Usefulness of multiple burr-hole operation for child moyamoya disease

Excellent results of multiple burr-hole operation (MBHO) for child moyamoya disease are reported in this study. Three patients of moyamoya disease had MBHO. After MBHO, transient, ischemic attacks disappeared in a patient despite progressing stenosis of the major cerebral arteries, and remarkable neurological improvement was recognized in a patient who had encephaloduroarteriosynangiosis. Another patient slowly improved and became able to go to junior high school. N-isopropyl-p-[I-123] iodoamphetamine (IMP-SPECT) findings also improved in all patients. There was no mortality or morbidity, and no new neurological deficits or bleedings developed during the follow up period. The authors recommend the MBHO as the surgical treatment of choice for not only adult but also child moyamoya disease because of its safety and effectiveness, and also report thr usefulness of MBHO for the patients who have already received other bypass operations.