Related Experiment Video
Updated: Apr 14, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Early surgical treatment benefits early staged pediatric moyamoya disease--single case report
Go Matsuoka1, Yasuo Aihara, Koji Yamaguchi
1Department of Neurosurgery, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho Shinjuku-ku, Tokyo, 162-8666, Japan.
Insights
Early surgical revascularization for pediatric moyamoya disease relieved severe headaches in a young patient. Superficial temporal artery-middle cerebral artery bypass improved cerebral perfusion, suggesting timely intervention benefits even in early stages.
Area of Science:
- Neurology
- Neurosurgery
- Pediatric Neurology
Background:
- Moyamoya disease is a rare cerebrovascular disorder affecting children.
- Surgical revascularization aims to improve cerebral blood flow (CBF) and prevent ischemic events.
- Treatment timing is debated, particularly for asymptomatic patients with normal CBF.
Observation:
- A 10-year-old female with unilateral moyamoya disease presented with headache and near-normal CBF.
- Angiography indicated Suzuki stage II, transitioning to III.
- Superficial temporal artery-middle cerebral artery (STA-MCA) double bypass was performed.
Findings:
- STA-MCA bypass effectively relieved the patient's severe headache.
- The surgery improved cerebral perfusion.
- Angiography at 7 months showed significant external carotid artery supply to intracranial arteries via bypass grafts.
Implications:
- Early surgical intervention may be beneficial for pediatric moyamoya disease patients experiencing symptoms like headache.
- Improving perfusion pressure and cerebral circulation through bypass surgery can alleviate symptoms even in early disease stages.
- This case highlights the potential benefits of timely STA-MCA bypass in managing pediatric moyamoya disease.
Purpose:
Surgical revascularization for pediatric moyamoya disease improves cerebral blood flow (CBF) and consequently may prevent further ischemic events. However, the timing of the treatment is controversial especially for patients with no ischemic symptom and normal CBF. The purpose of this case report is to inform and infer the surgical treatment timing for pediatric moyamoya disease patients.
Case Report:
A 10-year-old female patient with unilateral moyamoya disease complaining of only headache as a symptom and whose Suzuki stage was II or in transition to III by angiography and CBF was almost normal was admitted to Tokyo Women's Medical University Hospital. We performed superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses for the patient because we estimated her headache was derived from low perfusion in the brain. STA-MCA bypass surgery was not only effective for relief of her severe headache but also valid for her cerebral perfusion. Her angiography showed much supply from external carotid artery to intracranial arteries via bypass grafts in 7 months.
Conclusion:
Our case showed early surgical treatment was beneficial for relief of severe headache even for early staged pediatric moyamoya disease patients by improving perfusion pressure and cerebral circulation.
More Related Videos
06:54A Model for Encephalomyosynangiosis Treatment after Middle Cerebral Artery Occlusion-Induced Stroke in Mice
Published on: June 22, 2022
09:57Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
