Neurological Surgery No Shinkei Geka Volume 27, Issue 11 (November 1999)

New Ideas for Indirect Revascularization Surgery for Moyamoya Disease Sunao TAKEMURA 1 , Shinya SATO 1 , Akira KUROKI 1 , Shinjiro SAITO 1 , Takamasa KAYAMA 1 1Department of Neurosurgery, Yamagata University School of Medicine Keyword: EDAMS , infarction , moyamoya disease pp.987-992
Published Date 1999/11/10
  • Abstract
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We had performed indirect revascularization surgery, mainly EMS, for cases with moyamoya disease,because EMS can revascularize a large area including the territory of anterior cerebral artery. However, inour initial cases, we found that three sides in two cases had post-operative ischemic complications. Thesecases suggested that intracranial hypertension due to pressure exerted by swelling caused by edema in themyoflap after EMS was one of the reasons for these infarctions.

For the prevention of intracranial hypertension due to the edema in the myoflap, when we did EDAMS with dural pedicle insertion, we put into practice the new ideas about shaving the boneflaps to half of theiroriginal thickness, and prescribled 200/s Mannitol after surgery, We tried these new ideas concerning treat-ment on four sides in three cases with moyamoya disease, and we were able to get good outcomes withoutany new neurological deficits.

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Neurological Surgery 脳神経外科
27巻11号 (1999年11月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院