Multiple Burr-Hole Surgery for the Treatment of Moyamoya Disease and Quasi-Moyamoya Disease in Chilrirnn: Preliminary Surgical and Imaging Results

被引:10
作者
Mirone, Giuseppe [1 ]
Cicala, Domenico [2 ]
Meucci, Chiara [1 ]
d'Amico, Alessandra [3 ]
Santoro, Claudia [4 ]
Muto, Mario [5 ]
Cinalli, Giuseppe [1 ]
机构
[1] Santobono Pausilipon Childrens Hosp, Dept Pediat Neurosurg, Naples, Italy
[2] Santobono Pausilipon Childrens Hosp, Dept Pediat Neuroradiol, Naples, Italy
[3] Federico II Univ Naples, Sch Med, Dept Neuroradiol, Naples, Italy
[4] Luigi Vanvitelli Univ Campania, Sch Med, Dept Woman Child Gen & Specialist Surg, Naples, Italy
[5] AORN Cardarelli, Dept Neuroradiol, Naples, Italy
关键词
Advent calendar technique; Indirect revascularization; Moyamoya disease; Multiple burr-hole technique; Neurofibromatosis; PWI MRI; Quasi-moyamoya disease; INVERSION-RECOVERY IMAGES; LEPTOMENINGEAL IVY SIGN; SINGLE-CENTER EXPERIENCE; CEREBRAL HEMODYNAMICS; ADULT PATIENTS; FLUID; REVASCULARIZATION; OPERATION; CHILDREN;
D O I
10.1016/j.wneu.2019.03.282
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: Moyamoya disease (MMD) is characterized by a progressive spontaneous occlusion of distal internal carotid arteries and its main branches. It is necessary to promptly diagnose and treat this condition, especially in children, because of the high risk of stroke and consequent severe disability. In this study, we examine the role of multiple burr-hole surgery (MBHS) in the treatment of pediatric patients with MMD and quasi-MMD and the role of perfusion magnetic resonance imaging (MRI) in the surgical indication and during follow-up. METHODS: We reviewed preoperative, early postoperative, and late postoperative MRI perfusion and digital subtraction angiography images together with clinical and surgical outcomes in 10 children with MMD treated by MBHS. RESULTS: Fourteen MBHS procedures (6 unilateral, 2 bilateral, and 2 single-setting bilateral) were performed in 10 children. Clinical and radiologic follow-up for all patients ranges from 16 months to 7 years. No ischemic events (transient ischemic attacks or stroke) occurred during the follow-up period. Postoperative digital subtraction angiography showed good revascularization around the burr-hole sites in all patients. The functional efficacy of the surgery was confirmed by dynamic susceptibility contrast perfusion MRI studies in 8 patients. CONCLUSIONS: Our data underline the good rate of success of MBHS in pediatric MMD and quasi-MMD. This technique results in good collateral revascularization, improved cerebral perfusion and excellent short and long-term symptoms control, with low perioperative risk. Postoperative changes of perfusion parameters and ivy sign MRI finding seem to show a positive correlation and mainly occur in posterior middle cerebral artery territory.
引用
收藏
页码:E843 / E855
页数:13
相关论文
共 41 条
[1]  
Ball W S Jr, 2001, Magn Reson Imaging Clin N Am, V9, P207
[2]   Cerebral Blood Flow Improvement after Indirect Revascularization for Pediatric Moyamoya Disease: A Statistical Analysis of Arterial Spin-Labeling MRI [J].
Blauwblomme, T. ;
Lemaitre, H. ;
Naggara, O. ;
Calmon, R. ;
Kossorotoff, M. ;
Bourgeois, M. ;
Mathon, B. ;
Puget, S. ;
Zerah, M. ;
Brunelle, F. ;
Sainte-Rose, C. ;
Boddaert, N. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2016, 37 (04) :706-712
[3]   Long-term Outcome After Multiple Burr Hole Surgery in ChildrenWith Moyamoya Angiopathy: A Single-Center Experience in 108 Hemispheres [J].
Blauwblomme, Thomas ;
Mathon, Bertrand ;
Naggara, Olivier ;
Kossorotoff, Manoelle ;
Bourgeois, Marie ;
Puget, Stephanie ;
Meyer, Philippe ;
Brousse, Valentine ;
de Montalembert, Marianne ;
Brunelle, Francis ;
Zerah, Michel ;
Sainte-Rose, Christian .
NEUROSURGERY, 2017, 80 (06) :950-956
[4]   MR perfusion imaging in moyamoya syndrome - Potential implications for clinical evaluation of occlusive cerebrovascular disease [J].
Calamante, F ;
Ganesan, V ;
Kirkham, FJ ;
Jan, W ;
Chong, WK ;
Gadian, DG ;
Connelly, A .
STROKE, 2001, 32 (12) :2810-2816
[5]   Childhood Moyamoya Disease and Moyamoya Syndrome: A Pictorial Review [J].
Currie, Stuart ;
Raghavan, Ashok ;
Batty, Ruth ;
Connolly, Daniel J. A. ;
Griffiths, Paul D. .
PEDIATRIC NEUROLOGY, 2011, 44 (06) :401-413
[6]   CRANIAL BURR HOLE FOR REVASCULARIZATION IN MOYAMOYA DISEASE [J].
ENDO, M ;
KAWANO, N ;
MIYASAKA, Y ;
YADA, K .
JOURNAL OF NEUROSURGERY, 1989, 71 (02) :180-185
[7]  
Fukui M, 1997, CLIN NEUROL NEUROSUR, V99, pS238
[8]   Mapping of a familial Moyamoya disease gene to chromosome 3p24.2-p26 [J].
Ikeda, H ;
Sasaki, T ;
Yoshimoto, T ;
Fukui, M ;
Arinami, T .
AMERICAN JOURNAL OF HUMAN GENETICS, 1999, 64 (02) :533-537
[9]   Linkage analysis of moyamoya disease on chromosome 6 [J].
Inoue, TK ;
Ikezaki, K ;
Sasazuki, T ;
Matsushima, T ;
Fukui, M .
JOURNAL OF CHILD NEUROLOGY, 2000, 15 (03) :179-182
[10]   The Leptomeningeal Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease: Positron Emission Tomography Study [J].
Kaku, Yasuyuki ;
Iihara, Koji ;
Nakajima, Norio ;
Kataoka, Hiroharu ;
Fukushima, Kazuhito ;
Iida, Hidehiro ;
Hashimoto, Nobuo .
CEREBROVASCULAR DISEASES, 2013, 36 (01) :19-25