Surgical Outcomes for Moyamoya Angiopathy at Barrow Neurological Institute With Comparison of Adult Indirect Encephaloduroarteriosynangiosis Bypass, Adult Direct Superficial Temporal Artery–to–Middle Cerebral Artery Bypass, and Pediatric Bypass

Abla, Adib A.; Gandhoke, Gurpreet S.; Clark, Justin C.; Oppenlander, Mark E.; Velat, Gregory J.; Zabramski, Joseph M.; Albuquerque, Felipe C.; Nakaji, Peter; Spetzler, Robert F.; Wanebo, John E.

doi:10.1227/neu.0000000000000017

Cited by 83 publications

(38 citation statements)

References 37 publications

(36 reference statements)

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“…Indirect surgical methods have a higher success rate and are used more often for pediatric moyamoya disease patients that present with ischemic symptoms and perfusion defects in territory of middle cerebral artery [14]. Still under debate is the ideal treatment method for severely ischemic pediatric moyamoya disease patients due to poor circulation in anterior or middle cerebral arteries and those presenting with epilepsy [15].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

Magsi

Khoja

Rameez

et al. 2016

Case Reports in Neurological Medicine

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Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS), in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness) at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA). Bilateral EDAS was done in the same year, after which his symptoms improved and patient had moderate functional recovery. Conclusion. A rare disease, moyamoya has been left unexplored in Pakistan; physicians and surgeons when dealing with cases in the pediatric population presenting with symptoms of stroke, signs of generalized weakness, and seizures should consider moyamoya disease as a possibility. Furthermore, this case demonstrates the effectiveness of EDAS procedure for the treatment of moyamoya disease.

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Section: Discussionmentioning

confidence: 99%

Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

Magsi

Khoja

Rameez

et al. 2016

Case Reports in Neurological Medicine

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“…It has been defined as a intracranial arteriopathy commonly denoted by bilateral stenosis of the internal carotid arteries (ICAs) and middle cerebral arteries (MCAs), which are responsible for transient ischemic attacks (TIAs) or strokes [14,15].…”

Section: Moyamoya Diseasementioning

confidence: 99%

Use of Cerebral Revascularization Techniques in the Endovascular Era. Is it Still a Useful Technique?

Zaed

Tinterri

Mario

2019

SN Compr. Clin. Med.

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Cerebral revascularization (CR) was a revolutionary surgical technique first introduced by Professor Yasargil in 1967 in the treatment of cerebral ischemia's case. In the following decades, its use was subjected to several modifications and implementations, to the point that its purpose has been expanded to other several cerebrovascular diseases. In the more recent years, its use was strongly reduced because of the advancement of the endovascular techniques, which have been showed to bring a significant number of benefits and avoid the most common surgical complications; not last, these endovascular techniques reduces in a significant way the recovery length and gives an effective treatment for those patients who were not suitable for traditional surgery. In this review, the authors search the literature to analyze the cases in which such techniques is still of use for the treatment of neurovascular diseases. CR is still a useful technique in the treatment of several pathologies, among which are moyamoya disease, complex intracranial aneurysms, and skull base tumors. A good neurosurgeon should be able to master both surgical and neurovascular approach. The teaching of CR seem to be even harder since the few cases suitable to this approaches are sometimes not enough to allow a resident or a young neurosurgeon to gain experience. CR remains an important tool in neurosurgeons' armamentarium. In this review, authors analyze the role of the cerebral revascularization techniques in the contemporary era and study the pathologies for which it can be used, in particular, moyamoya disease, complex intracranial aneurysms, and skull base tumors. KeywordsCerebral revascularization . Moyamoya disease . Complex intracranial aneurysms . Skull base tumors Abbreviations STA Superficial temporal artery EC Extracranial IC Intracranial CR Cerebral revascularization ICA Internal carotid artery MCA Middle cerebral artery TIA Transient ischemic attack EDAS Encephalo-duro-arterio-synangiosis GTR Gross total resection STR Subtotal resection

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“…Nevertheless, the efficacy of the indirect bypass has been shown to decrease inversely with age [68]. Conversely, direct bypass has been shown to be more effective in adults [80][81][82].…”

Section: Surgical Outcomesmentioning

confidence: 99%

Surgical treatment of pediatric moyamoya disease

Rhee

Tork

Sabbag

et al. 2015

J Pediatr Neuroradiol

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Cerebral ischemia is a well-recognized cause of morbidity in the pediatric population. Moyamoya disease, first described in 1957 by Takeuchi and Shimizu, is an idiopathic chronic vasculopathy that often presents with ischemia. Moyamoya syndrome presents with similar clinical manifestations and disease progression but may occur unilaterally or in the setting of a predisposing condition. Both direct and indirect revascularization procedures have proven to be efficacious for pediatric moyamoya patients.

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Surgical Outcomes for Moyamoya Angiopathy at Barrow Neurological Institute With Comparison of Adult Indirect Encephaloduroarteriosynangiosis Bypass, Adult Direct Superficial Temporal Artery–to–Middle Cerebral Artery Bypass, and Pediatric Bypass

Cited by 83 publications

References 37 publications

Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

Use of Cerebral Revascularization Techniques in the Endovascular Era. Is it Still a Useful Technique?

Surgical treatment of pediatric moyamoya disease

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