Surgical Treatment of Adult Moyamoya Disease

被引:35
作者
Lee, Si Un [1 ,2 ]
Oh, Chang Wan [1 ,2 ]
Kwon, O-Ki [1 ,2 ]
Bang, Jae Seung [1 ,2 ]
Ban, Seung Pil [1 ,2 ]
Byoun, Hyoung Soo [1 ,2 ]
Kim, Tackeun [1 ,2 ]
机构
[1] Seoul Natl Univ, Dept Neurosurg, Bundang Hosp, 82,Gumi Ro 173 Beon Gil, Seongnam Si 13620, Gyeonggi Do, South Korea
[2] Seoul Natl Univ, Dept Neurosurg, Coll Med, 101 Daehak Ro Jongno Gu, Seoul 03080, South Korea
关键词
Adult; Moyamoya; Surgical treatment; Revascularization; Outcome; SYMPTOMATIC CEREBRAL HYPERPERFUSION; EXTRACRANIAL-INTRACRANIAL BYPASS; NORTH-AMERICAN ADULTS; LONG-TERM OUTCOMES; CLINICAL-FEATURES; REVASCULARIZATION SURGERY; FOLLOW-UP; BIFRONTAL ENCEPHALOGALEO(PERIOSTEAL)SYNANGIOSIS; NEUROLOGIC DETERIORATION; CONSERVATIVE TREATMENT;
D O I
10.1007/s11940-018-0511-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of review Moyamoya disease (MMD) is being increasingly diagnosed with the development of radiological surveillance technology and increased accessibility to medical care. Accordingly, there have been several recent reports on treatment outcomes in MMD. In this review, we summarize recent advances in surgical treatment and outcomes of adult MMD, while addressing related controversies. Recent findings Recent studies suggest that revascularization surgery leads to significantly more favorable outcomes for stroke prevention, angiographic and hemodynamic changes, and clinical outcomes than does conservative treatment for adult patients with ischemic MMD. Moreover, direct revascularization methods should be considered as the first-line treatment over indirect methods, although the latter may be considered if a direct method is not possible. In cases of hemorrhagic MMD, several studies have demonstrated that surgical treatment is more effective than conservative treatment in preventing further hemorrhage. In addition to revascularization surgery, endovascular treatment is emerging as a breakthrough therapy for hemorrhagic MMD. Summary Accumulating evidence regarding the surgical treatment of adult MMD suggests the benefit of revascularization over conservative management for both ischemic and hemorrhagic patients. However, the benefit of revascularization in asymptomatic adult MMD remains unclear.
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页数:14
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