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

Kawabori, Masahito; Kuroda, Satoshi; Nakayama, Naoki; Hirata, Kenji; Shiga, Toru; Houkin, Kiyohiro; Tamaki, Nagara

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

Kawabori, Masahito; Kuroda, Satoshi; Nakayama, Naoki et al.

World Neurosurgery, 2013, 80(5), 612-619

Permalink : https://hdl.handle.net/2115/70808

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アクセス権	open access
URI	https://hdl.handle.net/2115/70808
タイトル	Effective Surgical Revascularization Improves Cerebral Hemodynamics and Resolves Headache in Pediatric Moyamoya Disease
著者	Kawabori, Masahito ; Kuroda, Satoshi ; Nakayama, Naoki ; Hirata, Kenji ; Shiga, Toru ; Houkin, Kiyohiro ; Tamaki, Nagara
e-Rad_Researcher 50399870 著者名 Kawabori, Masahito
e-Rad_Researcher 10301904 著者名 Kuroda, Satoshi
e-Rad_Researcher 40421961 著者名 Nakayama, Naoki
e-Rad_Researcher 30431365 著者名 Hirata, Kenji
著者名 Shiga, Toru
e-Rad_Researcher 90229146 著者名 Houkin, Kiyohiro
e-Rad_Researcher 30171888 著者名 Tamaki, Nagara
言語	英語
キーワード	Headache
	moyamoya disease
	bypass surgery
	cerebral hemodynamics
発行日	2013-11
出版者	Elsevier
収録物名	World Neurosurgery
巻(号)	80(5)
ページ	612-619
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 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/
PISSN	1878-8750
関連情報	PMID 23022638
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.wneu.2012.08.005