Document Detail


Temporal change of 3-T magnetic resonance imaging/angiography during symptomatic cerebral hyperperfusion following superficial temporal artery-middle cerebral artery anastomosis in a patient with adult-onset moyamoya disease.
MedLine Citation:
PMID:  18548300     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is a safe and effective treatment for moyamoya disease, although recent evidence suggests its substantial risk for symptomatic cerebral hyperperfusion. The diagnostic value of single-photon emission computed tomography (SPECT) for postoperative hyperperfusion in moyamoya patients is well established, but that of magnetic resonance (MR) imaging/angiography is undetermined. A 22-year-old woman with hemorrhagic-onset moyamoya disease underwent STA-MCA anastomosis on the right hemisphere, but she suffered from transient left hemiparesis and facial paresis owing to cerebral hyperperfusion from 3 to 11 days after surgery as delineated by SPECT. The time-sequential 3-T MR angiography revealed intense high signal of donor STA and dilated branches of MCA around the site of the anastomosis. These findings were most prominent at 8 days after surgery, when her neurologic signs were most apparent. Intensive blood pressure control relieved her symptom and she was discharged without neurologic deficit. MR findings normalized 3 months later. The characteristic findings of 3-T MR angiography, which was not evident by 1.5-T MR angiography in the previous studies, may reflect intrinsic pathology of postoperative cerebral hyperperfusion. It could be a useful diagnostic tool after revascularization surgery for moyamoya disease.
Authors:
Misaki Kohama; Miki Fujimura; Shunji Mugikura; Teiji Tominaga
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-06-12
Journal Detail:
Title:  Neurosurgical review     Volume:  31     ISSN:  0344-5607     ISO Abbreviation:  Neurosurg Rev     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-05     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908181     Medline TA:  Neurosurg Rev     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  451-5; discussion 455     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebral Revascularization / adverse effects*
Cerebrovascular Circulation / physiology*
Female
Humans
Magnetic Resonance Angiography*
Moyamoya Disease / diagnosis,  physiopathology,  surgery*
Subarachnoid Hemorrhage / diagnosis*,  etiology*,  therapy
Time Factors

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