脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
特集 もやもや病
もやもや病間接血行再建術における中硬膜動脈の温存方法
杉野 寿哉三上 毅飯星 智史寶金 清博三國 信啓
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2012 年 40 巻 2 号 p. 89-93

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We present the preservation of middle meningeal artery (MMA) in surgical revascu-
larization for moyamoya disease. We examined 10 patients with moyamoya disease and performed surgical revascularization. The mean age of the patients was 27.8 years. We presurgically evaluated the three-dimensional (3-D) relationships of MMA and cranial sutures in the pterion by volumetric imaging of 3-D contrast enhanced computed tomography (CT). The 3-D anatomies were visualized by adjusting the window width, window level, and opacity level of the specific CT value for each structure, and the relationship of the MMA and the suture. This visualization was crucial for drilling to perform craniotomies. The MMA from bone to dura is exposed for drilling around the pterion. The preservation of the MMA with this method was achieved in all patients with moyamoya disease.
Presurgical evaluation using volumetric imaging of 3-D CT is a convenient and valuable method for obtaining the anatomic information. The usefulness of the drilling distal to the pterion in patients with moyamoya disease to preserve MMA was confirmed.
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© 2012 一般社団法人 日本脳卒中の外科学会
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