出血発症成人もやもや病に関するJapan Adult Moyamoya (JAM) trial

抄録

Recurrent bleedings have been known to aggravate the prognoses of the patients who experienced cerebral bleeding attacks related to moyamoya disease. Hemodynamic stress on the moyamoya vessels as collateral pathways has been attributed to the bleeding episodes. Bypass surgery has been performed for these patients to reduce the hemodynamic stress on the moyamoya vessels. However, it has not yet been statistically proven whether the bypass surgery can significantly decrease the recurrent bleeding attacks.
To establish the treatment guidelines for moyamoya disease with hemorrhagic onset, 20 Japanese centers have combined to evaluate the benefit of direct anastomotic bypass surgery such as superficial temporal artery to middle cerebral artery anastomosis in randomized patients who have experienced hemorrahgic episodes related to moyamoya disease and who have received either best medical treatment alone or best medical treatment plus bypass surgery. This prospective randomized controlled trial named as Japan Adult Moyamoya (JAM) Trial was initiated in January, 2001. Twenty-one patients have been already enrolled in this study.