Manejo anestésico de paciente con enfermedad de Moyamoya sometido a encefaloduroarteriomiosinangiosis

Moyamoya’s disease is an unusual vascular entity with important physiopathological implications. Vascular stenosis in main cerebral arteries causes a loss in self-regulation, with high risk of hypoxia. It generates neovascularization too, that implies a high probability of rupture and intracerebral hemorrhage. One of the most extended therapy is the encephalo-dural–arterial synangiosis. This treatment consists of implanting superficial temporal artery in the cortical region affects. The most appropriate anesthetic technique as well as the strategies to optimize cerebral perfusion are still under discussion. In this article we present our experience with a patient undergoing this procedure under total intravenous anesthesia, with preservation of neurological status after extubation.