Touho Hajime, Yanagawa Nobuko, Kuroiwa Toshihiko
Department of Neurosurgery, Touho Neurosurgical Clinic, Ikeda-city, Osaka, Japan.
No Shinkei Geka. 2010 Dec;38(12):1109-13.
Moyamoya disease is a chronically progressive and occlusive cerebrovascular disease. Steno-occlusion of the terminal portion of the internal carotid artery occurs bilaterally, and fine vascular network gradually develops at the base of the brain and they act as collaterals to the distal portion of the anterior and middle cerebral arteries. Steno-occlusion of the posterior cerebral artery develops in accord with progression of the disease. Intracranial omental transplantation is one of the indirect bypass surgeries for the treatment of cerebral ischemia, especially in the territories of the anterior/posterior cerebral artery in moyamoya disease. In the present report, one of sixty-seven moyamoya disease patients who had been treated with intracranial omental transplantation, showed chronological change of the mass of the transplanted omentum in accord with decrease/increase in the patient's body weight. In addition, the patient experienced headache which appeared and disappeared in accord with increase and decrease in the patient's body weight, respectively. The transplanted omentum was thought to act in the same way as fat tissue in other portions of the body. Measurement of body weight is thought to be as important as radiological examination using computed tomography/magnetic resonance imaging in the follow-up period after intracranial omental transplantation in moyamoya disease.
烟雾病是一种慢性进行性闭塞性脑血管疾病。双侧颈内动脉末端出现狭窄闭塞,脑底部逐渐形成细小血管网,并作为大脑前动脉和大脑中动脉远端的侧支循环。大脑后动脉的狭窄闭塞随着疾病进展而出现。颅内大网膜移植是治疗脑缺血的间接搭桥手术之一,尤其适用于烟雾病中大脑前/后动脉供血区域。在本报告中,67例接受颅内大网膜移植治疗的烟雾病患者中有1例,其移植大网膜的质量随患者体重的减轻/增加呈现出相应的时间变化。此外,该患者经历了头痛,头痛分别随患者体重的增加和减轻而出现和消失。移植的大网膜被认为与身体其他部位的脂肪组织作用相同。在烟雾病患者颅内大网膜移植后的随访期,体重测量被认为与使用计算机断层扫描/磁共振成像的放射学检查同样重要。