Yuan Hongyao,Xu Xinke,Chen Cheng,et al.Analysis of diagnosis and surgical treatment of childhood moyamoya disease[J].Journal of Clinical Pediatric Surgery,,18():739-743.[doi:10.3969/j.issn.1671-6353.2019.09.006]
Analysis of diagnosis and surgical treatment of childhood moyamoya disease
- CLC:
- R726;R742
- Abstract:
- Objective To explore the diagnosis,surgical treatment and prognosis of moyamoya disease in young children.Methods From March 2015 to March 2018,clinical data retrospectively reviewed for 15 hospitalized children with moyamoya disease (age ≤ 6 years) were analyzed retrospectively.Their clinical features and surgical efficacies were summarized.And initial symptoms,Suzuki stages,imaging features,surgical approaches and surgical efficacy were analyzed.Results The initial symptoms were TIA (n=5),cerebral infarction (n=8) and headache & dizziness (n=2).And Suzuki stage was Ⅱ(n=1),Ⅲ(n=6),Ⅳ(n=5) and Ⅴ(n=3).Twelve children underwent a total of 17 side operations,including left (n=2),right (n=5) and bilateral (n=5).All children underwent encepho-dural-myo-synangiosis (EDMS) and three sides underwent concurrent multiple buur holes (MBH).The average follow-up period was 16.3 (12-30) months.MRA/DSA indicated that external carotid artery was compensated for blood supply to had better perfusion.Ischemic symptoms were relieved in 16 hemispheres (94.1%) and stabilized in 1 hemisphere (5.9%).There was one case of subdural hemorrhage and the remainder had no complications such as cerebral infarction,hemorrhage,diaphragmatic space-occupying or scalp necrosis.Conclusion EDMS is both safe and effective for MMD in young children.And combining EDMS and MBH of frontal bone for achieving a greater range of indirect revascularization may further improve cerebral perfusion.
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Memo
收稿日期:2019-06-23。
基金项目:国家自然科学基金（编号：81873739）
通讯作者:李军亮,Email:junliangli@aliyun.com