EVALUATION OF CEREBRAL BLOOD-FLOW AND HEMODYNAMIC RESERVE IN SYMPTOMATIC MOYAMOYA DISEASE USING STABLE XENON-CT BLOOD-FLOW

Moyamoya disease is a vascular abnormality seen in children and adults characterized by progressive narrowing of the internal carotid, middl e, anterior, and posterior cerebral arteries and the development of le ptomeningeal and proximal internal carotid artery collaterals, which a ppear diaphanous on angiogram. Although adults tend to present with su barachnoid hemorrhage and children with ischemic events, the clinical sequelae in these two populations overlap. Expanding upon work done at this institution using stable xenon computer tomographic blood flow d eterminations with acetazolamide and carbon dioxide challenge to predi ct which population of patients with severe carotid disease and hemody namic compromise would benefit from surgical intervention, we used sim ilar rationale to determine which patients with moyamoya disease would likely benefit from revascularization. Data and outcome concerning fo ur such patients make up the body of this report.