Hemodynamic Evaluation after Surgical Treatments for Moyamoya Disease

Thirty-one patients were treated by various revascularization procedures, mainly by encephalo-myo-synangiosis. A total of 113 rCBF measurements were performed by a 133Xe inhalation method. Preoperative mCBF values were markedly lower in most of the young patients than in healthy young volunteers, while there is no significant difference between the adult groups. Postoperatively, mCBF increased by an average of 7.1% in the children, while it decreased slightly or remained unchanged in the adults. Postoperative improvement of abnormal distribution of rCBF was demonstrated in approximately two-thirds of the children, as compared with the adults showing little improvement. Pre- and postoperative C02 responses were examined in 4 children, and impaired C02 response was improved in all the operated hemispheres. Our experience suggests that the surgical treatment can be an effective procedure for preventing the progression of clinical findings caused by cerebral ischemia and for improving the cerebral hemodynamics, especially in children with moyamoya disease