Skip to main content
SpringerLink
Log in

Encephalo-duro-arterio-synangiosis in children with Moyamoya disease

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Balagura S, Farris WA (1985) Treatment of moyamoya disease by cerebroarteriosynangiosis. Surg Neurol 23: 270–274

    PubMed  Google Scholar 

  2. The EC/IC Bypass Study Group (1985) The international co-operative study of extracranial/intracranial arterial anastomoses (EC/IC bypass study): methodology and entry characteristics. Stroke 16: 397–405

    Google Scholar 

  3. The EC/IC Bypass Study Group (1985) Failure of extracraniali-ntracranial arterial bypass to reduce the risk of ischemic stroke: results of an international randomized trial. N Engl J Med 313: 1191–1200

    Google Scholar 

  4. Gibbs LM, Wise RJS, Leenders KLet al (1984) Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion. Lancet i: 310–314

    Google Scholar 

  5. Ishii R, Ichikawa A, Takeuchi S, Tanaka R (1986) Hemodynamic evaluation after surgical treatment for moyamoya disease. Jpn J Stroke 8: 200–207 (in Japanese)

    Google Scholar 

  6. Karasawa J (1978) Studies on the surgical treatment of moyamoya disease. J Nara Med Ass 29: 375–397 (in Japanese)

    Google Scholar 

  7. Karasawa J, Kikuchi H, Furuse S, Sakaki T, Yoshida Y, Ohnishi H, Taki W (1977) A surgical treatment of moyamoya disease. “Encephalo-myo-synangiosis”. Neurol Med Chir (Tokyo) 17: 29–37

    Google Scholar 

  8. Karasawa J, Kikuchi H, Furuse S, Kawamura J, Sakaki T (1978) Treatment of moyamoya disease with STA-MCA anastomosis. J Neurosurg 49: 679–688

    PubMed  Google Scholar 

  9. Karasawa J, Kikuchi H, Kawamura J, Sakai T (1980) Intracranial transplantation of the omentum for cerebrovascular moyamoya disease: a two-year follow-up study. Surg Neurol 14: 444–449

    PubMed  Google Scholar 

  10. Kikuchi H, Karasawa J, Nagata I (1986) Nation-wide investigation in occlusion of the circle of Willis. Report of 1985. In: Handa H (eds) Annual report of 1985 on the cooperative study of occlusion of the circle of Willis to the Ministry of Health and Welfare 19–25 (in Japanese)

  11. Kobayashi K, Takeuchi S, Tsuchida T, Ito J (1981) Encephalo-myo-synangiosis (EMS) to moyamoya disease-with special reference to postoperative angiography. Neurol Med Chir (Tokyo) 21: 1229–1238 (in Japanese)

    Google Scholar 

  12. Krayenbühl HA (1975) The moyamoya syndrome and the neurosurgeon. Surg Neurol 4: 353–360

    PubMed  Google Scholar 

  13. Kurokawa T, Tomita S, Ueda K, Narazaki O, Hanai T, Hasuo K, Matsushima T, Kitamura K (1985) Prognosis of occlusive disease of the circle of Willis (Moyamoya disease) in children. Pediatr Neurol 1: 274–277

    PubMed  Google Scholar 

  14. Kuwabara Y (1986) Evaluation of CBF, OEF, CMRO2 and mean transit time in moyamoya disease using positron emission computed tomography. Jpn J Nucl Med 23: 1381–1402 (in Japanese)

    Google Scholar 

  15. Matsushima T, Fujiwara S, Nagata S, Fujii K, Fukui M, Kitamura K, Hasuo K (1989) Surgical treatment for pediatric patients with Moyamoya Disease by indirect revascularization procedures (EDAS, EMS, EMAS). Acta Neurochir (Wien) 98: 135–140

    Google Scholar 

  16. Matsushima Y, Aoyagi M, Fukai N, Tanaka K, Tsuruoka S, Inaba Y (1982) Angiographic demonstration of cerebral revascularization after encephalo-duro-arterio-synangiosis performed on pediatric moyamoya patients. Bull Tokyo Med Dent Univ 29: 7–17

    PubMed  Google Scholar 

  17. Matsushima Y, Fukai N, Tanaka K, Tsuruoka S, Aoyagi M, Inaba Y (1980) A new operative method for moyamoya disease: A presentation of a case who underwent encephalo-duro-arterio (STA) -synangiosis. Nervous System in Children 5: 249–255 (in Japanese)

    Google Scholar 

  18. Matsushima Y, Fukai N, Tanaka K, Tsuruoka S, Inaba Y, Aoyagi M, Ohno K (1981) A new surgical treatment of moyamoya disease in children: a preliminary report. Surg Neurol 15: 313–320

    PubMed  Google Scholar 

  19. Matsushima Y, Inaba Y (1984) Moyamoya disease in children and its surgical treatment. Introduction of a new surgical procedure and its follow-up angiograms. Child's Brain 11: 155–170

    PubMed  Google Scholar 

  20. Matsushima Y, Yamaguchi T, Takasato Y, Tomida S, Fukumoto T, Suzuki R, Tomita H, Inaba Y (1986) Changes in symptoms after encephalo-duro-arterio-synangiosis (EDAS) in pediatric moyamoya disease. No To Hattatsu 18: 3–7 (in Japanese)

    PubMed  Google Scholar 

  21. Miyamoto S, Kikuchi H, Karasawa J, Nagata I, Yamazoe N, Akiyama Y (1988) Pitfalls in the surgical treatment of moyamoya disease. Operative techniques for refractory cases. J Neurosurg 68: 537–543

    PubMed  Google Scholar 

  22. Nakagawa Y, Gotoh S, Shimoyama M, Ohtsuka K, Mabuchi S, Sawamura Y, Abe H, Tsuru M (1983) Reconstructive operation for moyamoya disease-Surgical indication for the hemorrhagic type and preferable operative methods. Neurol Med Chir (Tokyo) 23: 464–470 (in Japanese)

    Google Scholar 

  23. Nakagawa Y, Shimoyama M, Kashiwaba T, Suzuki Y, Gotoh S, Miyasaka K, Takei H, Gotoh S, Ohtsuka K, Abe H, Tsuru M (1981) Reconstructive operation of moyamoya disease and its problems. Neurol Surg 9: 305–314 (in Japanese)

    Google Scholar 

  24. Okuno T, Hatsutori H, Mikawa H, Yonekawa Y, Handa H (1984) Prognosis of “Moyamoya disease”. In: Handa H (ed) Annual report of 1983 on the cooperative study of occlusion of the circle of Willis to the Ministry of Health and Welfare, pp 46–55

  25. Olds MV, Griebel RW, Hoffman HJ, Craven M, Chuang S, Schutz H (1987) The surgical treatment of childhood moyamoya disease. J Neurosurg 66: 675–680

    PubMed  Google Scholar 

  26. Spetzler RF, Roski RA, Kopaniky DR (1980) Alternative superficial temporal artery to middle cerebral artery revascularization procedure. Neurosurgery 7: 484–485

    PubMed  Google Scholar 

  27. Takeuchi S, Tsuchida T, Kobayashi K, Fukuda M, Ishii R, Tanaka R, Ito J (1983) Treatment of moyamoya disease by temporal muscle graft “Encephalo-myo-synangiosis”. Child's Brain 10: 1–15

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Neurological Institute, Faculty of Medicine, Kyushu University, Fukuoka, Japan

    T. Matsushima, M. Fukui & K. Kitamura

  2. Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan

    K. Hasuo & Y. Kuwabara

  3. Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan

    T. Kurokawa

Authors
  1. T. Matsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Kitamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Hasuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. Kuwabara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. Kurokawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsushima, T., Fukui, M., Kitamura, K. et al. Encephalo-duro-arterio-synangiosis in children with Moyamoya disease. Acta neurochir 104, 96–102 (1990). https://doi.org/10.1007/BF01842826

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01842826

Keywords

Search

Navigation