significantly lower in childhood patients who had cerebral infarction at onset. Of 40 adult patients with ischemic-type moyamoya disease, 35 (87.5%) have not experienced further episodes of stroke. However, 3 (7.5%) patients had cerebral infarction in the contralateral side or in the vertebrobasilar territory, and 2 (5.0%) suffered intracranial bleeding during follow-up periods. Of 34 adults who underwent bypass surgery for hemorrhagic-type moyamoya disease, 7 (20.6%) developed rebleeding. Statistical analysis revealed that STA-MCA anastomosis combined with indirect synangiosis may significantly reduce the risk for rebleeding. Clinical strategies should be decided for adult patients with asymptomatic moyamoya disease.
日本脳卒中の外科学会の論文
2002-09-30