scholarly journals INDIRECT CEREBRAL REVASCULARIZATION ON OPTHALMIC ARTERY BY USING A DRUG-ELUTING BALLON FOR SUSPECTED MOYAMOYA DISEASE

2022 ◽  
Vol 8 (1) ◽  
pp. 72-76
Author(s):  
Ahmad Sulaiman Alwahdy ◽  
Fritz Sumantri Usman
Keyword(s):  
Moyamoya Disease ◽  
Right Hemisphere ◽  
Cerebral Arteries ◽  
Asian Population ◽  
Clinical Results ◽  
Cerebral Revascularization ◽  
Middle Cerebral Arteries ◽  
Drug Eluting ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery

Moyamoya disease (MMD) is a rare idiopathic progressive vaso-occlusive disease causing multiple occlusion of cerebral vessels lead to ischemic stroke. Asian population is the most common race to be affected. We present a male patient 33-years old with suspected MMD with right hemiparesis and neurocognitive changes. On digital substraction angiography (DSA) there was appearance of ‘puff of smoke’ on his right hemisphere, stenosis middle cerebral arteries M1 bilaterally, stenosis of right opthalmic artery (OA), stenosis of left anterior cerebral artery (ACA) and aplasia of right ACA. Ballon angioplasty was performed on right OA that supply the contralateral symptomatic stenosis area (left A1) indirectly through anterior ethmoidal artery and anterior falcine artery (OA-ACA collateral). While no guidelines for the management of MMD, cerebral revascularization by using drug-eluting ballon (DEB) in right opthalmica artery is potentially effective treatment that could allow the brain to have good blood supply (gives good collateral to both ACA), reduces burden of the fragile moya-moya vessels to be ruptured followed by improvement of clinical results. Patient’s selection by understanding the stage, its progressivity and collateral formation are crucial before decision is made.

scholarly journals A case of Young Stroke due to Moyamoya Disease

2020 ◽  
Vol 15 (1) ◽  
pp. 110-113
Author(s):  
Md Abdur Razzak ◽  
Ghulam Kawnayn ◽  
Fateha Naznin ◽  
Quazi Audry Arafat Rahman
Keyword(s):  
Moyamoya Disease ◽  
Past History ◽  
Cerebral Arteries ◽  
Armed Forces ◽  
Cerebral Angiogram ◽  
Medical College ◽  
Middle Cerebral Arteries ◽  
History Of ◽  
Collateral Vessels ◽  
The Right

Moyamoya disease is a disease in which certain arteries in the brain are constricted. Blood flow is blocked by the constriction, and also by blood clots (thrombosis). A collateral circulation develops around the blocked vessels to compensate for the blockage, but the collateral vessels are small, weak, and prone to bleeding, aneurysm and thrombosis which may result in TIA, recurrent ischemic or hemorrhagic stroke or seizure. The disease may manifest in pediatric age or young adults. In May 2019 we have diagnosed a young lady with Moyamoya disease who presented with right sided hemiplegia, motor aphasia and dysphagia. She was labeled as hypertensive 6 months prior to this event and used to take anti-hypertensive irregularly and gave past history of occasional headache. Her CT scan and MRI of brain revealed left sided ischemic infarct involving frontotemporoparietal region and cerebral angiogram revealed narrowing of left MCA and non-visualization of distal part. There is extensive fine collaterals (Moyamoya vessels) giving the appearance of puffed smoke. The right ACA and MCA were also narrowed with appearance of early collateral vessels. She was treated with aspirin, PPI, NG feeding, antihypertensive medication, physiotherapy, rehabilitation therapy and other supportive care. His condition gradually improved and discharged on 2.7.19. He was referred to Department of Neurosurgery for cerebral revascularization by STA-MCA (superficial temporal and middle cerebral arteries) bypass surgery after stabilization and MR perfusion study. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 110-113

Moyamoya Disease

2019 ◽  
pp. 149-156
Author(s):  
Edward Smith
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Arteries ◽  
Pressure Control ◽  
Vascular Supply ◽  
External Carotid Artery ◽  
External Carotid ◽  
Middle Cerebral Arteries ◽  
Detailed Assessment ◽  
Collateral Vessels ◽  
Carotid Circulation

Moyamoya disease is defined by stenosis of the distal intracranial internal carotid arteries up to and including the bifurcation, with segments of the proximal anterior and middle cerebral arteries, dilated basal collateral vessels, and bilateral findings. Detailed assessment with digital subtraction angiography will define the severity of disease (Suzuki stage) and presence of spontaneous transdural collateral vessels from external carotid artery branches. These collateral vessels must be protected during surgical intervention. The surgical goal is to establish a new vascular supply to the areas of the brain at risk for stroke, utilizing vessels from the external carotid circulation. Blood pressure control and avoidance of hyperventilation are key to minimize perioperative stroke risk. Preoperative hydration, ongoing use of aspirin, and good pain control will also minimize surgical complications.

Caspase-3-dependent Apoptosis in Middle Cerebral Arteries in Patients with Moyamoya Disease

Neurosurgery ◽  
2006 ◽  
Vol 59 (4) ◽  
pp. 894-901 ◽  
Author(s):  
Yasushi Takagi ◽  
Ken-ichiro Kikuta ◽  
Nobutake Sadamasa ◽  
Kazuhiko Nozaki ◽  
Nobuo Hashimoto
Keyword(s):  
Moyamoya Disease ◽  
Caspase 3 ◽  
Cerebral Arteries ◽  
Middle Cerebral Arteries

Angiographic Profile in Childhood Moyamoya Disease

1991 ◽  
Vol 32 (6) ◽  
pp. 488-491 ◽  
Author(s):  
P. N. Jayakumar ◽  
B. Y. T. Arya ◽  
M. K. Vasudev
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
Small Vessel Disease ◽  
Cerebral Arteries ◽  
Japanese Literature ◽  
Middle Cerebral Arteries ◽  
The Common ◽  
Stenotic Lesions

The cerebral angiograms of 8 patients with childhood moyamoya disease showed that the common findings were stenosis/occlusion of the supraclinoid internal carotid artery and the proximal segments of the anterior and middle cerebral arteries and basal moyamoya. The volume of basal moyamoya and its collateral supply depended upon the stage of the disease. Leptomeningeal collaterals were frequent in the later stages. Stenotic lesions in the posterior circulation were seen in a majority (75%) of patients. A feature unique to the study was evidence of intracranial small-vessel disease and stenotic cervical internal carotid artery in half of the cases. The disease in the ethnic caucasian Indians seems largely similar to the classical disease frequently reported in the Japanese literature.

scholarly journals Histological Features of Middle Cerebral Arteries From Patients Treated for Moyamoya Disease

2007 ◽  
Vol 47 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Yasushi TAKAGI ◽  
Ken-ichiro KIKUTA ◽  
Kazuhiko NOZAKI ◽  
Nobuo HASHIMOTO
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Arteries ◽  
Histological Features ◽  
Middle Cerebral Arteries
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