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Postoperative neurological deterioration following the revascularization surgery in children with moyamoya disease
T Sakamoto1, M Kawaguchi, K Kurehara
1Department of Anesthesiology, Nara Medical University, Kashihara, Japan.
Insights
Moyamoya disease patients may experience strokes after revascularization surgery. Postoperative dehydration and crying are linked to these neurologic events, requiring careful perioperative monitoring.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Vascular Neurology
Background:
- Moyamoya disease is a rare, progressive cerebrovascular disorder.
- Revascularization surgery aims to improve blood flow to the brain in moyamoya disease patients.
- Neurologic deterioration post-surgery is a significant concern.
Observation:
- Four pediatric moyamoya disease patients experienced neurologic deterioration after revascularization.
- Anesthesia induction and intraoperative periods were uneventful.
- No immediate neurological deficits were noted upon emergence from anesthesia.
Findings:
- Strokes occurred 2, 4, 5, and 10 days postoperatively in the described cases.
- Dehydration and excessive crying were identified as potential triggers for stroke.
- These factors highlight a critical window for complications.
Implications:
- Perioperative care for moyamoya disease patients requires heightened vigilance.
- Strategies to prevent dehydration and manage crying are crucial.
- Further research into optimizing perioperative management is warranted to reduce stroke risk.
Abstract:
We describe four children with moyamoya disease who developed neurologic deterioration following revascularization surgery. In all cases, anesthesia was smoothly induced and the intraoperative course was uneventful. Emergence from anesthesia was prompt and no new neurological deficit was observed. However, the children suffered strokes on 2, 4, 5, and 10 days, postoperatively, respectively. Dehydration and crying were thought to be closely associated with the stroke in each case. This report suggests that attention should be paid during entire the perioperative period to avoid stroke in patients with moyamoya disease.