Case Reports
Bilateral Improvement of Cerebrovascular Reserve Following Unilateral Revascularization Surgery in Moyamoya Disease: A Case Report
2022 Volume 50 Issue 1 Pages 59-63
Details
2022 Volume 50 Issue 1 Pages 59-63
A 37-year-old man suffered a right hemispheric watershed infarction due to moyamoya disease (MMD). Single-photon emission computed tomography (SPECT) revealed a decrease in the cerebrovascular reserve (CVR) mainly in the left hemisphere. Cerebral angiography revealed the presence of a steal phenomenon from the right anterior cerebral artery (ACA) territory to the left ACA territory via the anterior communicating artery. He underwent left revascularization surgery four months after his first visit, and the postoperative course was uneventful. SPECT three months after the surgery revealed an increase in the CVR, but it was still insufficient. Furthermore, we planned a revascularization surgery for the other side. However, the surgery was postponed because of an inflammatory response caused by a periodontal disease. SPECT performed 18 months after the surgery revealed normalized CVR in both the cerebral hemispheres.
Based on the findings of SPECT, this is the first case to report an improvement in CVR in the hemisphere contralateral to the side where revascularization surgery for MMD was performed.
