A case report of moyamoya disease in children treated with encephalo-duro-myo-arterio-pericranial synangiosis

  • Julius July Department of Neurosurgery, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia; Neuroscience Center, Siloam Hospital, Tangerang, Indonesia https://orcid.org/0000-0002-1106-0864
DOI: https://doi.org/10.13181/mji.cr.204452
Keywords: encephalo-duro-myo-arterio-pericranial synangiosis, moyamoya disease, stroke, surgery, transient ischemic attack
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Abstract

Moyamoya disease that manifests during childhood may pose a special challenge for surgeons. We report a case of a 10-year-old girl who suffered from moyamoya disease and was successfully treated with encephalo-duro-myo-arterio-pericranial synangiosis (EDMAPS). She presented with a recurrent transient ischemic attack that worsened for 1 year. She was aphasic globally (sensory and motor) and had slightly weak right extremities. Her magnetic resonance angiography and computed tomography angiography showed the typical features of moyamoya disease with bilateral stenosis at the terminal internal carotid artery, bilaterally abnormal vascular networks, and a left ischemic event involving the temporoparietal region. She was recovered well after underwent bilateral EDMAPS, fully regained her language function after 3 months, and gathered her strength back. Therefore, EDMAPS could be a good, safe, and effective treatment for moyamoya disease in children.

References

  1. Kuroda S, Houkin K. Moyamoya disease: current concepts and future perspectives. Lancet Neurol. 2008;7(11):1056-66. https://doi.org/10.1016/S1474-4422(08)70240-0

  2. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med. 2009;360(12):1226-37. https://doi.org/10.1056/NEJMra0804622

  3. Yamada I, Suzuki S, Matsushima Y. Moyamoya disease: comparison of assessment with MR angiography and MR imaging versus conventional angiography. Radiology. 1995;196(1):211-8. https://doi.org/10.1148/radiology.196.1.7784569

  4. Katz DA, Marks MP, Napel SA, Bracci PM, Roberts SL. Circle of Willis: evaluation with spiral CT angiography, MR angiography, and conventional angiography. Radiology. 1995;195(2):445-9. https://doi.org/10.1148/radiology.195.2.7724764

  5. Nagiub M, Allarakhia I. Pediatric Moyamoya disease. Am J Case Rep. 2013;14:134-8. https://doi.org/10.12659/AJCR.889170

  6. Kim T, Oh CW, Bang JS, Kim JE, Cho WS. Moyamoya disease: treatment and outcomes. J Stroke. 2016;18(1):21-30. https://doi.org/10.5853/jos.2015.01739

  7. Uchino H, Kim JH, Fujima N, Kazumata K, Ito M, Nakayama N, et al. Synergistic interaction between direct and indirect bypasses in combined procedures: the significance of indirect bypasses in moyamoya disease. Neurosurgery. 2016;80(2):201-9. https://doi.org/10.1227/NEU.0000000000001201

  8. Amin-Hanjani S, Singh A, Rifai H, Thulborn KR, Alaraj A, Aletich V, et al. Combined direct and indirect bypass for moyamoya: quantitative assesment of direct bypass flow over time. Neurosurgery. 2013;73(6):962-7. https://doi.org/10.1227/NEU.0000000000000139

  9. Kuroda S, Houkin K, Ishikawa T, Nakayama N, Iwasaki Y. Novel bypass surgery for moyamoya disease using pericranial flap: its impacts on cerebral hemodynamics and long-term outcome. Neurosurgery. 2010;66(6):1093-101. https://doi.org/10.1227/01.NEU.0000369606.00861.91

  10. Hori S, Kashiwazaki D, Akioka N, Tomohide H, Hori E, Umemura K, et al. Surgical anatomy and preservation of the middle meningeal artery during bypass surgery for moyamoya disease. Acta Neurochir. 2015;157(1):29-36. https://doi.org/10.1007/s00701-014-2282-7

Published
2021-05-11
How to Cite
1.
July J. A case report of moyamoya disease in children treated with encephalo-duro-myo-arterio-pericranial synangiosis. Med J Indones [Internet]. 2021May11 [cited 2024Apr.20];30(3):228-31. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/4452
Issue
Vol. 30 No. 3 (2021): September
Section
Case Report/Series

Copyright (c) 2021 Julius July

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