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Additional Revascularization Using Multiple Burr Holes for PCA Involvement in Moyamoya Disease.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 Aug; Vol. 30 (8), pp. 105852. Date of Electronic Publication: 2021 May 17. - Publication Year :
- 2021
-
Abstract
- In specific cases of moyamoya disease (MMD), posterior cerebral artery (PCA) stenosis can develop after treatment of the anterior circulation and require additional revascularization. Here, we report two cases that underwent additional posterior indirect revascularization with multiple burr holes for PCA involvement after bilateral revascularization treatment of the anterior circulation. They presented with transient ischemic attack even after bilateral superficial temporal artery-middle cerebral artery bypass, and magnetic resonance angiography (MRA) showed that PCA stenosis had worsened. Indirect revascularization with multiple burr holes using Benz-marked skin incisions was performed. After surgery, the symptoms improved without perioperative complications, and cerebral angiography showed collateral circulation via the burr hole. Indirect revascularization for MMD is often combined with direct revascularization, and there are only a few reports on the use of multiple burr hole surgery alone. In addition, there are few reports of posterior circulation, despite the emphasis on the importance of PCA involvement in MMD. Indirect revascularization with multiple burr holes alone can be performed in multiple areas and applied to patients who cannot undergo direct revascularization using the occipital artery. The procedure is simple and less invasive than traditional direct revascularization procedures. Therefore, it can be effective, especially in pediatric cases of MMD with PCA involvement.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Cerebrovascular Circulation
Child
Female
Humans
Ischemic Attack, Transient diagnostic imaging
Ischemic Attack, Transient etiology
Ischemic Attack, Transient physiopathology
Moyamoya Disease complications
Moyamoya Disease diagnostic imaging
Moyamoya Disease physiopathology
Posterior Cerebral Artery diagnostic imaging
Posterior Cerebral Artery physiopathology
Surgical Instruments
Treatment Outcome
Vascular Patency
Cerebral Revascularization instrumentation
Ischemic Attack, Transient surgery
Moyamoya Disease surgery
Posterior Cerebral Artery surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 30
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Report
- Accession number :
- 34015559
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105852