Abstract
An investigation was made for indication and timing of the operation on the basis of cerebral angiogrm, CT findings and pre- and post-operative clinical symptome. Eight infantile cases out of eighteen cases of occlusion of the circle of Willis were operated on at our university hospital from 1977 to 1980.
(Result) Infantile cases of occlusion of circle of Willis were classified into 3 types.
Type 1 means eary stage of occlusion of circle of Willis. Occlusive lesion is still confined to the anterior half of the Circle of Willis and development of moyamoya vessels and collateral circulation is incomplete.
Type 2 means typical case of occlusion of circle of Willis having moyamoya vessels and transdural anastomosis. Transit type means cases like adult type.
Case of type 1 with operation (STA-MCA anastomosis+EMS) showed good improvement of clinical symptomes immediately after operation, and marked increase of blood flow to MCA teritory by postoperative cerebral angiography.
On the other hand, cases of Type 1 without operation become Type 2.
Case of Transit type were not improved well by operation.
Therefor timing and indication of operation to occlusion of circle of Willis are good on the stage of Type 1.
