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Mamiya T, Araki Y, Taoka T, Fujita N, Yokoyama K, Uda K, Muraoka S, Kanamori F, Takayanagi K, Ishii K, Nishihori M, Izumi T, Kato K, Saito R. Characteristics of donor vessels and cerebral blood flow in the chronic phase after combined revascularization surgery for moyamoya disease. Clin Neurol Neurosurg 2024; 236:108110. [PMID: 38171051 DOI: 10.1016/j.clineuro.2023.108110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE This study aimed to analyze whether the development of donor vessels after combined revascularization surgery for moyamoya disease (MMD) is related to cerebral blood flow (CBF) changes. METHODS We retrospectively reviewed the charts of 11 adult (12 hemispheres) and 13 pediatric (19 hemispheres) patients who underwent combined revascularization in our department. The total vessel cross-sectional area (TVA) was the sum of the cross-sectional areas of the superficial temporal, middle meningeal, and deep temporal arteries imaged using time-of-flight magnetic resonance angiography. The ipsilateral relative CBF (RCBF) on the brain surface in the craniotomy area was calculated by single-photon emission computed tomography. ΔTVA and ΔRCBF were defined as the preoperative and postoperative ratios of TVA and RCBF, and their correlations were analyzed in adult and pediatric patients. RESULTS The TVA and RCBF showed a significant increase after surgery, regardless of the age group. However, there was no significant correlation between ΔTVA and ΔRCBF in either the adult or pediatric groups. While the adult group exhibited significantly higher ΔRCBF values compared to the pediatric group (p < 0.01, r = -0.44), the ΔTVA values were higher in the pediatric group compared to the adult group (p = 0.06). CONCLUSIONS In the chronic phase after combined revascularization surgery for MMD, the development of measurable TVA of donor vessels does not necessarily correlate with an increase in CBF around the craniotomy area.
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Affiliation(s)
- Takashi Mamiya
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan.
| | - Yoshio Araki
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Toshiaki Taoka
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, Japan
| | - Kinya Yokoyama
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Kenji Uda
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Shinsuke Muraoka
- Department of Neurosurgery, Tosei General Hospital, Seto, Aichi, Japan
| | - Fumiaki Kanamori
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Kai Takayanagi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Kazuki Ishii
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Masahiro Nishihori
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Takashi Izumi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
| | - Katsuhiko Kato
- Functional Medical Imaging, Biomedical Imaging Sciences, Division of Advanced Information Health Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, Aichi, Japan
| | - Ryuta Saito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, Japan
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Hirayama A, Yonemochi T, Yokota K, Shigematsu H, Srivatanakul K, Sorimachi T. Cerebrovascular Reserve Impairment in the Anterior Cerebral Artery Territory Predicts Deep Temporal Artery Enlargement After Combined Revascularization Surgery in Moyamoya Disease. World Neurosurg 2022; 167:e344-e349. [PMID: 35963608 DOI: 10.1016/j.wneu.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A combined surgery of direct and indirect revascularization has been frequently performed in patients with moyamoya disease, though the efficacy of indirect revascularization surgery in adult patients with moyamoya disease has not been established. This study aimed to evaluate superficial temporal artery (STA) and deep temporal artery (DTA) diameters 1 day and 3 months after combined revascularization surgery in patients with moyamoya disease. We also investigated clinical factors related to DTA enlargement after surgery. METHODS We examined 78 cerebral hemispheres in 57 adult and pediatric patients with moyamoya disease who underwent combined revascularization surgery [STA-MCA bypass and encephalo-duro-myo-synangiosis] in our institution. STA and DTA diameters were measured on axial magnetic resonance angiography images at 1 day and 3 months after surgery. RESULTS DTA diameter increased in 64 hemispheres (82.1%). DTA diameter increase in association with STA diameter decrease was found in 39 hemispheres (50%). The proportion of hemispheres with a reduction in STA diameter was significantly higher in hemispheres with DTA enlargement than in hemispheres with DTA reduction (P = 0.0088). Among the 64 hemispheres with DTA enlargement, 51 (79.7%) showed cerebrovascular reserve (CVR) impairment in the anterior cerebral artery (ACA) territory before surgery. CVR impairment in the ACA territory was the only clinical factor related to DTA enlargement (P < 0.001). CONCLUSION The DTA frequently enlarges after combined revascularization surgery, even in adult patients with moyamoya disease. In patients with impaired CVR in the ACA territory, blood supply from the DTA to the ACA territory can be expected after combined revascularization surgery.
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Affiliation(s)
- Akihiro Hirayama
- Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Takuya Yonemochi
- Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Kazuma Yokota
- Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Hideaki Shigematsu
- Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Takatoshi Sorimachi
- Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan
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Fujimura M, Tominaga T, Kuroda S, Takahashi JC, Endo H, Ogasawara K, Miyamoto S. 2021 Japanese Guidelines for the Management of Moyamoya Disease: Guidelines from the Research Committee on Moyamoya Disease and Japan Stroke Society. Neurol Med Chir (Tokyo) 2022; 62:165-170. [PMID: 35197402 PMCID: PMC9093674 DOI: 10.2176/jns-nmc.2021-0382] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Miki Fujimura
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Satoshi Kuroda
- Department of Neurosurgery, University of Toyama School of Medicine
| | - Jun C Takahashi
- Department of Neurosurgery, Kindai University Faculty of Medicine
| | | | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University School of Medicine
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
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Ito M, Kawabori M, Sugiyama T, Tokairin K, Tatezawa R, Uchino H, Kazumata K, Houkin K, Fujimura M. Impact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct/indirect combined revascularization surgery for adult Moyamoya disease. Neurosurg Rev. [DOI: 10.1007/s10143-022-01749-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
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Shulgina AA, Lukshin VA, Usachev DY, Korshunov AE, Belousova OB, Pronin IN. [Combined cerebral revascularization for moyamoya disease]. Zh Vopr Neirokhir Im N N Burdenko 2021; 85:47-59. [PMID: 33864668 DOI: 10.17116/neiro20218502147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Combined cerebral revascularization with direct and indirect components is recognized as the most appropriate method for treating patients with Moyamoya disease all over the world, however, large studies on its effectiveness in Russia have not yet been conducted. THE AIM OF THE STUDY Was to evaluate the results of combined cerebral revascularization in patients with Moyamoya disease with an analysis of the clinical state and perfusion and angiographic features of neoangiogenesis. MATERIAL AND METHODS For the period from 2013 to 2020 in N.N. Burdenko National Medical Research Center of Neurosurgery 79 combined revascularizations were performed in 55 patients with Moyamoya disease. The average age was 13.9±10.11 years. All patients were examined according to a single protocol, including a comprehensive assessment of the clinical symptoms, the state of the brain tissue, the cerebral vascular system, and cerebral blood flow. The results of surgical treatment were evaluated in the early postoperative and long-term periods. The average follow-up period was 14.66±13.17 months. In the postoperative period, the dynamics of neurological status and cerebral blood flow were assessed and the features of neoangiogenesis from various components of revascularization were studied. RESULTS In the early postoperative period, in 77.2% of cases, a good treatment result was observed, with no negative dynamics of the neurological status. Ischemic stroke in the operated hemisphere developed in 4 cases (5.1%). In the follow-up period, an improvement in neurological symptoms was observed in 76.6%. Improvement of cerebral blood flow was noted in 92.4% of cases, direct anastomoses functioned in 94.3%, and signs of neovascularization in the area of indirect synangiosis were observed in 80.0%. At the same time, a complementary influence of direct and indirect components of revascularization was revealed in ensuring good general angiographic and perfusion results. CONCLUSIONS Combined revascularization is a highly effective method of surgical treatment of all patients with Moyamoya disease.
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Affiliation(s)
| | - V A Lukshin
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | | | | | - I N Pronin
- Burdenko Neurosurgical Center, Moscow, Russia
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Matsuo S, Amano T, Miyamatsu Y, Yamashita S, Yasaka M, Okada Y, Nakamizo A. Carotid ultrasonography predicts collateral development following combined direct and indirect revascularization surgery in adult ischemic Moyamoya disease. Clin Neurol Neurosurg 2021; 203:106590. [PMID: 33711640 DOI: 10.1016/j.clineuro.2021.106590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/12/2021] [Accepted: 02/27/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The relationship between carotid ultrasonographic parameters and postoperative collateral development in adult ischemic moyamoya disease (MMD) patients who received combined direct and indirect revascularization surgery remains unclear. Herein, we investigated the postoperative changes in carotid ultrasonographic parameters in patients with adult ischemic MMD. METHODS We studied 28 adult ischemic MMD patients (31 hemispheres) who underwent combined revascularization surgery. Patients underwent preoperative and postoperative (within 14 days and 3, 12, and 24 months after surgery) magnetic resonance imaging and carotid ultrasonography. We defined the hemisphere in which all signal intensities of the superficial temporal, middle meningeal, and deep temporal arteries were increased compared with that before surgery on magnetic resonance angiography as well-developed collateral establishment. RESULTS Patients with good collateral establishment on MRA at 2-year after surgery had a lower external carotid artery (ECA) pulsatility index (PI) (P = 0.0413) and ECA/internal carotid artery (ICA) pulsatility index (PI) ratio (P = 0.0427) at 3-month post-operation. At 3-month post-operation, a cut-off ECA PI of 1.416 (sensitivity 40.0 %, specificity 92.3 %, area under the curve 0.7282, likelihood ratio 5.20, P = 0.0404) and ECA/ICA PI ratio of 0.8768 (sensitivity 50.0 %, specificity 92.31 %, area under the curve 0.7308, likelihood ratio 6.50, P = 0.0415) provided reliable values for good prediction of collateral development at 2 years after revascularization. CONCLUSION ECA/ICA PI ratio and ECA PI at 3-month after surgery can be one of the indicators for predicting future well-developed neovascularization on MRA and better outcome in patients with adult ischemic MMD who received combined direct and indirect revascularization surgery.
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Affiliation(s)
- Satoshi Matsuo
- Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
| | - Toshiyuki Amano
- Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yuichiro Miyamatsu
- Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Sojiro Yamashita
- Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masahiro Yasaka
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasushi Okada
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Akira Nakamizo
- Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Nishizawa T, Fujimura M, Katsuki M, Mugikura S, Tashiro R, Sato K, Tominaga T. Prediction of Cerebral Hyperperfusion after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis by Three-Dimensional-Time-of-Flight Magnetic Resonance Angiography in Adult Patients with Moyamoya Disease. Cerebrovasc Dis 2020; 49:396-403. [DOI: 10.1159/000509740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/24/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction: Superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis is an effective surgical procedure for adult patients with moyamoya disease (MMD) and is known to have the potential to prevent cerebral ischemia and/or hemorrhagic stroke. Cerebral hyperperfusion (CHP) syndrome is one of the serious complications of this procedure that can result in deleterious outcomes, such as delayed intracerebral hemorrhage, but the prediction of CHP before revascularization surgery remains challenging. The present study evaluated the diagnostic value of preoperative three-dimensional (3D)-time-of-flight (TOF) magnetic resonance angiography (MRA) for predicting CHP after STA-MCA anastomosis for MMD. Materials and Methods: The signal intensity of the peripheral portion of the intracranial major arteries, such as the anterior cerebral artery (ACA), MCA, and posterior cerebral artery (PCA) ipsilateral to STA-MCA anastomosis, on preoperative MRA was graded (0–2 in each vessel) according to the ability to visualize each vessel on 97 affected hemispheres in 83 adult MMD patients. Local cerebral blood flow (CBF) at the site of anastomosis was quantitatively measured by N-isopropyl-p-[123I]-iodoamphetamine single-photon emission computed tomography 1 and 7 days after surgery, in addition to the preoperative CBF value at the corresponding area. Then, we investigated the correlation between the preoperative MRA score and the development of CHP. Results: The CHP phenomenon 1 day after STA-MCA anastomosis (local CBF increase over 150% compared with the preoperative value) was evident in 27 patients (27/97 hemispheres; 28%). Among them, 8 (8 hemispheres) developed CHP syndrome. Multivariate analysis revealed that the hemispheric MRA score (0–6), the summed ACA, MCA, and PCA scores for the affected hemisphere, was significantly associated with the development of CHP syndrome (p = 0.011). The hemispheric MRA score was also significantly correlated with the CHP phenomenon, either symptomatic or asymptomatic (p < 0.001). Conclusion: The signal intensity of the intracranial major arteries, including the ACA, MCA, and PCA, on preoperative 3D-TOF MRA may identify adult MMD patients at higher risk for CHP after direct revascularization surgery.
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Ishii D, Okazaki T, Matsushige T, Shinagawa K, Sakamoto S, Oshita J, Kurisu K. Chronic Dilatation of Superficial Temporal Artery and Middle Meningeal Artery Associated with Development of Collateral Circulation After Bypass Surgery for Moyamoya Angiopathy. World Neurosurg 2018; 119:e864-e873. [DOI: 10.1016/j.wneu.2018.07.287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
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TOMINAGA T, SUZUKI N, MIYAMOTO S, KOIZUMI A, KURODA S, TAKAHASHI JC, FUJIMURA M, HOUKIN K. Recommendations for the Management of Moyamoya Disease: A Statement from Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) [2nd Edition]. ACTA ACUST UNITED AC 2018. [DOI: 10.2335/scs.46.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Teiji TOMINAGA
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Norihiro SUZUKI
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Susumu MIYAMOTO
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Akio KOIZUMI
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Satoshi KURODA
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Jun C. TAKAHASHI
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Miki FUJIMURA
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
| | - Kiyohiro HOUKIN
- On behalf of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) Research on Intractable Diseases of the Ministry of Health, Labour and Welfare
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Ishii D, Okazaki T, Matsushige T, Shinagawa K, Ichinose N, Sakamoto S, Kurisu K. Postoperative Dilatation of Superficial Temporal Artery Associated with Transient Neurologic Symptoms After Direct Bypass Surgery for Moyamoya Angiopathy. World Neurosurg 2017; 106:435-441. [PMID: 28720528 DOI: 10.1016/j.wneu.2017.07.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In moyamoya angiopathy, transient neurologic symptoms (TNS) are occasionally observed after superficial temporal artery (STA)-middle cerebral artery direct bypass surgery. The purpose of this study was to investigate the correlation between TNS and postoperative magnetic resonance imaging as well as perform a perfusion study. METHODS We reviewed 52 hemispheres in 33 consecutive patients with moyamoya angiopathy. TNS were defined as reversible neurologic dysfunction without any apparent intracranial infarction or hemorrhage. All patients underwent magnetic resonance imaging and single-photon emission computed tomography before and within 5 days after surgery. Maximum diameter of STA on time-of-flight magnetic resonance angiography and the dilatation ratio of STA were calculated. The presence of signal changes on fluid-attenuated inversion recovery images and regional cerebral blood flow were also evaluated. RESULTS TNS were observed in 13 of 52 (25%) cases 1-16 days after surgery. The mean preoperative STA dilatation, postoperative STA dilatation, and dilatation ratio of STA were 1.33 mm ± 0.27, 1.67 mm ± 0.30, and 29.31% ± 28.13%. Postoperative intraparenchymal cortical hyperintensity lesions and high-intensity signals in the cortex sulci (ivy sign) were detected in 24 (46.2%) cases and 29 (55.8%) cases, respectively. Univariate analyses demonstrated no association between TNS and postoperative signal change on fluid-attenuated inversion recovery images as well as cerebral blood flow. Only >1.5-fold dilatation of STA was significantly correlated with TNS (P < 0.0001). CONCLUSIONS STA dilatation was correlated with TNS after direct bypass surgery for moyamoya angiopathy.
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Affiliation(s)
- Daizo Ishii
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Takahito Okazaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshinori Matsushige
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Katsuhiro Shinagawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuhiko Ichinose
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigeyuki Sakamoto
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kaoru Kurisu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Wang P, Guan P, Guo J, Cao L, Xu G, Yu X, Wang Y, Wang Z. Prostaglandin I2 upregulates the expression of anterior pharynx-defective-1α and anterior pharynx-defective-1β in amyloid precursor protein/presenilin 1 transgenic mice. Aging Cell 2016; 15:861-71. [PMID: 27240539 PMCID: PMC5013024 DOI: 10.1111/acel.12495] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2016] [Indexed: 12/30/2022] Open
Abstract
Cyclooxygenase‐2 (COX‐2) has been recently identified to be involved in the pathogenesis of Alzheimer's disease (AD). Yet, the role of an important COX‐2 metabolic product, prostaglandin (PG) I2, in the pathogenesis of AD remains unknown. Using human‐ and mouse‐derived neuronal cells as well as amyloid precursor protein/presenilin 1 (APP/PS1) transgenic mice as model systems, we elucidated the mechanism of anterior pharynx‐defective (APH)‐1α and pharynx‐defective‐1β induction. In particular, we found that PGI2 production increased during the course of AD development. Then, PGI2 accumulation in neuronal cells activates PKA/CREB and JNK/c‐Jun signaling pathways by phosphorylation, which results in APH‐1α/1β expression. As PGI2 is an important metabolic by‐product of COX‐2, its suppression by NS398 treatment decreases the expression of APH‐1α/1β in neuronal cells and APP/PS1 mice. More importantly, β‐amyloid protein (Aβ) oligomers in the cerebrospinal fluid (CSF) of APP/PS1 mice are critical for stimulating the expression of APH‐1α/1β, which was blocked by NS398 incubation. Finally, the induction of APH‐1α/1β was confirmed in the brains of patients with AD. Thus, these findings not only provide novel insights into the mechanism of PGI2‐induced AD progression but also are instrumental for improving clinical therapies to combat AD.
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Affiliation(s)
- Pu Wang
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Pei‐Pei Guan
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Jing‐Wen Guo
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Long‐Long Cao
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Guo‐Biao Xu
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Xin Yu
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Yue Wang
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
| | - Zhan‐You Wang
- College of Life and Health Sciences Northeastern University Shenyang 110819 China
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Takizawa K, Sorimachi T, Ishizaka H, Osada T, Srivatanakul K, Momose H, Matsumae M. Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma. J Neurosurg 2016; 124:1679-83. [DOI: 10.3171/2015.5.jns1567] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
The middle meningeal artery (MMA) is suspected to play an important role in the development of chronic subdural hematoma (CSDH). The aim of this study was to clarify whether the MMA was enlarged in patients with CSDHs.
METHODS
The authors retrospectively assessed 55 patients in whom CSDH was diagnosed between 2010 and 2014 and who underwent MR angiography (MRA) after the onset of CSDH. The authors compared MMA diameters between hemispheres with and without CSDHs on MR angiograms. A case-control study was also performed with 55 sex- and age-matched patients with incidental unruptured aneurysms as controls.
RESULTS
In 55 patients with CSDHs, the diameters of the 79 MMAs on the CSDH side were significantly larger than the diameters of the 31 MMAs on the non-CSDH side (p < 0.05). In 24 patients with bilateral CSDHs, no significant difference was found between the MMA diameters on the larger hematoma side and those on the smaller hematoma side. In 13 patients who underwent MRA before the onset of the CSDH, the MMAs on MR angiograms acquired after onset of the CSDH were significantly larger than those on MR angiograms acquired before the CSDH onset (p < 0.05). The diameters of the MMAs in 55 patients with CSDHs were significantly larger than those of the MMAs in the 55 control patients (p < 0.05).
CONCLUSIONS
The MMA is enlarged with development of a CSDH. Information about the MMA observed on MRA in patients with CSDHs may be useful in developing a strategy for future treatment of CSDHs.
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Abstract
The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases. However, no systematic review describing the importance of MMA has been published. In this study, we used the PUBMED database to perform a review of the literature on the MMA to increase our understanding of its role in neurosurgery. After performing this review, we found that the MMA was commonly used to access DAVFs and meningiomas. Pseudoaneurysms and true aneurysms in the MMA can be effectively treated via endovascular or surgical removal. In MMD, the MMA plays a very important role in the development of collateral circulation and indirect revascularization. For recurrent CDSHs, after burr hole irrigation and drainage have failed, MMA embolization may be attempted. The MMA can also contribute to the occurrence and treatment of migraines. Because the ophthalmic artery can ectopically originate from the MMA, caution must be taken to avoid causing damage to the MMA during operations.
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Affiliation(s)
- Jinlu Yu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yunbao Guo
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Baofeng Xu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Kan Xu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
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14
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Cho HH, Cheon JE, Kim SK, Choi YH, Kim IO, Kim WS, Lee SM, You SK, Shin SM. Quantitative Assessment of Neovascularization after Indirect Bypass Surgery: Color-Coded Digital Subtraction Angiography in Pediatric Moyamoya Disease. AJNR Am J Neuroradiol 2015; 37:932-8. [PMID: 26680463 DOI: 10.3174/ajnr.a4614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 09/15/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE For the postoperative follow-up in pediatric patients with Moyamoya disease, it is essential to evaluate the degree of neovascularization status. Our aim was to quantitatively assess the neovascularization status after bypass surgery in pediatric Moyamoya disease by using color-coded digital subtraction angiography. MATERIALS AND METHODS Time-attenuation intensity curves were generated at ROIs corresponding to surgical flap sites from color-coded DSA images of the common carotid artery, internal carotid artery, and external carotid artery angiograms obtained pre- and postoperatively in 32 children with Moyamoya disease. Time-to-peak and area under the curve values were obtained. Postoperative changes in adjusted time-to-peak (ΔTTP) and ratios of adjusted area under the curve changes (ΔAUC ratio) of common carotid artery, ICA, and external carotid artery angiograms were compared across clinical and angiographic outcome groups. To analyze diagnostic performance, we categorized clinical outcomes into favorable and unfavorable groups. RESULTS The ΔTTP at the common carotid artery increased among clinical and angiographic outcomes, in that order, with significant differences (P = .003 and .005, respectively). The ΔAUC ratio at the common carotid artery and external carotid artery also increased, in that order, among clinical and angiographic outcomes with a significant difference (all, P = .000). The ΔAUC ratio of ICA showed no significant difference among clinical and angiographic outcomes (P = .418 and .424, respectively). The ΔTTP for the common carotid artery of >1.27 seconds and the ΔAUC ratio of >33.5% for the common carotid artery and 504% for the external carotid artery are revealed as optimal cutoff values between favorable and unfavorable groups. CONCLUSIONS Postoperative changes in quantitative values obtained with color-coded DSA software showed a significant correlation with outcome scores and can be used as objective parameters for predicting the outcome in pediatric Moyamoya disease, with an additional cutoff value calculated through the receiver operating characteristic curve.
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Affiliation(s)
- H-H Cho
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea
| | - J-E Cheon
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea Department of Radiology (J.-E.C., Y.H.C., I.-O.K., W.S.K.), Seoul National University College of Medicine, Seoul, Korea Institute of Radiation Medicine (J.-E.C., I.-O.K., W.S.K.), Seoul National University Medical Research Center, Seoul, Korea
| | - S-K Kim
- Division of Pediatric Neurosurgery (S.-K.K.), Seoul National University Children's Hospital, Seoul, Korea
| | - Y H Choi
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea Department of Radiology (J.-E.C., Y.H.C., I.-O.K., W.S.K.), Seoul National University College of Medicine, Seoul, Korea
| | - I-O Kim
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea Department of Radiology (J.-E.C., Y.H.C., I.-O.K., W.S.K.), Seoul National University College of Medicine, Seoul, Korea Institute of Radiation Medicine (J.-E.C., I.-O.K., W.S.K.), Seoul National University Medical Research Center, Seoul, Korea
| | - W S Kim
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea Department of Radiology (J.-E.C., Y.H.C., I.-O.K., W.S.K.), Seoul National University College of Medicine, Seoul, Korea Institute of Radiation Medicine (J.-E.C., I.-O.K., W.S.K.), Seoul National University Medical Research Center, Seoul, Korea
| | - S-M Lee
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea
| | - S K You
- From the Department of Radiology (H.-H.C., J.-E.C., Y.H.C., I.-O.K., W.S.K., S.-M.L., S.K.Y.), Seoul National University Hospital, Seoul, Korea
| | - S-M Shin
- Department of Radiology (S.-M.S.), Seoul Metropolitan Government-Seoul National University, Boramae Medical Center, Seoul, Korea
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15
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Ancelet C, Boulouis G, Blauwblomme T, Kossorotoff M, Rodriguez-regent C, Mellerio C, Grevent D, Meder J, Trystram D, Oppenheim C, Zerah M, Puget S, Sainte-rose C, Boddaert N, Brunelle F, Naggara O. Imagerie du Moya-Moya. Rev Neurol (Paris) 2015; 171:45-57. [DOI: 10.1016/j.neurol.2014.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 11/11/2014] [Indexed: 01/15/2023]
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16
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Guidelines for Diagnosis and Treatment of Moyamoya Disease (Spontaneous Occlusion of the Circle of Willis). Neurol Med Chir (Tokyo) 2012; 52:245-66. [DOI: 10.2176/nmc.52.245] [Citation(s) in RCA: 601] [Impact Index Per Article: 50.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Affiliation(s)
- Koji YOSHINAGA
- Reproductive Sciences Branch, NICHD, NIH, DHHS, Maryland 20892-7510, USA
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18
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Wu M, Huang Z, Zhang D, Wang L, Sun J, Wang S, Zhao Y, Zhao J. Color doppler hemodynamic study of the superficial temporal arteries in superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery for Moyamoya disease. World Neurosurg 2011; 75:258-63. [PMID: 21492727 DOI: 10.1016/j.wneu.2010.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 09/10/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To observe the hemodynamic changes of the superficial temporal artery (STA) by color Doppler and the correlation between the results of angiography and the hemodynamic changes of the STA after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery for moyamoya disease. METHODS This study included 26 cases of moyamoya disease; standard STA-MCA bypass surgery were performed in all patients. GE-LOGIQ9 color ultrasound with 7L transducer was used to monitor STA hemodynamic changes, including peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (Vm), pulse index (PI), and resistance index (RI), preoperatively and 1 week and 3 months after surgery in 10 cases. In 22 cases, color Doppler of STA and digital subtraction angiography of the external carotid artery (ECA), internal carotid artery (ICA), common carotid artery (CCA), and vertebral artery (VA) were performed preoperatively and 1 week after surgery. Based on the patency of STA-MCA on angiography, the patients were divided into two groups: 11 patients were in the patent group, and 11 patients were in the nonpatent group. Statistical significance was evaluated using analysis of variance of random block design and paired samples t test. SPSS software version 11.5 was used. RESULTS In the 10 cases, there was no significant difference among the three imaging series in PSV. Compared with the preoperative values, the values of EDV and Vm 1 week and 3 months after surgery were significantly higher (P < 0.05). The difference was not significant, however, between 1 week and 3 months after surgery. The PI and RI at 1 week and 3 months after surgery were significantly lower than the preoperative values (P < 0.05); there was no significant difference between 1 week and 3 months after surgery. Among the 22 cases, the values of PSV, EDV, and Vm increased significantly (P < 0.05) and the values of PI and RI decreased significantly(P < 0.01) after surgery in the patent group. In the nonpatent group, the values of PSV and PI decreased significantly after surgery (P < 0.05). EDV, Vm, and RI had no significant changes after surgery. CONCLUSIONS Higher blood flow can develop in anastomosed STA after STA-MCA bypass surgery. The hemodynamic changes of STA after surgery mainly occurred at an early period after operation with little change at 3-month follow-up examination. The increase of blood flow in STA may be due to the low resistance of the intracranial vascular bed. Postoperative Doppler examination of the STA may predict angiographic results of the anastomosis in the early postoperative period. Continuous observation is necessary to identify an accurate correlation between quantitative alteration of the Doppler parameters and angiographic results.
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Affiliation(s)
- Mingxing Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Bacigaluppi S, Dehdashti AR, Agid R, Krings T, Tymianski M, Mikulis DJ. The contribution of imaging in diagnosis, preoperative assessment, and follow-up of moyamoya disease. Neurosurg Focus 2009; 26:E3. [DOI: 10.3171/2009.01.focus08296] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this review was to evaluate the imaging tools used in diagnosis and perioperative assessment of moyamoya disease, with particular attention to the last decade.
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Affiliation(s)
- Susanna Bacigaluppi
- 1Divisions of Neurosurgery and
- 3Department of Neurosciences and Biomedical Technologies, University of Milan-Bicocca, Milan, Italy
| | | | - Ronit Agid
- 2Neuroradiology, University Health Network, Toronto Western Hospital, University of Toronto, Ontario, Canada; and
| | - Timo Krings
- 2Neuroradiology, University Health Network, Toronto Western Hospital, University of Toronto, Ontario, Canada; and
| | | | - David J. Mikulis
- 2Neuroradiology, University Health Network, Toronto Western Hospital, University of Toronto, Ontario, Canada; and
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