LONG-TERM RESULTS OF SURGICALLY TREATED MOYAMOYA-DISEASE

Various surgical procedures have been tried for patients with Moyamoya disease. The most effective treatment, however, is still controversia l. We retrospectively evaluated the long-term results of 71 patients ( 26 men and 45 women) with Moyamoya disease surgically treated in our i nstitute. They consisted of 56 pediatric patients (younger than 15 yea rs) and 15 adult patients. Symptoms in all patients were due to cerebr al ischemia. We did 123 operations on 119 hemispheres: 18 superficial temporal artery-middle cerebral artery (STA-MCA) anastomoses, six STA- MCA anastomoses with indirect bypass (IB), 41 encephalo-duro-arterio-s ynangiosis (EDAS), 29 encephalo-duro-arterio-myo-synangiosis (EDAMS) a nd 29 ribbon EDAMS. Average follow-up periods for each procedure were: 7 years for STA-MCA anastomosis, 6.2 years for STA-MCA anastomosis wi th indirect bypass, 11 years for EDAS, 5.6 years for EDAMS and 2.6 yea rs for ribbon EDAMS, respectively. The results of each procedure were satisfactory because the preoperative transient ischemic attacks disap peared. Analysis of follow-up angiograms shows excellent filing of the ACA and MCA territory in the patients undergoing ribbon EDAMS. Howeve r, long-term follow-up study shows that about 10% of the patients had severe difficulty in social or school life because of intellectual imp airment. (C) 1997 Elsevier Science B.V.