Journal of Cerebrovascular and Endovascular Neurosurgery

  • 제12권3호
  • /
  • Pages.182-189
  • /
  • 2010
  • /
  • 2234-8565(pISSN)
  • /
  • 2287-3139(eISSN)
대한뇌혈관외과학회 (Korean Society of Cerebravascular Surgeons)
권호 표지

Comparison of the Complications Arising After Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Adult Moyamoya Disease and Atherosclerotic Disease

  • Kim, Yong-Chan (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Seung-Hyun (Department of Neurosurgery, Kang-Nam General Hospital) ;
  • Bang, Jae-Seung (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Hwang, Gyo-Jun (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Kwon, O-Ki (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Oh, Chang-Wan (Department of Neurosurgery, Seoul National University Bundang Hospital)
  • 발행 : 2010.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

Objective : To assess the results of superficial temporal artery-middle cerebral artery anastomosis (SMA) in atherosclerotic disease (ASD) and in adult moyamoya disease (MMD) by comparing the complications that arise. Methods : We retrospectively reviewed patients with ASD or adult MMD treated by means of SMA, between December 2000 and December 2006, at our neurovascular center. During this period, we performed 115 SMAs on 108 patients: 61 on ASD patients (61 SMAs; the ASD group) and 47 on adult MMD patients (54 SMAs; the MMD group). Results : We found a higher incidence of postoperative 1 month neurological deficits (P1NDs) and a lower incidence of transient neurological deficits (TNDs) in the MMD group than in the ASD group (p-value=0.047). Patients with a preoperative stroke (cerebral infarction/hemorrhage) history were more likely to develop P1ND than were the patients with a preoperative history of transient ischemic attack (TIA), in both the ASD (p-values=0.012 and 0.033, respectively) and MMD groups (p-values=0.000 and 0.015, respectively), regardless of overall patients (n=108) and single SMA group (n=62). Delayed seizure (seizure occurring > 1 month after SMA) occurred only in 8 MMD patients (8/47, 17.0%; p-value=0.003) out of all 108 patients and in 2 patients (2/10, 20%, p-value=0.014) out of the single SMA group. Major morbidity at the final follow-up period (Karnofsky performance scale (KPS)${\leq}$70) was 6.4% (3 patients) in 47 MMD patients and 0% in 61 ASD patients. Minor morbidity ($80{\leq}KPS{\leq}90$) was also 6.4% (3 patients) in 47 MMD patients and 1.6% (1 patient) in 61 ASD patients. Conclusion : The present study suggests that, in both ASD and MMD, the presence of preoperative stroke (infarction) correlated strongly with the postoperative P1ND. In addition, it may also be suggested that complex and protracted surgical modalities may have influences on the incidence of P1ND. Furthermore, we found that only MMD patients experienced delayed seizure attacks after SMA, and we think this may be related to the delayed formation of angiogenesis, which may increase irritation to cortex.

키워드

참고문헌

  1. Anderson RE, Reichman OH, Davis DO. Radiological evaluation of temporal artery-middle cerebral artery anastomosis. Radiology 113:73-9, 1974. https://doi.org/10.1148/113.1.73
  2. Austin G, Laffin D, Hayward W. Physiological factors in the selection of patients for superficial temporal artery to middle cerebral artery anastomoses. Surgery 75:861-8, 1974.
  3. Chater N, Popp J. Microsurgical vascular bypass for occlusive cerebrovascular disease; Review of 100 cases. Surg Neurol 6 : 115-8, 1976.
  4. Chater N, Spetaler R, Mani J. The spectrum of cerebrovascular occlusive disease suitable for microvascular bypass surgery. Angiology 26:235-51, 1975. https://doi.org/10.1177/000331977502600301
  5. Deruly R, Lecuire J, Brel P, Capdeville. Results in 51 patients with EC-IC bypass: Technical and clinical considerations. In Microsurgery for Cerebral Ischemia, edited by Peerless SJ, McCormick CW, New York : Springer-Verlag, 1980, pp 344-9.
  6. Gratsl O, Schmiedek P, Spetzler R, Steinhoff H, Marguth F. Clinical experience with extra-intracranial arterial anastomosis in 65 cases. J Neurosurg 44:313-24, 1976. https://doi.org/10.3171/jns.1976.44.3.0313
  7. Hiroyuki N, Toshinari M, Sanami K, Nobuyuki H, Takashi O. Long term results of surgically treated Moyamoya disease. Clin Neurol Neurosurg 99:S156-61, 1997.
  8. Kim DS, Yoo DS, Huh PW, Kim JK, Cho KS, Kang JK. Recent Surgical Treatment of Moyamoya Disease. J Korean Neurosurg Soc 30:800-4, 2001.
  9. Kudo T, Fukuda S. Spontanous occlusion of the circle of Willis: a disease entry, its pathology and clinical features. Adv Neurol Sci 20:750-7, 1976.
  10. Mehdorn HM, Hoffman WF, Chater NL. Microneurosurgical arterial bypass for cerebral ischemia: The San Francisco experience, In Microsurgery for Cerebral Ischemia, edited by Peerless SJ, McCormick CW, New York : Springer-Verlag, 1980, pp 350-6.
  11. Mesiwala AH, Sviri G, Fatemi N, Britz GW, Newell DW. Long-term outcome of superficial temporal artery-middle cerebral artery bypass for patients with moyamoya disease in the US. Neurosurg Focus 24 : E15, 2008.
  12. Miyamoto S, Akiyama Y, Nagata I, Karasawa J, Nozaki K, Hashimoto N et al. Long-term outcome after STA-MCA anastomosis for moyamoya disease. Neurosurg Focus 5 : e5, 1998.
  13. Ogawa A, Yoshinoto T, Suzuki J. Sakurai Y. Cerebral blood flow in moyamoya disease , part I : correlation with age and regional distribution. Acta Neurochir( Wien) 105 : 30-4, 1990. https://doi.org/10.1007/BF01664854
  14. Popp AJ, Chater N. Extracranial to intracranial vascular anastomosis for occlusive cerebrovascular disease: Experience in 110 patients. Surgery 82:648-54, 1977.
  15. Reichman OH. Extracranial intracranial arterial anastomosis. In Cerebral Vascular Disease. Ninth Princeton Conference, edited by Whisnant JP, Sandok BA, Grune & Stratton, New York : 1975, pp 175-85.
  16. Reichman OH. Complications of cerebral revascularization. Clin Neurosurg 23:318-35, 1976 https://doi.org/10.1093/neurosurgery/23.CN_suppl_1.318
  17. Reichman OH, Anderson RE, Roberts TS, Heibrun MP. The treatment of intracranial occlusive cerebrovascular disease by STA cortical MCA anastomosis. In Microneurosurgery, edited by Handa H, Igaku S, Ltd., Tokyo, 1975.
  18. Reichman OH, Davis DO, Roberts TS, Satovick RM. Anastomosis between STA and cortical branch of MCA for the treatment of occlusive cerebrovascular disease. In Reconstructive Surgery of Brain Arteries, edited by Merer FT, Akademiai K, Budapest, 1974.
  19. Reichman OH, Satovick RM, Davis DO, Roberts TS. Collateral circulation to the middle cerebral territory by anastomosis of superficial temporal and cortical arteries. In Present Limits of Neurosurgery, edited by Fusek I, Kune Z, Avicenum, Czechoslovak Medical Press : Prague, 1972, pp 369-73.
  20. Reis CV, Safavi-Abbasi S, Zabramski JM, Gusmao SN, Spetzler RF, Preul MC. The history of neurosurgical procedures for moyamoya disease. Neurosurg Focus 20 : E7, 2006. https://doi.org/10.3171/foc.2006.20.4.4
  21. Roberto CH, Michael S, Philip K, Robert HA, Scott C. Temporary neurological deterioration after extracranial intracranial bypass. Neurosurgery 15:178-85, 1984. https://doi.org/10.1227/00006123-198408000-00006
  22. Robertson JT, Watridge CB. The surgical management of extracranial and intracranial occlusive disease. Med Clin North Am 63:681-93, 1979. https://doi.org/10.1016/S0025-7125(16)31668-6
  23. Samson DS, Boone S. Extracranial - intracranial(EC-IC) arterial bypass: Past performance and current concepts. Neurosurgery 3:79-86, 1978. https://doi.org/10.1227/00006123-197807000-00014
  24. Samson D, Hodosh RM, Clark WK. Microsurgical treatment of transient cerebral ischemia: Preliminary results in 50 patients. JAMA 241:376-8, 1979. https://doi.org/10.1001/jama.241.4.376
  25. Samson D, Watts C, Clark K. Cerebral revascularization for transient ischemic attacks. Neurology 27:767-71, 1977 https://doi.org/10.1212/WNL.27.8.767
  26. Suzuki J, Kodama N. Moyamoya disease; a review. Storke 14 : 104-9,1983.
  27. Taki W, Yonekawa Y, Kobayash A, Ishikawa M, Kikuchi H, Nishizawa Y et al. Cerebral circulation and metabolism in adults; moyamoya disease: PET study. Acta Neurochir(Wien) 100 : 150-4, 1989. https://doi.org/10.1007/BF01403603
  28. Yonekawa Y, Handa H, Moritake K, Taki W. Revascularization in children with moyamoya disease; lowdensity area and regional cerebral blood flow after operation. In Microsurgical Anastomosis for Cerebral ischemia, edited by Handa H, Kikuchi H, Yonekawa Y, New York : Igaku-Shoin, 1985, pp272-4.
  29. Yoshikazu O, Takeshi S, Masahiro N, Kanji Y, Tobru Y, Chie Y. Effectiveness of superficial temporal artery-middle cerebral artery anastomosis in adult moyamoya disease : cerebral hemodynamics and clinical course in ischemic and hemorrhagic varieties. Stroke 29:625-30, 1998. https://doi.org/10.1161/01.STR.29.3.625
  30. Zipfel GJ, Fox DJ Jr, Rivet DJ. Moyamoya disease in adults: the role of cerebral revascularization. Skull Base 15:27-41, 2005. https://doi.org/10.1055/s-2005-868161