Intracerebral hemorrhage after prophylactic revascularization in a patient with adult moyamoya disease.
BACKGROUND
The effect of revascularization surgery for a patient with moyamoya disease remains controversial.


METHODS
A 60-year-old man presented with bleeding from asymptomatic moyamoya vessels 10 years after prophylactic revascularization surgery. Cerebral angiography 10 years after the surgery demonstrated that the bilateral direct anastomoses remained effective and a small aneurysm persisted in the anterior choroidal artery. The territories of perfusion through the anastomoses and the size of the aneurysm remained unchanged compared with the angiograms performed 10 years ago.


CONCLUSIONS
Direct revascularization surgery may not always resolve microaneurysms in the moyamoya vessels and prevent rebleeding in patients with hemorrhagic moyamoya disease or bleeding in the nonaffected side.
Otawara
Yasunari
Y
Department of Neurosurgery, Iwate Medical University, Morioka, Iwate, 020-8505 Japan. ootawara-nsu@umin.ac.jp
Ogasawara
Kuniaki
K
Seki
Kaoru
K
Kibe
Michihiro
M
Kubo
Yoshitaka
Y
Ogawa
Akira
A
D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D002548:Cerebral Revascularization; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000150:complications / Q000601:surgery*; D017211:Treatment Failure