Measurement of Cerebral Vessel Flow Velocity during Direct Anastomosis for the Treatment of Moyamoya Disease with Severe Brain Atrophy : A Case Report

Abstract

The authors describe a case of a twentyone-month-old moyamoya disease patient with severe brain atrophy in the right cerebral hemisphere. The patient had fixed left hemiparesis. Superficial temporal artery-middle cerebral artery anastomosis on the right side was performed in order to prevent cerebral ischemia development. Intraoperatively, making a distinction between the cortical artery and vein was difficult under the surgical microscope due to a marked decrease in oxygen consumption on the right side. Then, flow velocity was measured in the cortical artery and superficial veins using Doppler flowmetry, and this disclosed that a flow velocity wave could be detected in the artery but not in the veins, i. e. it could distinguish artery from vein. In summary, intraoperative measurement of flow velocity was useful for distinguishing between cortical arteries and veins in the surgical management of moyamoya disease with severe brain atrophy.