Impact of RNF213 p.R4810K variant on postoperative temporal muscle swelling used in encephalo-myo-synangiosis after combined revascularization for Moyamoya disease

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

Impact of RNF213 p.R4810K variant on postoperative temporal muscle swelling used in encephalo-myo-synangiosis after combined revascularization for Moyamoya disease

Mizushima, Makoto; Ito, Masaki; Uchino, Haruto et al.

Neurosurgical review, 2024, 48(1), 15

Permalink : https://hdl.handle.net/2115/97355

このアイテムのアクセス数:29件（2026-07-20 18:56 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/97355
タイトル	Impact of RNF213 p.R4810K variant on postoperative temporal muscle swelling used in encephalo-myo-synangiosis after combined revascularization for Moyamoya disease
著者	Mizushima, Makoto ; Ito, Masaki ; Uchino, Haruto ; Sugiyama, Taku ; Fujimura, Miki
著者名 Mizushima, Makoto
e-Rad_Researcher 10399850 著者名 Ito, Masaki
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
	Revascularization
	RNF213 variant
	Surgical complication
	Temporal muscle swelling
発行日	2024-12-31
出版者	Springer
収録物名	Neurosurgical review
巻(号)	48(1)
ページ	15
抄録	Postoperative neurological deterioration due to brain compression by the swollen temporal muscle pedicle used in encephalo-myo-synangiosis (EMS) is a potential complication of combined revascularization for Moyamoya disease (MMD). However, the factors contributing to this phenomenon remain poorly understood. This study aimed to identify factors associated with postoperative temporal muscle swelling following combined revascularization. A total of 37 consecutive combined revascularization using temporal muscle pedicle performed between 2021 and 2023 were analyzed. Postoperative temporal muscle volume was measured through serial CT scans on postoperative days (POD) 0, 1, 7, 14, and 30. Multiple regression analysis was performed to assess factors contributing to swelling, including RNF213 p.R4810K variant, a known genetic risk for Asian MMD. Surgical outcomes and collateral vessel development were also examined. Results showed a significant increase in muscle pedicle volume on POD 1 and 7 across all 37 hemispheres, followed by a marked decrease by POD 30, compared to POD 0. These chronological volume changes were significant in adults (n = 31) but not in pediatric patients (n = 6). Multiple regression analysis identified the RNF213 p.R4810K as sole significant factor positively associated with maximal muscle volume (regression coefficient 0.485, P = 0.0078). Favorable surgical outcomes were achieved in 36 of 37 cases (97.3%) over a mean follow-up of 2.2 years, with indirect collateral development confirmed in 27 adult (87%) and 6 pediatric (100%) hemispheres. Results suggest the RNF213 p.R4810K variant is associated with increased postoperative temporal muscle swelling after combined revascularization, especially in adult MMD patients, indicating a potential genetic influence on this complication.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s10143-024-03165-7
PISSN	0344-5607
EISSN	1437-2320
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s10143-024-03165-7