Koduri Sravanthi, Wilkinson D Andrew, Griauzde Julius M, Gemmete Joseph J, Maher Cormac O
Departments of1Neurosurgery and.
2Radiology, University of Michigan, Ann Arbor, Michigan.
J Neurosurg Pediatr. 2019 Jul 1;24(1):9-13. doi: 10.3171/2019.2.PEDS18603. Epub 2019 Apr 12.
Moyamoya syndrome predisposes patients to ischemic or hemorrhagic stroke due to progressive narrowing of intracranial vessels with subsequent small-vessel collateralization. Dural arteriovenous fistulae (DAVFs) are most commonly noted after venous sinus or cortical vein thrombosis and are believed to be primarily due to venous hypertension and elevated sinus pressures, although there is no known association with moyamoya syndrome, or with surgical treatment for moyamoya disease (MMD). The authors present the case of a 14-year-old girl with Down syndrome treated using pial synangiosis for MMD who subsequently was noted to have bilateral DAVFs. This case provides a new perspective on the origins and underlying pathophysiology of both moyamoya syndrome and DAVFs, and also serves to highlight the importance of monitoring the moyamoya population closely for de novo cerebrovascular changes after revascularization procedures.
烟雾综合征使患者易患缺血性或出血性中风，原因是颅内血管逐渐狭窄并随后形成小血管侧支循环。硬脑膜动静脉瘘（DAVF）最常见于静脉窦或皮质静脉血栓形成后，被认为主要是由于静脉高压和窦压升高，尽管目前尚无证据表明其与烟雾综合征或烟雾病（MMD）的外科治疗存在关联。作者报告了一例14岁唐氏综合征女孩的病例，该女孩因烟雾病接受软脑膜吻合术治疗，随后被发现患有双侧硬脑膜动静脉瘘。该病例为烟雾综合征和硬脑膜动静脉瘘的起源及潜在病理生理学提供了新的视角，同时也凸显了在血运重建术后密切监测烟雾病患者有无新发脑血管变化的重要性。
