Chronological volume changes of the temporal muscle pedicle used for encephalo-myo-synangiosis in combined revascularization for moyamoya disease : a prospective observational study

Mizushima, Makoto; Ito, Masaki; Fujima, Noriyuki; Uchino, Haruto; Sugiyama, Taku; Fujimura, Miki

Chronological volume changes of the temporal muscle pedicle used for encephalo-myo-synangiosis in combined revascularization for moyamoya disease : a prospective observational study

Mizushima, Makoto; Ito, Masaki; Fujima, Noriyuki et al.

Neurologia medico-chirurgica, 2023, 63(7), 304-312

Permalink : https://hdl.handle.net/2115/93197

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アクセス権	open access
URI	https://hdl.handle.net/2115/93197
タイトル	Chronological volume changes of the temporal muscle pedicle used for encephalo-myo-synangiosis in combined revascularization for moyamoya disease : a prospective observational study
著者	Mizushima, Makoto ; Ito, Masaki ; Fujima, Noriyuki ; Uchino, Haruto ; Sugiyama, Taku ; Fujimura, Miki
著者名 Mizushima, Makoto
e-Rad_Researcher 10399850 著者名 Ito, Masaki
e-Rad_Researcher 80431360 著者名 Fujima, Noriyuki
e-Rad_Researcher 40775144 著者名 Uchino, Haruto
e-Rad_Researcher 70748863 著者名 Sugiyama, Taku
e-Rad_Researcher 00361098 著者名 Fujimura, Miki
言語	英語
キーワード	Encephalo-myo-synangiosis
	Moyamoya disease
	Swollen temporal muscle
	Time-course
	Vascular disorder
発行日	2023-04-20
収録物名	Neurologia medico-chirurgica
巻(号)	63(7)
ページ	304-312
抄録	Although postoperative neurological events due to brain compression by the swollen temporal muscle are a rare complication, the chronological volume changes of the temporal muscle pedicle and their clinical impact have not yet been documented. This prospective observational study aimed to investigate the chronological volume changes in the temporal muscle pedicle in Moyamoya disease (MMD). Eighteen consecutive combined revascularization procedures using the temporal muscle were performed for symptomatic MMD in 2021. The postoperative pedicle volume was quantified using repeated computed tomography images on postoperative days (PODs) 0, 1, 7, 14, and 30. Postoperative neurological events with radiological evaluations and collateral development evaluated using magnetic resonance angiography obtained 6 months after surgery were studied. On average, the postoperative temporal muscle pedicle volume was most significantly increased by as much as 112% ± 9.6% on POD 7 (P < 0.001) and decreased by as little as 52% ± 21% on POD 30 (P < 0.0001) relative to POD 0. One exceptional patient (overall incidence, 5.6%) demonstrated postoperative transient neurological events due to brain compression by the swollen temporal muscle with decreased focal cerebral blood flow in the adjacent cortical area. The postoperative collateral development via direct and indirect revascularizations was confirmed in 16 (89%) and 12 (67%) hemispheres, respectively. All patients, except for one rebleeding case, showed independent outcomes at the mean latest follow-up period on 290 ± 96 days after surgery. Our observations confirmed the temporal profile of muscle pedicle volume changes after combined revascularization. Through routine attempts to avoid the unfavorable effects of temporal muscle swelling, combined revascularization can provide favorable outcomes in symptomatic MMD.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
PISSN	0470-8105
EISSN	1349-8029
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.2176/jns-nmc.2023-0008