[Pial synangiosis for moyamoya disease. The Bordeaux experience].
BACKGROUND
Different surgical methods may be used for the treatment of moyamoya disease. The authors report their experience with pial synangiosis revascularization.


METHODS
We reviewed the clinical, surgical as well as radiographic records of all patients who underwent cerebral revascularization surgery using pial synangiosis for a symptomatic moyamoya disease at a single institution, Bordeaux University Hospital.


RESULTS
Over a 6-year period (2007-2013), 17 procedures were performed in 9 patients. Median age at presentation was 11.5 years and six patients presented with an ischemic event. As regards previous medical history, five patients were diagnosed with moyamoya syndrome. Median time between the symptoms onset and the first surgical procedure was 5.9 months. The average age of the first surgery was 11.8 years and the median time between the two synangiosis was 3.5 months. One patient died of a malignant ischemic stroke after the second procedure. At long-term follow-up, no patient experienced any symptoms recurrence.


CONCLUSIONS
Pial synangiosis typically results in an increase in collaterals from the superficial temporal artery or middle meningeal artery to the brain. It is a simple and effective surgical technique to prevent further moyamoya manifestation and to stabilize or improve the neurologic prognosis.
Service de neurochirurgie, hôpital Pellegrin, 33076 Bordeaux, France.
V
V
Jecko
Service de neurochirurgie, hôpital Pellegrin, 33076 Bordeaux, France.
G
G
Penchet
Department of Neurosurgery, Institute of Neurological Sciences, Southern General Hospital, 1345, Govan road, Glasgow G51 4TF, Royaume-Uni. Electronic address: Charles.Champeaux@gmail.com.
C
C
Champeaux
D000293:Adolescent; D002533:Cerebral Angiography / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008576:Meningeal Arteries / Q000473:pathology / Q000601:surgery*; D009072:Moyamoya Disease / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications*; D013699:Temporal Arteries / Q000601:surgery*; D016896:Treatment Outcome
Accident vasculaire cérébral; Brain stroke; Maladie de Moya-Moya; Moyamoya disease; Pial synangiosis; Reperfusion; Revascularisation; Revascularization; Synangiose piale