间接旁路手术是治疗小儿莫亚莫亚氏病的一种方法

IF 0.7 Q4 CLINICAL NEUROLOGY
Mohamed Farouk, Ibrahim Mohamed El-Tantawy, Mohamed Ali Kassem, Ashraf Ezzeldein, Mostafa Mahmoud Nabeeh, Mohamed M. Elsherbini
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引用次数: 0

摘要

莫亚莫亚病(MMD)是一种原因不明的慢性罕见脑血管疾病,其特征是颈内动脉(ICA)末端及其主要分支广泛狭窄。作为一种代偿机制,穿孔器扩张形成脆弱的侧支血管,通过脑血管造影术观察狭窄区域周围的异常血管网络,就像 "空中飘浮的烟雾"。我们对本医院的数据库进行了回顾性研究。所有在2015年1月至2022年12月期间接受手术血管重建治疗的因MMD导致的缺血性脑卒中患者均被纳入研究范围。通过导管数字减影血管造影术(DSA)确定MMD的条件是两侧颈内动脉末端存在狭窄,且脑底周围出现异常侧支 "moyamoya血管"。对临床、放射学和随访数据进行了回顾性分析。在上述时间段内,在我院所有确诊为缺血性脑卒中的儿童患者中,有9名患者被诊断为moyamoya病,其中6人接受了手术治疗。其中 5 例(83.3%)接受了单侧 EDMS 手术,1 例(16.67%)接受了双侧分期手术,但未增加神经功能缺损。小儿莫亚莫亚相关中风患者的间接血管再通手术再灌注率高,疗效良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Indirect bypass surgery as a line of management of pediatric moyamoya disease
Moyamoya disease (MMD) is a chronic, rare cerebrovascular disorder of unknown cause featured by extensive narrowing of the terminal internal carotid artery (ICA) and its main branches. As a compensatory mechanism, perforators dilate forming fragile collateral vessels that appear as an abnormal vascular network resembling ‘puff of smoke drifting in the air’ observed via angiography around stenotic area in the brain. The database of the current hospital was retrospectively studied. All patients with ischemic strokes owing to MMD treated with surgical revascularization between January 2015 and December 2022 were included. MMD was identified on catheter-based digital subtraction angiography (DSA) by the presence of stenosis at the terminal portions of both internal carotid arteries and the development of abnormal collateral “moyamoya vessels” around the base of the brain. Clinical, radiological and follow-up data were retrospectively analyzed. During the mentioned time window, nine patients were diagnosed with moyamoya disease among all pediatric patients with established diagnosis of ischemic stroke in our institute; six of them underwent surgery. Unilateral EDMS was performed in 5 cases (83.3%), while one patient (16.67%) underwent staged bilateral surgeries with no added neurological deficit. Indirect revascularization surgery for pediatric moyamoya-related stroke patients has high rates of reperfusion and promising outcomes.
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