Yk. Tu et al., COMBINED ENCEPHALO-ARTERIO-SYNANGIOSIS AND ENCEPHALO-MYO-SYNANGIOSIS IN THE TREATMENT OF MOYAMOYA-DISEASE, Clinical neurology and neurosurgery, 99, 1997, pp. 118-122
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.