[Effects of indirect EC/IC bypass operations on adult moyamoya patients]

We have performed indirect EC/IC operations, mainly the EDAS, on 50 pediatric and 4 adult moyamoya patients. In this paper, we report on the effects of the indirect EC/IC operations performed on the 4 adult patients, three females presented with intracranial hemorrhage and a male presented with intracranial hemorrhage and a male presented with infarction. The procedures performed were 6 EDAS, one EAS and a simple hematoma removal which was revealed later to have effected as indirect EC/IC bypass surgery. The patients were all in their twenties. All the patients had pre- and postoperative angiography and the result were compared and was correlated with changes in CT and neurological signs. Case 1 had hematoma removal right after the hemorrhagic attack. Angiograms taken 10 months later showed marked revascularization of the brain through the dural arteries on the operated side. EDAS which was performed later on the other side worked well and the postoperative angiograms taken 9 months later, showed satisfactory revascularization of the operated brain with decrease in moyamoya vessels. The patient has Rt. hemiparesis but she can enjoy skiing. Case 2 had been asymptomatic preoperatively, 10 months after the initial hemorrhagic attack. Bilateral EDAS was done. Angiograms 12 months later showed marked revascularization of the brain through the EC system and marked decrease in moyamoya vessels was seen in the Rt. side in which better revascularization presented. The patient lives a normal life as a housewife.(ABSTRACT TRUNCATED AT 250 WORDS)