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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 104 (1990), S. 96-102 
    ISSN: 0942-0940
    Keywords: Moyamoya disease ; surgical treatment ; encephalo-duro-arterio-synangiosis ; advantages and disadvantages
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Encephalo-duro-arterio-synangiosis (EDAS) was done in 16 Japanese children with Moyamoya disease on 22 sides. The results were evaluated clinically, angiographically, and by positron emission computed tomography (PET). Postoperative external carotid angiograms showed a good collateral circulation through EDAS in 72 percent of the treated sides. Two-thirds of the sides examined by PET showed improvement in cerebral blood circulation, particularly at the surgically-treated cortex. Postoperatively the symptoms disappeared in those with good new collateral formation. TIA, RIND, and/or involuntary movement disappaered in 31 percent and partially so in 44 percent 6 months after EDAS. The TIA in the lower limb and/ or involuntary movement persisted in some children. This surgical approach seems applicable particularly for children with the ischaemic type of Moyamoya disease, however, the procedure also has drawbacks. Development of collateral circulation was insufficient in some cases, and the territories of the anterior cerebral artery (ACA) or posterior cerebral artery (PCA) were often not covered, even in those with a good new collateral formation in the middle cerebral arterial (MCA) area.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Moyamoya disease ; surgical treatment ; cases refractory to EDAS ; operative techniques of the second operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three cases of Moyamoya disease successfully treated by reoperation are reported with special reference to the operative techniques in the second operation. These children first underwent encephalo-duro-arterio-synangiosis (EDAS). Because two of the three postoperative collateral formations through EDAS were either poor or not present at all and their symptoms remained. Encephalo-myosynangiosis (EMS) was later added in the posterior frontal and/or parietal regions of the same side as the former EDAS. In the remaining one, the collaterals through EDAS were well formed but transient ischaemic attack (TIA) persisted in the lower limb. The collateral to the middle cerebral arterial (MCA) distribution, even though seemingly well formed, was not sufficient to obtain a complete subsidence of the symptoms. In this case encephalo-myo-arteriosynangiosis (EMAS) was later added to the antero-medial frontal region of the same side as the EDAS to form collaterals to the anterior cerebral arterial (ACA) distribution. In all three cases the angiograms after the second operation showed good formation of collaterals, and the symptoms subsided. The causes of poor collateral formation through EDAS and operative techniques for the additional operation for those cases refractory to EDAS are discussed.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: MR ; Cervical myelopathy ; Juvenile amyotrophy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eight patients with a juvenile type of distal and segmental muscular atrophy of the upper extremities (DSMA), a type of cervical flexion myelophathy, were evaluated using MR imaging. In the neutral position there was no spinal cord compression, but in flexion the spinal cord was displaced anteriorly and was compressed by the posterior surfaces or margins of the vertebrae and/or any herniated disks in all cases. In flexion, compression of the cord was exaggerated in seven patients by the anterior displacement of the posterior margin of the thecal sac, which was accompanied by dilated posterior internal vertebral veins. In patients suspected of having DSMA, MR images made in flexion are regarded essential for verifying the diagnosis.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 144 (1985), S. 93-95 
    ISSN: 1432-1076
    Keywords: Moyamoya disease ; Arterial occlusive disease ; Short stature ; Syndactylia ; Cerebrovascular circulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We treated a Japanese boy with moyamoya disease accompanied by synbrachydactylia, funnel chest, pes equinus and short stature. Angiograms showed the anomalous origin of the occipital artery in addition to the moyamoya vascular network at the base of the brain. A generalised mesenchymal anomaly was suggested in this case.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 96 (1989), S. 83-87 
    ISSN: 0942-0940
    Keywords: Jugular foramen neurinoma ; magnetic resonance imaging ; computed tomography ; surgical anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Four cases of jugular foramen neurinoma, extending from the posterior fossa into the temporal bone through the jugular foramen, are reported. The information provided by magnetic resonance imaging was compared with that by computed tomography. Due to the excellent sensitivity, the absence of bone artifacts, and the ease of imaging in any plane, magnetic resonance imaging gave better information particularly about the location of the tumour than X-CT scan did. It included the dumb-bell-shaped tumour through the jugular foramen, the extra-axial nature of the tumour, and the precise anatomical relationships between the tumour and the facial and acoustic nerves or the internal carotid artery. Sagittal and coronal views clearly demonstrated the superior and inferior margins of the tumour. The information is very useful not only for preoperative diagnosis but also for planning the surgical approaches and postoperative follow-up.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0942-0940
    Keywords: Moyamoya disease ; paediatric case ; surgical treatment ; indirect non-anastomotic EC-IC bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Surgical results of paediatric patients with Moyamoya disease who were treated by indirect revascularization procedures are reported. Encephalo-duro-arterio-synangiosis (EDAS), encephalomyo-arterio-synangiosis (EMAS), and/or encephalo-myo-synangiosis (EMS) were performed on 47 sides of 29 children with Moyamoya disease. The results of those non-anastomotic EC-IC bypass procedures were evaluated clinically, angiographically, and by computed tomography (CT). Postoperative external carotid angiograms showed a good collateral formation through EDAS, EMAS, or EMS in about 70–80 percent of all surgically treated sides. The symptoms such as TIA, RIND, and/or involuntary movements disappeared in the cases with a good collateral formation but not in those with insufficient development of the collateral circulation. The indirect EC-IC bypass surgery seems effective for most of the children with Moyamoya disease who present with ischaemic signs.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0942-0940
    Keywords: Unilateral Moyamoya disease ; Moyamoya disease ; Akin Moyamoya disease ; unilateral occlusion or stenosis of ICA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The clinical features of 6 children who are probable sufferers of “unilateral” Moyamoya disease are here reported. They showed angiographic findings which were compatible with those of Moyamoya disease, albeit only on one side. They did not, however, show any basic aetiologic factors. The age of onset, the clinical symptoms and the findings of electroencephalography, angiography, and positron emission tomography in these cases were also quite similar to those in the cases of Moyamoya disease except for unilateral involvement. All 6 patients underwent either direct or indirect EC-IC bypass sugery. In 3 children who received encephalo-duro-arteriosynangiosis, an indirect bypass procedure, the collateral circulation was well formed postoperatively. In the follow-up study, 2 of the 6 cases starting with a unilateral lesion developed bilateral involvement later. However, the other 4 cases persisted in showing only unilateral involvement. These 4 cases may suggest the existence of “unilateral” Moyamoya disease in the paediatric age, and it is recommended that such cases be treated similarly to those of bilateral Moyamoya disease.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Keywords: Balloon test occlusion ; internal carotid artery ; compressed spectral arrays (CSAs): electroencephalography (EEG) ; Matas test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We used the compressed spectral arrays (CSAs) of the electroencephalogram (EEG) to monitor cerebral blood flow related events in balloon test occlusion of the internal carotid artery (balloon Matas test). Reliability of the CSAs was examined in 22 patients subjected to the test. Of 9 patients who underwent subsequent permanent carotid occlusion, in 6 there was no change on CSAs and/or in neurological conditions. In 2 patients, there was a slowing on CSAs prior to the appearance of neurological deterioration during clinical testing. CSAs transformed these EEG changes into a succinct graphic display. In 1 of the 2, for whom the Matas test was repeated 1 year later, there was a change from positive to negative and delayed cerebral infarction occurred after carotid occlusion. In the other patient, an ischaemic insult occurred during the balloon occlusive procedures. The third patient had a fatal delayed ischaemic complication 3 days after surgical ligation of the cervical carotid artery, despite the negative balloon Matas test. Complications in these 3 patients were presumably related to thromboembolic mechanisms. The balloon Matas test monitored by CSAs is useful for detecting change in brain functions attributed to an inadequate blood flow. However, this test is unreliable for predicting thrombo-embolic complications.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1920
    Keywords: ‘Essential’ hemifacial spasm ; Microsurgical neurovascular decompression ; Vertebral angiogram ; AICA ; PICA ; Redundant vertebral artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fifty-one patients with hemifacial spasm secondary to facial nerve compression by normal appearing, elongated, tortuous and/or dilated arteries, were treated by microsurgical neurovascular decompression. Post-operatively, 91% of 44 of these patients with one to six year postoperative follow-ups were satisfactory. The angiographic findings showed significant increase in the number of common trunk anomalies. Variations of the anterior and posterior inferior cerebellar and vertebral arteries are discussed in relation to nerve compression.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1920
    Keywords: Mitochondrial encephalomyopathy ; MELAS ; Computed tomography ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among mitochondrial encephalomyopathies, MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes, Pavlakis et al. 1983) is recognized as a distinct syndrome characterized by generalized convulsions and recurrent stroke-like episodes. The neuroradiological findings of three patients with MELAS are reported here. Retrospective review shows that MELAS should be included in the differential diagnosis of infarct-like lesions of the cerebrum.
    Type of Medium: Electronic Resource
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