[Effect of various surgical procedures for moyamoya disease in children and adults]

We reviewed our various surgical procedures for moyamoya disease to clarify which treatment is better to relieve the patients with moyamoya disease. We reviewed follow-up angiography, clinical manifestation and EEG. Twenty (5 males and 15 females) patients with moyamoya disease were admitted to our hospital during the period from 1973 to 1991. A child group (under 15 yrs.) consisted of 9 patients: 18 hemispheres underwent, 2 DAS, 13 EDAS, 1 EDAMS, 2 STA-MCA anastomosis+EMAS. In the adult group, there were 11 patients: 19 hemispheres underwent, 4 DAS, 10 EAD-S, 3 STA-MCA anastomosis, 1 EAS, 1 EMAS. Thirty-seven operations were performed totally on these subjects and they were studied by follow-up angiography. In the child group, both of direct (STA-MCA+EMAS) and indirect EDAS group (EDAS, EDAMS) procedures for revascularization showed favorable collateral formation postoperatively. DAS was inferior to EDAS in the formation of collateral channels. This may be due to the significance of contact between the STA band and the brain surface. In the adult group, only 2 DAS, 2 EDAS, 1 EDAMS, 2 STA-MCA, 1 EMAS showed favorable results. Formation of collateral channels in adults was inferior to that in children.