LONG-TERM FOLLOW-UP-STUDY AFTER EXTRACRANIAL-INTRACRANIAL BYPASS-SURGERY FOR ANTERIOR CIRCULATION ISCHEMIA IN CHILDHOOD MOYAMOYA DISEASE

被引:196
作者
KARASAWA, J [1 ]
TOUHO, H [1 ]
OHNISHI, H [1 ]
MIYAMOTO, S [1 ]
KIKUCHI, H [1 ]
机构
[1] KYOTO UNIV, KYOTO 606, JAPAN
关键词
MOYAMOYA DISEASE; REVASCULARIZATION; STROKE; CHILDREN;
D O I
10.3171/jns.1992.77.1.0084
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Between May, 1974, and March, 1991, 104 patients with moyamoya disease, all under 16 years old at the time of first surgery, underwent superficial temporal-to-middle cerebral artery anastomosis and/or encephalomyosynangiosis. The mean follow-up period was 9.6 years (range 4.8 to 16.0 years). Hemiplegia was the most frequent symptom before the first operation. Transient ischemic attacks (TIA's) were noted in 57 patients and minor stroke with hemiplegia in 44. The most frequent type of cortical dysfunction was aphasia (21 cases). Postoperatively, the incidence of TIA's and/or completed stroke with motor weakness of the extremities was markedly decreased, but visual disturbance progressed and major or minor stroke with visual disturbance was found in two cases. In patients under the age of 3 years, a major stroke prior to surgery resulted in a poor outcome in 36% of cases. Preoperative major stroke in patients between the ages of 3 and 7 years was less frequent, and poor outcomes were seen in 17% of this group. There were no major preoperative strokes in patients with surgery after the age of 7 years, and no poor outcomes were recorded in this group. A major preoperative stroke prior to surgery had adverse impact on the ultimate patient intelligence quotient (IQ) following surgery. All patients operated on after the age of 7 years had a normal or borderline IQ at follow-up examination.
引用
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页码:84 / 89
页数:6
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