Mechanism of the re-buildup phenomenon in moyamoya disease--analysis of local cerebral hemodynamics with intra-arterial digital subtraction angiography.
The authors investigated the mechanism of the re-buildup phenomenon on electroencephalogram in 14 patients of moyamoya disease with superficial temporal artery-middle cerebral artery anastomosis. Visualization of the lateral view of the common carotid angiography was performed with intra-arterial digital subtraction angiography (IA-DSA), using a 4/sec x 3 sec + 2/sec x 5 sec + 1/sec x 5 sec film sequence. The catheter tip was inserted into C5/6 level and 250 mgI/ml of iopamidol was used as the contrast agent; 6 ml in total was injected over 1.5 seconds. Circulation times of the common carotid artery (C3 portion)-ascending parietal vein (delta TTPs) and common carotid artery-internal cerebral vein (delta TTPD) were measured before hyperventilation (HV), immediately after HV, and 3 minutes after HV during pre- and postoperative periods. delta TTPD in the preoperative period was prolonged by HV and was normalized at 3 minutes after HV but delta TTPs were prolonged immediately after and 3 minutes after HV. In the postoperative period, however, these values did not change significantly immediately after and 3 minutes after HV. These findings indicate that delayed cerebral blood flow response to HV is a pathogenetic factor of the re-buildup phenomenon in moyamoya disease.
Touho
H
H
Department of Neurosurgery, Osaka Neurological Institute.
Karasawa
J
J
Shishido
H
H
Morisako
T
T
Yamada
K
K
Nagai
S
S
Shibamoto
K
K
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002648:Child; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009072:Moyamoya Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*