Department of Neurosurgery, Loma Linda University School of Medicine, 11234 Anderson St., Loma Linda CA, 92354, USA.
Department of Neurosurgery, Loma Linda University School of Medicine, 11234 Anderson St., Loma Linda CA, 92354, USA.
Neurochirurgie. 2022 Oct;68(5):493-497. doi: 10.1016/j.neuchi.2022.03.007. Epub 2022 May 24.
Moyamoya disease (MMD) affects young patients, is generally progressive, and results in strokes or cerebral hemorrhages for which medical management is not effective.
To determine the effectiveness of surgical management with minimally invasive cerebral revascularization in MMD.
We conducted a retrospective cohort study of patients undergoing extracranial-intracranial microsurgical revascularization surgery with mini-craniotomy, analyzing the epidemiological, clinical, neuroimaging, postoperative evolution, and complications. We describe the technique in detail. Key outcomes included graft patency, complications, and recurrence of ischemic or hemorrhagic stroke.
From September 2017 to December 2020, 12 brain revascularization procedures for MMD were performed in eight patients (four bilateral), and all 12 grafts were classified as patent. The main complication was contralateral cerebral infarction identified by postoperative neuroimaging in a patient without clinical symptomatology. There was no case of scalp ischemia or necrosis when performing the minimally invasive approach with linear incision.
The results of this study suggest that the minimally invasive extracranial-intracranial cerebral revascularization procedure for MMD in adults is effective, with graft patency in all cases and minimal morbidity.
烟雾病（MMD）影响年轻患者，通常呈进行性发展，并导致中风或脑出血，而药物治疗对此无效。
确定微创性脑血管重建术在 MMD 中的外科治疗效果。
我们对接受迷你开颅颅外-颅内显微血管重建手术的患者进行了回顾性队列研究，分析了其流行病学、临床、神经影像学、术后演变和并发症。我们详细描述了该技术。主要结果包括移植物通畅情况、并发症以及缺血性或出血性中风的复发。
2017 年 9 月至 2020 年 12 月，8 名患者（4 名双侧）共进行了 12 例脑血运重建手术，所有 12 个移植物均被分类为通畅。主要并发症是术后神经影像学显示的对侧脑梗死，但该患者无临床症状。采用线性切口的微创方法时，没有头皮缺血或坏死的情况发生。
本研究结果表明，成人微创性颅外-颅内脑血管重建术治疗 MMD 是有效的，所有病例的移植物均通畅，且发病率较低。
