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Effective Surgical Revascularization Improves Cerebral Hemodynamics and Resolves Headache in Pediatric Moyamoya Disease

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Title: Effective Surgical Revascularization Improves Cerebral Hemodynamics and Resolves Headache in Pediatric Moyamoya Disease
Authors: Kawabori, Masahito Browse this author →KAKEN DB
Kuroda, Satoshi Browse this author →KAKEN DB
Nakayama, Naoki Browse this author →KAKEN DB
Hirata, Kenji Browse this author →KAKEN DB
Shiga, Toru Browse this author
Houkin, Kiyohiro Browse this author →KAKEN DB
Tamaki, Nagara Browse this author →KAKEN DB
Keywords: Headache
moyamoya disease
bypass surgery
cerebral hemodynamics
Issue Date: Nov-2013
Publisher: Elsevier
Journal Title: World Neurosurgery
Volume: 80
Issue: 5
Start Page: 612
End Page: 619
Publisher DOI: 10.1016/j.wneu.2012.08.005
PMID: 23022638
Abstract: Objective: Headache is one of major clinical presentations in pediatric moyamoya disease. However, the clinical features and underlying mechanisms are not fully understood. This study aimed to clarify the clinical feature of headache in pediatric moyamoya disease and the effect of surgical revascularization. Methods: This study included 29 pediatric patients who underwent superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis and indirect bypass for moyamoya disease. Their medical records were precisely evaluated to identify clinical features of their headache. The findings on MRI, SPECT, and PET were also analyzed. Results: Preoperative headache was documented in 11 (38%) of 29 patients. Majority of them complained of severe headache in the frontal or temporal region in the morning. Headache was significantly related to more advanced disease stage and to the decreases in cerebral blood flow and its reactivity to acetazolamide. Surgical revascularization completely resolved headache in all 11 patients. Conclusion: These findings strongly suggest that disturbed cerebral hemodynamics may play key roles to develop severe headache in pediatric moyamoya disease. STA-MCA anastomosis and EDMAPS may be effective procedures to rapidly resolve their headache by widely supplying collateral blood flow to the operated hemispheres.
Rights: © 2013. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/70808
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 川堀 真人

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