title: Early surgical treatment benefits early staged pediatric moyamoya disease--single case report.
abstract: OBJECTIVE
  Surgical revascularization for pediatric moyamoya disease improves cerebral blood flow (CBF) and consequently may prevent further ischemic events. However, the timing of the treatment is controversial especially for patients with no ischemic symptom and normal CBF. The purpose of this case report is to inform and infer the surgical treatment timing for pediatric moyamoya disease patients.
  
  
  METHODS
  A 10-year-old female patient with unilateral moyamoya disease complaining of only headache as a symptom and whose Suzuki stage was II or in transition to III by angiography and CBF was almost normal was admitted to Tokyo Women's Medical University Hospital. We performed superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses for the patient because we estimated her headache was derived from low perfusion in the brain. STA-MCA bypass surgery was not only effective for relief of her severe headache but also valid for her cerebral perfusion. Her angiography showed much supply from external carotid artery to intracranial arteries via bypass grafts in 7 months.
  
  
  CONCLUSIONS
  Our case showed early surgical treatment was beneficial for relief of severe headache even for early staged pediatric moyamoya disease patients by improving perfusion pressure and cerebral circulation.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Matsuoka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Aihara
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Akitsugu
authors.initials: A
authors.lastname: Kawashima
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Okada
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009072:Moyamoya Disease / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*