Korean J Pediatr.  2012 Nov;55(11):408-413. 10.3345/kjp.2012.55.11.408.

Indirect revascularization surgery for moyamoya disease in children and its special considerations

• Wang KC
• Phi JH
• Lee JY
• Kim SK
• Cho BK

• KMID: 1781701
• DOI: http://doi.org/10.3345/kjp.2012.55.11.408

Abstract

Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

Keyword

Moyamoya disease; Child; Surgery

MeSH Terms

Adult
Cerebral Infarction
Child
Humans
Hyperthyroidism
Moyamoya Disease
Perfusion
Perioperative Care