Characteristic Pattern of the Cerebral Hemodynamic Changes in the Acute Stage After Combined Revascularization Surgery for Adult Moyamoya Disease: N-isopropyl-p-[123I] iodoamphetamine Single-Photon Emission Computed Tomography Study

Miki Fujimura, Teiji Tominaga

研究成果: Chapter

抄録

Objective: Surgical revascularization for moyamoya disease (MMD) prevents cerebral ischemic attack by improving cerebral blood flow (CBF) and could also reduce the risk of re-bleeding in hemorrhagic-onset patients. We sought to clarify the cerebral hemodynamic changes in the acute stage after revascularization surgery for adult MMD. Materials and methods: The present study includes 54 consecutive adult patients with MMD (21–76 years old, 43.1 average), undergoing superficial temporal artery-middle cerebral artery anastomosis with indirect pial synangiosis on 65 affected hemispheres. We prospectively performed single-photon emission computed tomography (SPECT) at postoperative day (POD) 1 and 7 of 65 surgeries. Perioperative management was conducted with strict blood pressure control (100–130 mmHg) and minocycline hydrochloride administration. Results: The outcome of 65 surgeries was favorable except for one (1.5%), which manifested as delayed intracerebral hemorrhage due to local hyperperfusion. The postoperative SPECT revealed the characteristic CBF improvement pattern with transient local hyperperfusion (POD1) and subsequent distribution of CBF in wider vascular territory (POD7) on 37 hemispheres (56.9%, 37/65). Conclusion: The revascularization surgery is a safe and effective treatment for adult MMD, while transient local hyperperfusion should be strictly managed by intensive perioperative care.

本文言語English
ホスト出版物のタイトルActa Neurochirurgica, Supplementum
出版社Springer Science and Business Media Deutschland GmbH
ページ57-61
ページ数5
DOI
出版ステータスPublished - 2021

出版物シリーズ

名前Acta Neurochirurgica, Supplementum
132
ISSN(印刷版)0065-1419
ISSN(電子版)2197-8395

ASJC Scopus subject areas

  • 外科
  • 臨床神経学

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