モヤモヤ病の治療について:-特に脳内出血例について文献的考察より-

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Fifteen cases of Moyamoya disease, which were treated in our hospital from 1960 to 1980, are studied and followed up. Follow up terms are ranging from a year to 24 years. Seven young patients whose ages are under 15 years old and 8 adult patients are included in this series and the male to female ratio is 3: 4 in the former group and 3: 5 in the latter group. The initial symptoms are ischemic cerebrovascular attacks (75%), subarachnoid hemorrhage (20%) and intracerebral bleeding (7%). In the young patient group, the main symptoms and signs are ischemic cerebrovascular attacks which often recur and major neurological deficits are left in many cases. However, the mortality of cerebrovascular attacks is very low in this group. In adult patients, on the other hand, intracranial hemorrhage such as subarachnoid or intracerebral hemorrhage occurres at the high rate of 50%and 25%, respectively, and their mortality rate is rather high.<BR>As the etiology of Moyamoya disease is still obscure, no effective treatment has been found as yet. However, STA-MCA anastomosis is effective to prevent the recurrence of ischemic cerebral attack in some cases and decreases the amount of abnormal vascular net in all cases. So far as the treatment of intracerebral hemorrhage in Moyamoya disease is concerned, evacuation of hematoma alone is often followed by recurrence of bleeding from the abnormal vascular net around basal ganglia (the so-called Moyamoya) later. In this series, a patient died of such recurrence of cerebral hemorrhage and his autopsy revealed a large putaminal hemorrhage from one of the abnormal vessels itself in the left basal ganglia. Because STA-MCA anastomosis decrease the burden of the abnormal vascular net-work in respect of collateral circulation, it may also be the effective treatment both for Moyamoya disease with intracranial hemorrhage, and for the prevention against the recurrent hematoma in the case that the abnormal vascular net-work should result in the origin of the hemorrhage.
The Japanese Society on Surgery for Cerebral Strokeの論文

モヤモヤ病の治療について:-特に脳内出血例について文献的考察より-

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