Cerebral oxygenation state in childhood moyamoya disease: a near-infrared spectroscopy study

Near-infrared spectroscopy was used to measure the relative concentration changes of oxygenated hemoglobin (HbO(2)), deoxygenated hemoglobin (HbR), and total hemoglobin (t-Hb) before, during, and after hyperventilation in eight patients with childhood moyamoya disease who underwent surgery. The patients were divided into the following two groups: those with and those without re-build-up phenomenon on electroencephalography. All patients except one exhibited decreased concentrations of HbO(2) and t-Hb during hyperventilation and decreased concentrations of HbO(2) and increased concentrations of HbR after hyperventilation. The difference between the hemoglobin concentration during and after hyperventilation was significantly greater in the group with the re-build-up phenomenon than the group without it (P <0.03, Mann-Whitney U test). The patients with the re-build-up phenomenon had lower HbO(2) and higher HbR concentrations after hyperventilation. The concentrations of HbO(2) and HbR reflect an alteration in the oxygenated blood supply and/or oxygen use. Thus, it is strongly suggested that regional cerebral hypoxia and metabolic oxygen disturbances play an important role in the occurrence of the re-build-up phenomenon. Near-infrared spectroscopy is a useful noninvasive method to evaluate the efficacy of surgical treatment in childhood moyamoya disease.