[Successfully performed STA-MCA anastomosis using a branch of the STA scarcely visible on cerebral angiography in two patients with ischemic type moyamoya disease].

Preparation of a scalp artery as a donor is the first step in the procedure of direct anastomosis for the treatment of ischemic type moyamoya disease. In some cases, the scalp artery is not visualized well on cerebral angiograms. Another scalp artery must be used as a donor or it is interposed between the proximal portion of the firstly selected scalp artery and a branch of the middle cerebral artery in that condition.

[Chronological mass change of intracranial transplanted omentum in accord with decrease/increase in a patient's body weight--case report].

Moyamoya disease is a chronically progressive and occlusive cerebrovascular disease. Steno-occlusion of the terminal portion of the internal carotid artery occurs bilaterally, and fine vascular network gradually develops at the base of the brain and they act as collaterals to the distal portion of the anterior and middle cerebral arteries. Steno-occlusion of the posterior cerebral artery develops in accord with progression of the disease.

[Clinical study of acute brain swelling during operation for moyamoya disease].

Treatment for moyamoya disease includes direct and indirect anastomosis. During surgery, acute and massive brain swelling has been encountered infrequently just after opening of the dura mater, while mild or moderate brain swelling is frequently found just after opening of the dura mater. Four out of 866 cases operated on by the first author in the last twenty-two years showed acute and massive brain swelling and the operation had to be completed as soon as possible.

[Acute brain swelling during operations for three patients with moyamoya disease resulting in performance of indirect anastomosis as a substitute for direct anastomosis].

Surgery for the treatment of moyamoya disease includes direct and indirect anastomosis. In the present study, three cases with moyamoya disease, in which acute brain swelling in the operative field occurred just after opening of the dura mater and indirect anastomosis was performed as a substitute for direct anastomosis to terminate the operation earlier than originally planned. They all waked immediately from general anesthesia and showed no neurological deterioration.

Cerebral ischemia due to compression of the brain by ossified and hypertrophied muscle used for encephalomyosynangiosis in childhood moyamoya disease.

Background: Encephalomyosynangiosis is one of the indirect method in which ischemic brain surface is covered by temporal muscle for the treatment of moyamoya disease.

Case Descriptions: A 14-year-old girl who had been treated with bilateral STA-MCA anastomosis and EMS in 1999 was admitted on January 5, 2005. She showed transient incomplete palsy on the left side of the face and the ipsilateral upper extremity.

Subcutaneous tissue graft including a scalp artery and a relevant vein for the treatment of cerebral ischemia in childhood moyamoya disease.

Background: Simple indirect anastomosis was introduced for the treatment of moyamoya disease with cerebral ischemia in the territory of anterior cerebral arteries (ACAs) or middle cerebral arteries (MCAs), and its clinical usefulness was discussed.

Methods: The study included 19 patients with childhood moyamoya disease who were operated on with subcutaneous tissue graft including a scalp artery and a relevant vein (group 1). They all had repetitive transient ischemic attacks (TIAs) in the territory of ACAs or MCAs.

[Mask anesthesia for cerebral angiography in childhood moyamoya disease].

Cerebral angiography is performed for diagnosis and management of moyamoya disease and in childhood moyamoya disease is usually carried out under general anesthesia after tracheal intubation. Mechanical irritation to trachea resulting in pain,cough,and increase in secretion after termination of the general anesthesia sometimes occurs and it sometimes causes hyperventilation resulting in hypocapnea. Continuous hypocapnea sometimes causes appearance of ischemic attacks in moyamoya disease.

A simple surgical technique of direct anastomosis for treatment of moyamoya disease: technical note.

Background: An arteriotomy on a branch of the middle cerebral artery (MCA) is required in the procedure of the direct anastomosis for the treatment of moyamoya disease, and the artery comes to be collapsed after blood is washed out. The phenomenon makes the microsurgical procedure difficult during direct anastomosis.

Methods: A piece of 3-0 blue monofilament polypropylene suture (PROLENE*, ETHICON Inc.

[Strategy for omental transplantation in moyamoya disease].

Intracranial omental transplantation is sometimes indicated for treatment of ischemia in the territory both of the anterior cerebral artery and of the posterior cerebral artery in certain cases with moyamoya disease. The surgical process for omental transplantation is thought to be complicated and time-consuming. For this reason some technical improvements for intracranial omental transplantation are presented in this report.

[Strategy for direct anastomosis in moyamoya disease].

Direct and/or indirect revascularization is usually performed in the surgical management of moyamoya disease. The surgical technique for direct anastomosis is thought to be difficult in some patients with moyamoya disease. In the present report, a more reliable technique for direct anastomosis is reported and demonstrated.

[Strategy for vascular reconstruction for failed indirect anastomosis in adult Moyamoya disease--a case report].

There exist moyamoya disease patients who require vascular reconstruction for failed indirect anastomosis. In the present study, a 36-year-old female required ipsilateral direct anastomosis for failed right fronto-temporo-parietal combined indirect bypass procedure. One of the frontal branches of the right superficial temporal artery (STA) was left intact between the other frontal branch and a parietal branch of the right STA, both of which had been used in the indirect anastomosis.

[Nutritional assessment in the surgical treatment of childhood moyamoya disease].

Pre- and postoperative values of total protein (TP), total cholesterol (TCH), hemoglobin (HGB), red blood cell (RBC) and hematocrit (HCT) were measured in the surgical treatment of seventeen patients with childhood moyamoya disease. Six out of the 17 patients had bypass surgery twice, so twenty-three cases in total were included in the present study. The postoperative parameters were measured 7 days after each operation.