Document Detail

Computed tomographic perfusion in assessing postoperative revascularization in moyamoya disease.
MedLine Citation:
PMID:  20860934     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Our purpose in this study is to evaluate the use of computed tomographic perfusion (CTP) as an imaging modality to assess revascularization after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass in patients with moyamoya disease. CASE DESCRIPTION: We present a series of 5 patients (mean age, 35; range, 20-50) with moyamoya disease who underwent STA-MCA bypass for ischemic stroke or transient ischemic attack (TIA). Preoperatively, all patients were evaluated with CTP; all showed clinically significant hypoperfusion in the MCA territory. All surgeries were performed by the senior author (ASB) and there were no periprocedural complications. Postoperative CTPs were performed to assess improvement after the bypass. The postoperative CTP images clearly demonstrated patency of the bypass and restoration of flow, particularly in the MCA distribution. At follow-up (mean, 18 months), 3 patients continued to be asymptomatic, one patient's hemiparesis improved, and another patient's hemiparesis improved but remained aphasic (mean Glasgow Outcome Score, GOS = 4.5). All displayed a reduced risk of recurrent stroke; no MCA strokes were observed. CONCLUSION: This study demonstrates that CTP, a more convenient and less expensive imaging test than other available options, can provide an assessment of cerebral blood flow after cerebral bypass that appears to correlate with postoperative clinical and angiographic findings. In addition, in this small series of moyamoya patients, STA-MCA bypass appeared to prevent recurrent TIAs and strokes.
Anil K Nair; Doniel Drazin; Junichi Yamamoto; Alan S Boulos
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  World neurosurgery     Volume:  73     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-09-23     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-9; discussion e13     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Division of Neurosurgery, Albany Medical Center, Albany, NY 12208, USA.
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MeSH Terms
Cerebral Revascularization*
Cerebrovascular Circulation / physiology
Cohort Studies
Middle Aged
Moyamoya Disease / physiopathology,  radiography*,  surgery*
Perfusion Imaging*
Retrospective Studies
Tomography, X-Ray Computed*
Treatment Outcome
Vascular Patency
Young Adult

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