COMBINED ENCEPHALO-ARTERIO-SYNANGIOSIS AND ENCEPHALO-MYO-SYNANGIOSIS IN THE TREATMENT OF MOYAMOYA-DISEASE

From January 1990 to December 1995, a total of nine cases of Moyamoya disease were treated at the National Taiwan University Hospital with c ombined encephalo-arterio-synangiosis (EAS) and encephalo-myo-synangio sis (EMS). There were five males and four females and their ages range d from 6 months to 31 years. Of these, two cases had their first sympt om as intracranial hemorrhage and the rest of the cases had ischemic m anifestations. Surgical treatment with combined EAS and EMS was perfor med on 16 hemispheres of the nine cases. The superficial temporal arte ry with its anterior and posterior branches was isolated and fixed to the pial surface. Then, the muscle pedicle from the bivalved temporal muscle was used as a dural graft to cover the artery. All the cases sh owed good neovascularization on follow-up angiography performed at 2-3 months after surgery. These two patients with hemorrhagic symptoms we re followed for 52 and 61 months, respectively. Neither of these two c ases showed recurrent bleeding. For patients with ischemic symptoms, t he follow-up period ranged from 8 to 73 months (mean 41.7 months). All the patients showed improvement in their clinical symptoms. (C) 1997 Elsevier Science B.V.