%0 Journal Article
%T Cerebral Hemorrhage and Cerebral Infarction in 30 Cases of Adult Moyamoya Disease: Comparison between Conservative Therapy and Superficial Temporal Artery-Middle Cerebral Artery Anastomosis
%A HIROFUMI OYAMA
%A AKIRA KITO
%A HIDEKI MAKI
%A KENICHI HATTORI
%J Nagoya Journal of Medical Science
%D 2013
%I Nagoya University
%X To clarify the effect of surgery on the prevention cerebral hemorrhage in adult moyamoya disease, we compared postoperative courses between superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and conservative therapy. The study subjects were 30 adults with moyamoya disease. Unilateral STA-MCA anastomosis was conducted in 7 of these 30 cases, and bilateral STA-MCA anastomosis was conducted in 8 of these 30 cases. Therefore, anastomosis was performed in a total of 23 sides. The postoperative clinical course was observed for more than 5 years after the STA-MCA anastomosis. Cerebral hemorrhage occurred after operation in 2 sides (8.7%) among the 23 sides that received STAMCA anastomosis. On the contrary, hemorrhage occurred during conservative therapy in 5 sides (13.5%) among 37 non-operation sides (no significance in ¦Ö2 test). Cerebral infarction occurred in 3 sides (13%) among 23 sides treated with STA-MCA anastomosis. However, the infarction occurred in 2 sides (5.4%) among the 37 non-operation sides (no significance in ¦Ö2 test). Cerebral hemorrhage tended to occur less frequently after STA-MCA anastomosis, and bypass surgery was suggested to have some beneficial effect in preventing cerebral hemorrhage in adult moyamoya disease. However, it was revealed that STA-MCA anastomosis exacerbated the brain ischemia. Therefore, strict management is mandatory in the perioperative period.
%K Moyamoya disease
%K STA-MCA anastomosis
%K Intracerebral hemorrhage
%K Adult
%K Cerebral infarction
%U http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/7512/04_Oyama1.pdf