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[Chronic subdural hematoma developing after EMS for moyamoya disease]
No Shinkei Geka. Neurological Surgery
|August 1, 1982
Summary
A rare case of chronic subdural hematoma occurred after Encephalo-Myo-Synangiosis (EMS) surgery for moyamoya disease in a pediatric patient. This complication, though uncommon, highlights the need for vigilance following revascularization procedures.
Area of Science:
- Neurosurgery
- Neurology
- Pediatric Neurology
Background:
- Moyamoya disease is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
- Encephalo-Myo-Synangiosis (EMS) is a surgical procedure aimed at improving cerebral blood flow in moyamoya disease patients.
- Pediatric moyamoya disease often presents with neurological deficits such as hemiparesis.
Observation:
- A 2.5-year-old girl with moyamoya disease underwent left-sided EMS to address right hemiparesis.
- Following surgery, the patient developed symptoms of headache and vomiting.
- Imaging revealed a significant chronic subdural hematoma on the left side, requiring surgical evacuation.
Findings:
- The patient's initial hemiparesis improved post-EMS, but a new complication arose.
- A chronic subdural hematoma, weighing approximately 30g, was identified and surgically removed.
- A review of literature identified a similar case in a 5-year-old boy, suggesting a potential pattern.
Implications:
- This case underscores a potential, albeit rare, complication of EMS in pediatric moyamoya disease.
- Understanding the mechanism of chronic subdural hematoma formation post-EMS is crucial for preventative strategies.
- Further research may be warranted to elucidate the specific factors contributing to this complication.