Moyamoya Disease: Treatment and Outcomes

Tackeun Kim; 오창완; Jae Seung Bang; 김정은; 조원상

Moyamoya Disease: Treatment and Outcomes

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Type: Academic journal

Author: Tackeun Kim 오창완 Jae Seung Bang 김정은 조원상

Journal: The Korean Stroke Society 대한뇌졸중학회지 대한뇌졸중학회지 제18권 제1호 KCI Accredited Journals

Published: 2016.1

Pages: 21 - 30 (10page)

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Moyamoya Disease: Treatment and Outcomes

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Although the pathogenesis of moyamoya disease (MMD) has not been fully elucidated, the effectiveness of surgical revascularization in preventing stroke has been addressed by many studies. The main mechanism of surgical revascularization is augmenting the intracranial blood flow using an external carotid system by either direct bypass or pial synangiosis. This can improve resting cerebral blood flow as well as vascular reserve capacity. For direct revascularization, the superficial temporal artery is used as the donor artery in most cases, although the occipital artery may be used in limited cases. Usually, the cortical branch of the middle cerebral artery is selected as the recipient of direct anastomosis. As for indirect revascularization, various techniques using different kinds of connective tissues have been introduced. In some cases, reinforcing the anterior cerebral artery and the posterior cerebral artery territories can be considered. The effectiveness of surgical revascularization for preventing ischemic stroke had been generally accepted by many studies. However, for preventing hemorrhagic stroke, new evidence has been added by a recent randomized controlled trial. The incidence of peri-operative complications such as stroke and hyperperfusion syndrome seems to be high due to the nature of the disease and technical demands for treatment. Preventing and adequately managing these complications are essential for ensuring the benefits of surgery.

#Moyamoya disease #Cerebral revascularization #Treatment outcome

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References (75)

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Miki Fujimura / 2014 / Genetics and Biomarkers of Moyamoya Disease: Significance of RNF213 as a Susceptibility Gene / 대한뇌졸중학회지 16(2):65~72

김택균 / 2015 / Epidemiology of Moyamoya Disease in Korea: Based on National Health Insurance Service Data / 대한신경외과학회지 57(6):390~395

Fukui M / 1997 / Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (‘moyamoya’ disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan / Clin Neurol Neurosurg 99(Suppl 2):S238~S240

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