手術手技の工夫　　もやもや病における血行再建術手技の工夫と血流改善効果

概要

論文の詳細を見る
Surgical treatment for moyamoya disease is basically a combination of direct and indirect revascularization because of the characteristic pathogenesis. Surgical goals are to increase the collateral channels as much as possible and to widely cover the territory of the poor cerebral blood flow. We preoperatively evaluate cerebral perfusion by angiography and single photon emission CT, and plan the direct bypass between STAs and each cortical branch of ACA and MCA. We then add the indirect revascularization over them on the 2 cranial windows. Recently, the middle meningeal artery also has been utilized as a donor of the direct revascularization. We estimated the postoperative perfusional change of the total revascularizations by SPECT, which showed improved cerebral blood flow and vascular reserve.
一般社団法人日本脳卒中の外科学会の論文