✓ Thirteen children with moyamoya disease who had no apparent cerebral infarction or hemorrhage were examined pre- and postoperatively by means of positron emission tomography (PET) to investigate the underlying cerebral circulation and metabolism and the effect of bypass surgery. The preoperative regional cerebral blood flow (rCBF) and mean transit time were significantly decreased and increased, respectively, in the cerebral cortex of these patients compared to control values. The regional cerebral blood volume (rCBV) and the regional oxygen extraction fraction (rOEF) had significantly increased to compensate for the reduced rCBF and perfusion pressure and also to maintain the regional cerebral metabolic rate of oxygen (rCMRO2). In the basal ganglia, rCBV elevation was more prominent than that in the cerebral cortex, although changes in rCBF, rOEF, and rCMRO2 were relatively minor.
Postoperative improvements were observed predominantly near the cortex where bypass surgery had been performed and in the basal ganglia. Direct and combined indirect bypass procedures improved cerebral circulation more effectively than single indirect bypass surgery. Although the angiographic findings were not always compatible with the clinical results, the postoperative improvements on PET scans correlated with the disappearance of transient ischemic attacks. In addition to the clinical courses and angiographic findings, PET analysis was indispensable in evaluating the cerebral circulation and metabolism in childhood moyamoya disease.
Abe H, , Kamiyama H, & Kuroda S, et al: Cerebral blood flow in the children with spontaneous occlusion of the circle of Willis: Comparison with that of healthy children, in Yonekawa Y (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1991. National Cardiovascular Center: Osaka, Japan, 1992, pp 21–25 Abe H, Kamiyama H, Kuroda S, et al: Cerebral blood flow in the children with spontaneous occlusion of the circle of Willis: Comparison with that of healthy children, in Yonekawa Y (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1991. National Cardiovascular Center: Osaka, Japan, 1992, pp 21–25
Baron JC, , Bousser MG, & Rey A, et al: Reversal of focal “misery-perfusion syndrome” by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography. Stroke 12:454–459, 1981 Baron JC, Bousser MG, Rey A, et al: Reversal of focal “misery-perfusion syndrome” by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography. Stroke 12:454–459, 1981
Cahan LD: Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease. Pediatr Neurosci 12:58–62, 1985–1986 Cahan LD: Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease. Pediatr Neurosci 12:58–62, 1985–1986
The EC/IC Bypass Study Group: Failure of extracranialintracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med 313:1191–1200, 1985 The EC/IC Bypass Study Group: Failure of extracranialintracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med 313:1191–1200, 1985
Frackowiack RSJ, , Lenzi GL, & Jones T, et al: Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure and normal values. J Comput Assist Tomogr 4:727–736, 1980 Frackowiack RSJ, Lenzi GL, Jones T, et al: Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure and normal values.J Comput Assist Tomogr 4:727–736, 1980
Fukui M, , Ikezaki K, & Matsushima T, et al: Endothelin, elastase-like activity, elastase inhibitory capacity in the sera of patients with moyamoya disease, in Yonekawa Y (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1991. National Cardiovascular Center: Osaka, Japan, 1992, pp 72–77 Fukui M, Ikezaki K, Matsushima T, et al: Endothelin, elastase-like activity, elastase inhibitory capacity in the sera of patients with moyamoya disease, in Yonekawa Y (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1991. National Cardiovascular Center: Osaka, Japan, 1992, pp 72–77
Fukui M, , Matsushima T, & Fujii K, et al: Differences in cerebral hemodynamics and metabolism between pediatric and adult patients with moyamoya disease: a study using positron emission tomography, in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1987. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1988, pp 76–80 Fukui M, Matsushima T, Fujii K, et al: Differences in cerebral hemodynamics and metabolism between pediatric and adult patients with moyamoya disease: a study using positron emission tomography, in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1987. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1988, pp 76–80
Fukui M, , Matsushima T, & Kuwabara Y, et al: Hemodynamic evaluation of moyamoya disease in children with positron emission computed tomography before and after neurosurgical procedures (EDAS, EMS, EMAS), in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1986. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1987, pp 91–98 Fukui M, Matsushima T, Kuwabara Y, et al: Hemodynamic evaluation of moyamoya disease in children with positron emission computed tomography before and after neurosurgical procedures (EDAS, EMS, EMAS), in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1986. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1987, pp 91–98
Gibbs JM, , Wise RJ, & Leenders KL, et al: Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion. Lancet 1:310–314, 1984 Gibbs JM, Wise RJ, Leenders KL, et al: Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion. Lancet 1:310–314, 1984
Goto F, , Ebihara S, & Hata T: Local cerebral blood flow and CO2 responsiveness in patients with “moyamoya disease,” in Meyer JS, , Lechner H, & Reivich M (eds): Cerebral Vascular Disease 6. Amsterdam: Excerpta Medica, 1987, pp 91–96 Goto F, Ebihara S, Hata T: Local cerebral blood flow and CO2 responsiveness in patients with “moyamoya disease,” in Meyer JS, Lechner H, Reivich M (eds): Cerebral Vascular Disease 6. Amsterdam: Excerpta Medica, 1987, pp 91–96
Goto Y, & Yonekawa Y: Worldwide distribution of moyamoya disease. Neurol Med Chir 32:883–886, 1992 Goto Y, Yonekawa Y: Worldwide distribution of moyamoya disease. Neurol Med Chir 32:883–886, 1992
Gotoh F: Guideline to the diagnosis of occlusion of the circle of Willis, in Gotoh F (ed:) The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1978. Keio University: Tokyo, Japan, 1979, p 132 Gotoh F: Guideline to the diagnosis of occlusion of the circle of Willis, in Gotoh F (ed:) The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1978. Keio University: Tokyo, Japan, 1979, p 132
Inoue T, , Matsushima T, & Nagata S, et al: Frontal encephalo-myo-arterio-synangiosis (EMAS). Cereb Stroke 20:297–300, 1992 Inoue T, Matsushima T, Nagata S, et al: Frontal encephalo-myo-arterio-synangiosis (EMAS). Cereb Stroke 20:297–300, 1992
Karasawa J, , Kikuchi H, & Furuse S, et al: A surgical treatment of “moyamoya” disease: “Encephalo-myo-synangiosis.” Neurol Med Chir 17 (Part 1):29–37, 1977 Karasawa J, Kikuchi H, Furuse S, et al: A surgical treatment of “moyamoya” disease: “Encephalo-myo-synangiosis.” Neurol Med Chir 17 (Part 1):29–37, 1977
Karasawa J, , Kikuchi H, & Furuse S, et al: Treatment of moyamoya disease with STA-MCA anastomosis. J Neurosurg 49:679–688, 1978 Karasawa J, Kikuchi H, Furuse S, et al: Treatment of moyamoya disease with STA-MCA anastomosis. J Neurosurg 49:679–688, 1978
Karasawa J, , Touho H, & Ohnishi H, et al: Long-term follow-up study after extracranial -intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease. J Neurosurg 77:84–89, 1992 Karasawa J, Touho H, Ohnishi H, et al: Long-term follow-up study after extracranial -intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease. J Neurosurg 77:84–89, 1992
Kitamura K, , Fukui M, & Oka K, et al: Moyamoya disease, in Toole JF (ed): Handbook of Clinical Neurology. Amsterdam: Elsevier, 1989, Vol 11, pp 293–306 Kitamura K, Fukui M, Oka K, et al: Moyamoya disease, in Toole JF (ed): Handbook of Clinical Neurology. Amsterdam: Elsevier, 1989, Vol 11, pp 293–306
Kitamura K, , Matsushima T, & Kuwabara Y: Positron CT in children with moyamoya disease, in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1985. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1986, pp 120–128 Kitamura K, Matsushima T, Kuwabara Y: Positron CT in children with moyamoya disease, in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1985. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1986, pp 120–128
Krayenbühl HA: The moyamoya syndrome and the neurosurgeon. Surg Neurol 4:353–360, 1975 Krayenbühl HA: The moyamoya syndrome and the neurosurgeon. Surg Neurol 4:353–360, 1975
Kurokawa T, , Tomita S, & Ueda K, et al: Prognosis of occlusive disease of the circle of Willis (moyamoya disease) in children. Pediatr Neurol 1:274–277, 1985 Kurokawa T, Tomita S, Ueda K, et al: Prognosis of occlusive disease of the circle of Willis (moyamoya disease) in children. Pediatr Neurol 1:274–277, 1985
Kuwabara Y: [Evaluation of regional cerebral circulation and metabolism in moyamoya disease using positron emission computed tomography.] Jpn J Nucl Med 23:1381–1402, 1986 (Jpn) Kuwabara Y: [Evaluation of regional cerebral circulation and metabolism in moyamoya disease using positron emission computed tomography.] Jpn J Nucl Med 23:1381–1402, 1986 (Jpn)
Kuwabara Y, , Ichiya Y, & Otsuka M, et al: Cerebral hemodynamic change in the child and the adult with moyamoya disease. Stroke 21:272–277, 1990 Kuwabara Y, Ichiya Y, Otsuka M, et al: Cerebral hemodynamic change in the child and the adult with moyamoya disease. Stroke 21:272–277, 1990
Lammertsma AA, & Jones T: Correction for the presence of intravascular oxygen-15 in the steady state technique for measuring regional oxygen extraction ratio in the brain: 1. Description of the method. J Cereb Blood Flow Metab 3:416–424, 1983 Lammertsma AA, Jones T: Correction for the presence of intravascular oxygen-15 in the steady state technique for measuring regional oxygen extraction ratio in the brain: 1. Description of the method. J Cereb Blood Flow Metab 3:416–424, 1983
Matsushima T, , Fujiwara S, & Nagata S, et al: Reoperation for moyamoya disease refractory to encephalo-duro-arteriosynangiosis. Acta Neurochir 107:129–132, 1990 Matsushima T, Fujiwara S, Nagata S, et al: Reoperation for moyamoya disease refractory to encephalo-duro-arteriosynangiosis. Acta Neurochir 107:129–132, 1990
Matsushima T, , Fujiwara S, & Nagata S, et al: Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS). Acta Neurochir 98:135–140, 1989 Matsushima T, Fujiwara S, Nagata S, et al: Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS). Acta Neurochir 98:135–140, 1989
Matsushima T, , Fukui M, & Fujii K, et al: Two pediatric cases with occlusions of the ipsilateral internal carotid and posterior cerebral arteries associated with moyamoya vessels: “unilateral” moyamoya disease. Surg Neurol 33:276–280, 1990 Matsushima T, Fukui M, Fujii K, et al: Two pediatric cases with occlusions of the ipsilateral internal carotid and posterior cerebral arteries associated with moyamoya vessels: “unilateral” moyamoya disease. Surg Neurol 33:276–280, 1990
Matsushima T, , Fukui M, & Kitamura K, et al: Encephaloduro-arterio-synangiosis in children with moyamoya disease. Acta Neurochir 104:96–102, 1990 Matsushima T, Fukui M, Kitamura K, et al: Encephaloduro-arterio-synangiosis in children with moyamoya disease. Acta Neurochir 104:96–102, 1990
Matsushima T, , Inoue T, & Suzuki SO, et al: Surgical treatment of moyamoya disease in pediatric patients—comparison between the results of indirect and direct revascularization procedures. Neurosurgery 31:401–405, 1992 Matsushima T, Inoue T, Suzuki SO, et al: Surgical treatment of moyamoya disease in pediatric patients—comparison between the results of indirect and direct revascularization procedures. Neurosurgery 31:401–405, 1992
Matsushima Y, , Aoyagi M, & Koumo Y, et al: Effects of encephalo-duro-arterio-synangiosis on childhood moyamoya patients—swift disappearance of ischemic attacks and maintenance of mental capacity. Neurol Med Chir 31:708–714, 1991 Matsushima Y, Aoyagi M, Koumo Y, et al: Effects of encephalo-duro-arterio-synangiosis on childhood moyamoya patients—swift disappearance of ischemic attacks and maintenance of mental capacity. Neurol Med Chir 31:708–714, 1991
Miyamoto S, , Kikuchi H, & Karasawa J, et al: Pitfalls in the surgical treatment of moyamoya disease: operative techniques for refractory cases. J Neurosurg 68:537–543, 1988 Miyamoto S, Kikuchi H, Karasawa J, et al: Pitfalls in the surgical treatment of moyamoya disease: operative techniques for refractory cases. J Neurosurg 68:537–543, 1988
Nishimoto A, & Takeuchi S: Abnormal cerebrovascular network related to the internal carotid arteries. J Neurosurg 29:255–260, 1968 Nishimoto A, Takeuchi S: Abnormal cerebrovascular network related to the internal carotid arteries. J Neurosurg 29:255–260, 1968
Olds MV, , Griebel RW, & Hoffman HJ, et al: The surgical treatment of childhood moyamoya disease. J Neurosurg 66:675–680, 1987 Olds MV, Griebel RW, Hoffman HJ, et al: The surgical treatment of childhood moyamoya disease. J Neurosurg 66:675–680, 1987
Pantano P, , Baron JC, & Lebrun Grandié P, et al: Regional cerebral blood flow and oxygen consumption in human aging. Stroke 15:635–641, 1984 Pantano P, Baron JC, Lebrun Grandié P, et al: Regional cerebral blood flow and oxygen consumption in human aging. Stroke 15:635–641, 1984
Powers WJ, , Martin WRW, & Herscovitch P, et al: Extracranial-intracranial bypass surgery: hemodynamic and metabolic effects. Neurology 34:1168–1174, 1984 Powers WJ, Martin WRW, Herscovitch P, et al: Extracranial-intracranial bypass surgery: hemodynamic and metabolic effects. Neurology 34:1168–1174, 1984
Suzuki J, & Takaku A: Cerebrovascular “moyamoya” disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol 20:288–299, 1969 Suzuki J, Takaku A: Cerebrovascular “moyamoya” disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol 20:288–299, 1969
Suzuki SO, , Matsushima T, & Ikezaki K, et al: Surgical treatment for adult patients with moyamoya disease—with special reference to hemorrhagic type. Surg Cereb Stroke 20:463–467, 1992 Suzuki SO, Matsushima T, Ikezaki K, et al: Surgical treatment for adult patients with moyamoya disease—with special reference to hemorrhagic type. Surg Cereb Stroke 20:463–467, 1992
Tagawa T, , Naritomi H, & Mimaki T, et al: Regional cerebral blood flow, clinical manifestations, and age in children with moyamoya disease. Stroke 18:906–910, 1987 Tagawa T, Naritomi H, Mimaki T, et al: Regional cerebral blood flow, clinical manifestations, and age in children with moyamoya disease. Stroke 18:906–910, 1987
Takeuchi K, & Shimizu K: [Hypoplasia of the bilateral internal carotid arteries.] Brain Nerve 9:37–43, 1957 (Jpn) Takeuchi K, Shimizu K: [Hypoplasia of the bilateral internal carotid arteries.] Brain Nerve 9:37–43, 1957 (Jpn)
Takeuchi S, , Tanaka R, & Ishii R, et al: Cerebral hemodynamics in patients with moyamoya disease. A study of regional cerebral blood flow by the 133Xe inhalation method. Surg Neurol 23:468–474, 1985 Takeuchi S, Tanaka R, Ishii R, et al: Cerebral hemodynamics in patients with moyamoya disease. A study of regional cerebral blood flow by the 133Xe inhalation method. Surg Neurol 23:468–474, 1985
Takeuchi S, , Tsuchida T, & Kobayashi K, et al: Treatment of moyamoya disease by temporal muscle graft “encephalomyo-synangiosis.” Childs Brain 10:1–15, 1983 Takeuchi S, Tsuchida T, Kobayashi K, et al: Treatment of moyamoya disease by temporal muscle graft “encephalomyo-synangiosis.” Childs Brain 10:1–15, 1983
Taki W, , Yonekawa Y, & Kobayashi A, et al: Cerebral circulation and metabolism in adult's moyamoya disease—PET study. Acta Neurochir 100:150–154, 1989 Taki W, Yonekawa Y, Kobayashi A, et al: Cerebral circulation and metabolism in adult's moyamoya disease—PET study. Acta Neurochir 100:150–154, 1989
Uemura K, , Yamaguchi K, & Kojima S, et al: Regional cerebral blood flow in cerebrovascular “moyamoya disease.” Study by 133Xe clearance method and cerebral angiography. Brain Nerve 27:385–393, 1974 Uemura K, Yamaguchi K, Kojima S, et al: Regional cerebral blood flow in cerebrovascular “moyamoya disease.” Study by 133Xe clearance method and cerebral angiography. Brain Nerve 27:385–393, 1974
Usuki F, , Ohtani H, & Okadome T, et al: Immunocytochemical study on endothelial markers with cerebral vessel from a patient with familial moyamoya disease. Thromb Haemost 65:335–338, 1991 Usuki F, Ohtani H, Okadome T, et al: Immunocytochemical study on endothelial markers with cerebral vessel from a patient with familial moyamoya disease. Thromb Haemost 65:335–338, 1991
Yamashita M, , Oka K, & Tanaka K: Cervico—cephalic arterial thrombi and thromboemboli in moyamoya disease—possible correlation with progressive intimal thickening in the intracranial major arteries. Stroke 15:264–270, 1984 Yamashita M, Oka K, Tanaka K: Cervico—cephalic arterial thrombi and thromboemboli in moyamoya disease—possible correlation with progressive intimal thickening in the intracranial major arteries. Stroke 15:264–270, 1984
Yonekawa Y, , Handa H, & Okuno T: Moyamoya disease: diagnosis, treatment and recent achievement, in Barnett HJM (ed): Stroke. New York: Churchill Livingstone, 1986, Vol 2, pp 805–829 Yonekawa Y, Handa H, Okuno T: Moyamoya disease: diagnosis, treatment and recent achievement, in Barnett HJM (ed): Stroke. New York: Churchill Livingstone, 1986, Vol 2, pp 805–829
Yonekawa Y, & Kawano T: Follow-up study of 632 cases in spontaneous occlusion of the circle of Willis registered from 1983 to 1991, in Yonekawa Y (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1991. National Cardiovascular Center: Osaka, Japan, 1992, pp 41–47 Yonekawa Y, Kawano T: Follow-up study of 632 cases in spontaneous occlusion of the circle of Willis registered from 1983 to 1991, in Yonekawa Y (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1991. National Cardiovascular Center: Osaka, Japan, 1992, pp 41–47
Yonekawa Y, , Taki W, & Kobayashi A, et al: Cerebral circulation and metabolism of juvenile cases with “moyamoya” disease estimated by PET, in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1986. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1987, pp 88–90 Yonekawa Y, Taki W, Kobayashi A, et al: Cerebral circulation and metabolism of juvenile cases with “moyamoya” disease estimated by PET, in Handa H (ed): The Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Annual Report 1986. Hamamatsu Rosai Hospital: Hamamatsu, Japan, 1987, pp 88–90
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