REGIONAL CEREBRAL HEMODYNAMICS IN CHILDHOOD MOYAMOYA DISEASE

Regional cerebral blood flow (rCBF) and its reactivity to acetazolamid e were analyzed in a series of 15 cases of childhood moyamoya disease, using the xenon-133 inhalation method and single photon emission CT ( SPECT). Most of the patients had normal mean hemispheric cerebral bloo d flow (mCBF), comparable to that of age-matched healthy children. How ever, they had abnormal rCBF distribution and disturbed reactivity to acetazolamide in the territory of the internal carotid artery, especia lly in the frontal lobe. Surgical revascularization for the anterior c irculation, which consisted of STA-MCA anastomosis and indirect synang iosis, dramatically improved these cerebral hemodynamics in the anteri or circulation, including the frontal lobe, and reactivity to acetazol amide in the whole brain. These results suggest that surgical revascul arization for the anterior circulation should be carried out in order to improve cerebral hemodynamics as widely as possible, especially in the frontal lobe, and may improve cerebral perfusion reserve in the po sterior circulation.