Abstract
Twelve patients with Moyamoya disease were treated by Encephalo-Myo-Synangiosis (EMS) for the purpose of increasing external and internal collateral circulation. Fourteen EMS were performed in 10 patients, and 3 EMS and STA-MCA anastomosis were performed simultaneously in 2. The ages of the patients ranged from 7 to 46 years, and 9 patients were under 16-year-old. Their clinical manifestations were caused by the cerebral ischemia.
They were followed for 4 to 20 months. Decrease of TIA and improvements of paresis, ataxia, involuntary movement and dysarthria were obtained markedly in most of the young patients. But there were little improvements in the adult patients.
Postoperative external carotid angiogram showed good visualization of the middle cerebral arteries via the dilated deep temporal artery in most of the patients. Increased collateral circulation via the deep temporal artery after EMS seemed to be equal to that via STA after STA-MCA anastomosis. Abnormal vascular networks in the region of the basal ganglia were reduced in most of the patients underwent EMS.
Improvements on EEG and cerebral blood flow measured by 133Xe inhalation method were also obtained in most of the patients.
EMS is considered to be enough for surgical treatment of Moyamoya disease with symptoms by the cerebral ischemia, especially in the young patients.
