Summary
The incidence and causes of peri-operative haemodynamic complications in adult Moyamoya disease were examined by reviewing 55 surgically treated adult patients. Ninety-nine craniotomies were performed in these patients, and eight peri-operative complications (four infarctions, two haemorrhagic infarctions and two reversible ischaemic neurological deficits without a new lesion) were seen. All of the eight haemodynamic complications arose in the initially affected hemispheres regardless of the side of operation. Some nonsurgical haemodynamic risk factors, i.e., hypercapnia, hypocapnia and hypotension/hypovolaemia, were noted in all of the eight cases, although the statistical analysis could not clarify the relevance of such factors to peri-operative complications. Surgical factors which might be responsible for the complications were noted in three cases.
Sparing vital collateral vessels and minimum brain retraction as well as avoidance of non-surgical haemodynamic risk factors are considered to be essential to prevent peri-operative haemodynamic brain damage in adult Moyamoya disease.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Amine ARC, Moody RA, Meek W (1977) Bilateral temporal middle cerebral artery anastomosis for moyamoya syndrome. Surg Neurol 8: 3–6
Boone SC, Sampson DS (1978) Observation on moyamoya disease: a case treated with superficial temporal-middle cerebral artery anastomosis. Surg Neurol 9: 189–193
Karasawa J, Kikuchi H, Furuse S, Kawamura J, Sakaki T (1978) Treatment of moyamoya disease with STA-MCA anastomosis. J Neurosurg 49: 679–688
Kinugasa K, Mandai S, Kamata I, Sugui K, Ohmoto T (1993) Surgical treatment of moyamoya disease: operative technique for encephalo-duro-arterio-myo-synangiosis, its follow-up, clinical results and angiograms. Neurosurgery 32: 527–531
Kuro M, Karasawa J, Kuriyama Y, Kikuchi H (1981) Anesthetic management of “Moyamoya” disease in children. In: Kawabuchi J (ed) Proceedings of the 10th Japanese Conference on Surgery of Cerebral Stroke. Neuron, Tokyo, pp 207–211 (in Japanese)
Matsushima Y, Aoyagi M, Suzuki R, Tabata H, Ohno K (1991) Perioperative complications of encephalo-duro-arterio-synangiosis: prevention and treatment. Surg Neurol 36: 343–353
Nishimoto A, Takeuchi S (1968) Abnormal cerebrovascular network related to the internal carotid arteries. J Neurosurg 29: 255–260
Nishimoto A, Onbe H, Ueta K (1983) Clinical and cerebral blood flow study in moyamoya disease with TIA. Acta Neurol Scand 60 [Suppl 72]: 434–435
Oku S, Okumura F, Kikuchi H, Karasawa J, Takeuchi S, Nagata I (1985) The effects of arterial carbon dioxide tension on cerebral blood flow and on cerebral function in “Moyamoya” disease. The Journal of Japan Society for Clinical Anesthesia 5: 360–368 (in Japanese)
Sumikawa K, Nagai H (1983) Moyamoya disease and anesthesia. Anesthesiology 58: 204–205
Suzuki J, Takaku A (1969) Cerebrovascular “moyamoya” disease: disease showing abnormal net-like vessels in base of brain. Arch Neurol 20: 288–299
Suzuki J, Kodama N (1983) Moyamoya disease: a review. Stroke 14: 104–109
Uemura K, Yamaguchi K, Kojima S, Sakurai Y, Ito Z, Kawakami H, Kutuzawa T (1975) Regional cerebral blood flow on cerebrovascular “Moyamoya” disease. Brain Nerve (Tokyo) 27: 385–393 (in Japanese)
Yonekawa Y, Yasargil MG (1977) Brain vascularization by transplanted omentum: a possible treatment of cerebral ischaemia. Neurosurgery 1: 256–259
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Iwama, T., Hashimoto, N., Tsukahara, T. et al. Peri-operative complications in adult Moyamoya disease. Acta neurochir 132, 26–31 (1995). https://doi.org/10.1007/BF01404844
Issue Date:
DOI: https://doi.org/10.1007/BF01404844