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脑-硬脑膜-动脉血管融合术(EDAS)治疗儿童烟雾病。

Encephaloduroarteriosynangiosis (EDAS) for the treatment of childhood moyamoya disease.

作者信息

Ross I B, Shevell M I, Montes J L, Rosenblatt B, Watters G V, Farmer J P, O'Gorman A M

机构信息

Division of Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada.

出版信息

Pediatr Neurol. 1994 May;10(3):199-204. doi: 10.1016/0887-8994(94)90023-x.

Abstract

Moyamoya disease is defined by the angiographic demonstration of stenosis or occlusion of the vessels of the anterior circulation at the base of the brain and the concomitant development of collateral blood supply. Untreated, the disease is often clinically progressive, resulting in significant neurologic sequelae. Encephaloduroarteriosynangiosis (EDAS), which involves the transposition of a segment of a scalp artery onto the surface of the brain, is a surgical treatment aimed at improving collateral blood flow. Six children underwent 8 EDAS procedures and were followed from 6 months to 9 years after surgery. No patient experienced further deterioration in neurologic status. Postoperative angiography demonstrated cerebral revascularization from the donor scalp artery on 3 of the 6 EDASs that were studied. The 2 patients who did not revascularize after EDAS demonstrated angiographic regression of their disease. The data suggest that EDAS is a safe procedure for the treatment of childhood moyamoya disease. Given the potential severity of the sequelae, early operative intervention is recommended in all children with this disease.

摘要

烟雾病的定义是脑血管造影显示脑底部前循环血管狭窄或闭塞,并伴有侧支血供的同时发育。未经治疗,该疾病通常在临床上呈进行性发展,导致严重的神经后遗症。脑-硬脑膜-动脉血管融通术(EDAS),即将一段头皮动脉移位到脑表面,是一种旨在改善侧支血流的外科治疗方法。6名儿童接受了8次EDAS手术,并在术后6个月至9年进行了随访。没有患者的神经状态进一步恶化。术后血管造影显示,在接受研究的6次EDAS手术中的3次中,来自供体头皮动脉的脑血运重建。2名在EDAS术后未实现血运重建的患者显示其疾病的血管造影退缩。数据表明,EDAS是治疗儿童烟雾病的一种安全手术。鉴于后遗症的潜在严重性,建议对所有患有这种疾病的儿童进行早期手术干预。

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