A preliminary report of one session treatment with cranioplasty and STA-MCA bypass for hemorrhagic MMD patients with skull defect

To conduct a retrospective analysis of the safety and efficacy of one session treatment with cranioplasty and STA-MCA bypass after decompressive craniectomy (DC)in hemorrhagic moyamoya disease. From March 2019 to August 2021, five patients with hemorrhagic MMD after DC were admitted in nan fang hosp...

Full description

Saved in:
Bibliographic Details
Published in:World neurosurgery 2022-05
Main Authors: Wang, Gang, Wang, Zhibin, Wen, Yunyu, Chen, Siyuan, Li, Mingzhou, Zhang, Guozhong, Yu, Huiping, Zhang, Shichao, Xu, Haiyan, Qi, Songtao, Feng, Wenfeng
Format: Article
Language:English
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To conduct a retrospective analysis of the safety and efficacy of one session treatment with cranioplasty and STA-MCA bypass after decompressive craniectomy (DC)in hemorrhagic moyamoya disease. From March 2019 to August 2021, five patients with hemorrhagic MMD after DC were admitted in nan fang hospital. All patients received digital subtraction angiography (DSA) to exclude any spontaneous revascularization between the cortex and temporal muscle and the preservation of STA. Then one stage treatment with superficial temporal artery-middle cerebral artery (STA-MCA) bypass and cranioplasty were performed. If no suitable recipient artery was available, an encephalo-myo-synangiosis (EMS) procedure was used as a salvage plan. Four patients underwent direct STA-MCA bypass, while one underwent EMS due to absence of a suitable recipient artery. All patients had no hemorrhage on postoperative CT, and no new infarcts were detected on MRI. There were no new recurrent symptoms at clinical follow-up 8 to 24 months after surgery. Three patients had improved Glasgow Outcome Scores (GOS), and two patients had stable GOS scores. Perfusion CT showed improvement in cerebral hemodynamics. Four DSA follow-up were performed, suggesting graft patency. One session treatment with EC-IC bypass and cranioplasty are safe and effective in patients with MMD who have undergone previous decompressive craniectomy due to hemorrhagic attack.
ISSN:1878-8769