Abstract
Surgical treatment for childhood moyamoya disease has been established in the past 2 decades by an organized nationwide study. However, some controversial problems remain in this surgical treatment that were underestimated in the past study. In this paper, we present set a study focused on the problems associated with the combined surgical treatment of direct and indirect bypass surgery.
During the past 12 years, we performed 66 surgeries on 35 patients of childhood Moyamoya disease (under 15 years of age). A new ischemic lesion was perioperatively observed in 2 surgeries, which were asymptomatic. Of these 35 patients, TIA or RIND was transiently observed in 22% postoperatively, which had disappeared in 1 year (mean). No completed infarction was seen in these patients postoperatively. Quality of life (QOL) was satisfactory in most patients with TIA onset although patients with preoperative completed infarction revealed mental retardation and poor activity of daily life (ADL).
Patients with moyamoya disease can expect a good ADL and QOL with proper treatment before completed infarction takes place. Early screening tests and proper surgery are indispensable to improve the overall outcome of the treatment of childhood moyamoya disease.
