[Moyamoya syndrome in neuroanesthesia]

Cerebrovascular moyamoya, occurring as a result of a sudden cerebrovascular insufficiency, represents an occlusive process - usually bilateral - at the termination of the internal carotid artery and the circulus arteriosus cerebri (circle of Willis). In this disease, a web of small collateral blood vessels in the post-stenotic area is seen in carotid angiography. We report on a female of 35 years of age with moyamoya confirmed by cerebral angiography whose anamnesis was typical of the condition. Surgical treatment consisted of anastomosis from the left superficial temporal artery to a cortical artery to enhance blood flow through the moyamoya network on the left side. The anaesthetic procedure followed by us is presented as an example of anaesthetic management of all surgical interventions in patients with moyamoya. The following factors are considered to be important: Avoidance of hypertensive as well as of hypotensive phases normoventilation; sufficient protection against mental stress; closely meshed long-term supervision. (In German literature, the "moyamoya syndrome" is also known as Nishimoto-Takeuchi-Kudo-Suzuki's-disease).