Dural inversion procedure for moyamoya disease

1997 ◽  
Vol 86 (4) ◽  
pp. 719-723 ◽  
Author(s):  
Robert C. Dauser ◽  
Gerald F. Tuite ◽  
Charles W. McCluggage
Keyword(s):  
Moyamoya Disease ◽  
Middle Meningeal Artery ◽  
External Carotid ◽  
Collateral Flow ◽  
Content Type ◽  
Inversion Procedure ◽  
Surgical Treatments ◽  
The Brain ◽  
Meningeal Artery ◽  
Collateral Formation

✓ A variety of surgical procedures have been proposed for the treatment of moyamoya disease, but few have used the potential of the middle meningeal artery to any great extent. During the period of spontaneous collateral formation, patients with this disease are at risk for the development of transient ischemic attacks and strokes. Surgical treatments aimed at increasing collateral flow to the brain from the external carotid system have included both direct and indirect anastomotic methods. In this report, the authors describe a technique that used the middle meningeal artery circulation as a source of collateral blood supply by inverting dural flaps that are located on a large meningeal vessel, allowing the richly vascularized outer dural surface to contact a large surface area of the ischemic cortex. An extensive degree of revascularization was observed.

Traumatic exophthalmos due to an uncommon arteriovenous fistula without involvement of the cavernous sinus

1981 ◽  
Vol 55 (6) ◽  
pp. 993-996 ◽  
Author(s):  
Gianni B. Brada ◽  
Johannes Schramm ◽  
Achredt Kaernbach
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Middle Meningeal Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Complete Relief ◽  
Content Type ◽  
Base Of The Skull ◽  
Meningeal Artery ◽  
Fine Print

✓ A case of traumatic exophthalmos due to an arteriovenous fistula between the middle meningeal artery and the veins at the base of the skull is reported. There was no involvement of the cavernous sinus. Embolization following selective transfemoral catheterization of the external carotid artery resulted in complete relief of the symptoms.

Synergistic Interactions Between Direct and Indirect Bypasses in Combined Procedures: The Significance of Indirect Bypasses in Moyamoya Disease

Neurosurgery ◽  
2017 ◽  
Vol 80 (2) ◽  
pp. 201-209 ◽  
Author(s):  
Haruto Uchino ◽  
Jae-Hoon Kim ◽  
Noriyuki Fujima ◽  
Ken Kazumata ◽  
Masaki Ito ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Superficial Temporal Artery ◽  
Disease Onset ◽  
Chronic Phase ◽  
Temporal Artery ◽  
Middle Meningeal Artery ◽  
Hemodynamic Parameters ◽  
Combined Procedures ◽  
Multiple Variables ◽  
Meningeal Artery

Abstract BACKGROUND: Whether additional indirect bypasses effectively contribute to revascularization in combined procedures remains unclear in patients with moyamoya disease. OBJECTIVE: To evaluate the longitudinal changes associated with combined procedures while following up pediatric and adult patients long term and to assess whether any other clinical factors or hemodynamic parameters affected these changes to determine an optimal surgical strategy. METHODS: We studied 58 hemispheres in 43 adults and 39 hemispheres in 26 children who underwent combined revascularization for moyamoya disease. To evaluate bypass development, we assessed the sizes of the superficial temporal artery and middle meningeal artery using magnetic resonance angiography. Multivariate analysis determined the effects of multiple variables on bypass development. RESULTS: Indirect bypass (middle meningeal artery) development occurred in 95% and 78% of the pediatric and adult hemispheres, respectively. Of these, dual development of direct and indirect bypasses occurred in 54% of the pediatric hemispheres and in 47% of the adult hemispheres. Reciprocal superficial temporal artery regression occurred in 28% of the hemispheres during the transition from the postoperative acute phase to the chronic phase during indirect bypass development. Good indirect bypass development was associated with adult hemispheres at Suzuki stage 4 or greater (odds ratio, 7.4; 95% confidence interval, 1.4-39.4; P = .02). Disease onset type and preoperative hemodynamic parameters were not considered predictors for the development of surgical revascularization. CONCLUSION: Simultaneous direct and indirect bypass development was most frequently observed, regardless of patient age and hemodynamic status. Applying indirect bypass as an adjunct to direct bypass could maximize revascularization in adults and children.

Middle meningeal to middle cerebral arterial bypass for cerebral revascularization

1979 ◽  
Vol 50 (6) ◽  
pp. 802-804 ◽  
Author(s):  
Clinton F. Miller ◽  
Robert F. Spetzler ◽  
Dennis J. Kopaniky
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Middle Meningeal Artery ◽  
Cerebral Revascularization ◽  
Content Type ◽  
Arterial Bypass ◽  
Meningeal Artery ◽  
Fine Print

✓ A case is reported of successful anastomosis of the middle meningeal artery to a cortical branch of the middle cerebral artery. Based on the analyses of 50 random angiograms, the authors discuss the circumstances in which such an anastomosis might be practical and indicated.

Middle meningeal artery embolization for refractory chronic subdural hematoma

2000 ◽  
Vol 93 (4) ◽  
pp. 686-688 ◽  
Author(s):  
Shinya Mandai ◽  
Masaru Sakurai ◽  
Yuzo Matsumoto
Keyword(s):  
Liver Cirrhosis ◽  
Subdural Hematoma ◽  
Therapeutic Approach ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
Content Type ◽  
Meningeal Artery ◽  
Fine Print

✓ The authors present a case of refractory chronic subdural hematoma (CSH) in a 59-year-old man with coagulopathy due to liver cirrhosis. The patient was successfully treated by embolization of the middle meningeal artery after several drainage procedures. This new therapeutic approach to recurrent CSH is discussed.

Indocyanine green visualization of middle meningeal artery before craniotomy during surgical revascularization for moyamoya disease

2017 ◽  
Vol 159 (3) ◽  
pp. 567-575 ◽  
Author(s):  
Nozomu Tanabe ◽  
Shusuke Yamamoto ◽  
Daina Kashiwazaki ◽  
Naoki Akioka ◽  
Naoya Kuwayama ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Moyamoya Disease ◽  
Middle Meningeal Artery ◽  
Surgical Revascularization ◽  
Meningeal Artery

Total removal of large global meningiomas at the medial aspect of the sphenoid ridge

1971 ◽  
Vol 34 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Albert W. Cook
Keyword(s):  
Optic Nerve ◽  
Middle Cerebral Artery ◽  
Operative Technique ◽  
Middle Meningeal Artery ◽  
Medial Aspect ◽  
Total Removal ◽  
Content Type ◽  
Meningeal Artery ◽  
Sphenoid Ridge ◽  
Fine Print

✓ An operative technique for total removal of large global meningiomas at the medial aspect of the sphenoid ridge is described, and experience with 11 patients reported. The technique involves extradural liberation of the dural and tumor attachments to the underlying bone, and extradural occlusion of the blood supply through bone and middle meningeal artery. Subsequent procedures are carried out sequentially in the parasellar area to free the optic nerve and carotid, in the subtemporal tentorial region to release tumor from neighboring structures, and in the Sylvian fissure to isolate the middle cerebral artery.

Dural-cortical anastomosis in pial arteriovenous malformation

1979 ◽  
Vol 50 (4) ◽  
pp. 522-524 ◽  
Author(s):  
Shiro Waga ◽  
Atsunori Morikawa ◽  
Tadashi Kojima
Keyword(s):  
Arteriovenous Malformation ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Middle Meningeal Artery ◽  
Review Of The Literature ◽  
Total Removal ◽  
Content Type ◽  
Posterior Parietal ◽  
Meningeal Artery ◽  
Fine Print

✓ A patient is reported with a purely pial arteriovenous malformation (AVM) supplied from the posterior parietal artery. The prominent middle meningeal artery contributed to opacification of the angular branches distal to the AVM, but did not contribute to the AVM. After total removal of the AVM, the angular branches became opacified from the middle cerebral artery. Review of the literature suggests that hypertrophied dural arteries which do not contribute to the AVM's but which do opacify the cortical branches distal to the AVM's are rare.

Microregional blood flow changes in experimental cerebral ischemia

1971 ◽  
Vol 35 (2) ◽  
pp. 155-166 ◽  
Author(s):  
Y. Lucas Yamamoto ◽  
Kathryne M. Phillips ◽  
Charles P. Hodge ◽  
William Feindel
Keyword(s):  
Blood Flow ◽  
Cerebral Ischemia ◽  
Fluorescein Angiography ◽  
Focal Cerebral Ischemia ◽  
Gamma Activity ◽  
Collateral Flow ◽  
Silicon Detectors ◽  
Content Type ◽  
Perfusion Flow ◽  
The Brain

✓ A branch of the middle cerebral artery on the convexity of the dog brain was occluded to produce an area of focal cerebral ischemia which could then be defined by fluorescein angiography of the brain. Repeated fluorescein angiography and measurement of microregional cerebral blood flow by xenon133 injected into the carotid artery and monitored by miniature lithium-drifted silicon detectors for gamma activity demonstrated that the ischemic zone was reduced in size by better collateral flow when the animals were allowed to breathe 5% carbon dioxide and 95% oxygen. Conversely, hyperventilation reducing the pCO2 made the ischemic zone larger by reducing collateral flow. No evidence was found to indicate that hypercapnia preferentially deprived the ischemic zone of perfusion flow. Retrograde collateral flow in the surface arteries appeared effective in terms of microcirculatory perfusion.

Cranial burr hole for revascularization in moyamoya disease

1989 ◽  
Vol 71 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Masataka Endo ◽  
Nobuyuki Kawano ◽  
Yoshio Miyasaka ◽  
Kenzoh Yada
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Clinical Symptoms ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Burr Hole ◽  
Frontal Region ◽  
External Carotid ◽  
Content Type ◽  
Made In

✓ Currently, superficial temporal artery-middle cerebral artery (MCA) anastomosis, encephalomyosynangiosis (EMS), and encephalo-duro-arterio-synangiosis are used to treat moyamoya disease and are reported to effectively improve ischemic symptoms. All are methods of reversing the flow of blood from the external carotid artery system into the cortical branches of the MCA. As moyamoya disease advances, these operations alone will predictably not correct the deterioration in blood flow in the territory of the anterior cerebral artery. It was noted in a case of moyamoya disease with intraventricular hemorrhage that a burr hole, made in the frontal region for drainage purposes, induced marked neovascularization. Since then, similar frontal burr holes have been made in five juvenile cases of moyamoya disease; this procedure involved making a burr hole in both frontal bones and incising both the dura and the arachnoid membrane. In two cases a frontal burr hole was placed simultaneously with EMS, and in the others the frontal burr hole was made following EMS. The clinical symptoms improved after the frontal burr hole was made, and dynamic computerized tomography revealed improved circulation in the frontal regions. Together with conventional surgical therapy for juvenile cases of moyamoya disease, this operation is considered beneficial both to the circulation in the frontal region and for the protection of frontal brain function.

Pitfalls in the angiographic diagnosis of serious head injury

1980 ◽  
Vol 53 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Edward R. Savolaine ◽  
Arthur M. Gerber ◽  
Stephen F. Nowak
Keyword(s):  
Head Injury ◽  
Anterior Cerebral Artery ◽  
Emergency Situation ◽  
Middle Meningeal Artery ◽  
Apparent Displacement ◽  
Content Type ◽  
Mass Lesions ◽  
Angiographic Diagnosis ◽  
Meningeal Artery ◽  
Fine Print

✓ The problems in interpretation of emergency cerebral arteriograms are discussed with relation to the apparent displacement of “landmark” vessels that is actually produced by rotation or by the type of anteroposterior projection of the vessels, rather than by mass lesions. Anterior cerebral artery, middle meningeal artery, and pineal displacements are reviewed, along with possible pitfalls of diagnosis and attempts at correction. Utilization of dried skulls afforded depth visualization of middle meningeal artery grooves as well as the radiographic projection. The most reliable region on each different type of anteroposterior projection is discussed with regard to the emergency situation where repeat angiographic detections or special views may not be possible.

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