title: Edaravone Reduces Hyperperfusion-Related Neurological Deficits in Adult Moyamoya Disease: Historical Control Study.
abstract: OBJECTIVE
  Postoperative hyperperfusion-related transient neurological deficits (TNDs) are frequently observed in adult patients with moyamoya disease who undergo direct bypass procedures. The present study evaluated the effect of the free radical scavenger edaravone on postoperative hyperperfusion in adult moyamoya disease.
  
  
  METHODS
  This study included 92 hemispheres in 72 adult patients who underwent direct bypass for moyamoya disease. Serial measurements of cerebral blood flow were conducted immediately after surgery and on postoperative days 2 and 7. In 40 hemispheres for 36 patients, edaravone (60 mg/d) was administered from the day of surgery to postsurgical day 7. The incidence of postoperative hyperperfusion and associated TNDs were compared with a control group that included 52 hemispheres in 36 patients.
  
  
  RESULTS
  Radiological hyperperfusion was observed in 28 of 40 (70.0%) and 39 of 52 (75.0%) hemispheres in the edaravone and control groups, respectively (P=0.30). Hyperperfusion-related TND incidences were significantly lower in the edaravone group compared with the control group (12.5% versus 32.7%; P=0.024). Multivariate analysis demonstrated that edaravone administration (P=0.009) and left-sided surgery (P=0.037) were significantly correlated with hyperperfusion-related TNDs (odds ratios, 0.3 and 4.2, respectively).
  
  
  CONCLUSIONS
  Perioperative administration of edaravone reduced the incidence of hyperperfusion-related TNDs after direct bypass procedures in adult patients with moyamoya disease.
authors.affiliation: From the Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan (H.U., N.N., K.K., K.H.); and Department of Neurosurgery, University of Toyama, Japan (S.K.). uchinoh@hotmail.co.jp.
authors.forename: Haruto
authors.initials: H
authors.lastname: Uchino
authors.affiliation: From the Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan (H.U., N.N., K.K., K.H.); and Department of Neurosurgery, University of Toyama, Japan (S.K.).
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakayama
authors.affiliation: From the Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan (H.U., N.N., K.K., K.H.); and Department of Neurosurgery, University of Toyama, Japan (S.K.).
authors.forename: Ken
authors.initials: K
authors.lastname: Kazumata
authors.affiliation: From the Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan (H.U., N.N., K.K., K.H.); and Department of Neurosurgery, University of Toyama, Japan (S.K.).
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroda
authors.affiliation: From the Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan (H.U., N.N., K.K., K.H.); and Department of Neurosurgery, University of Toyama, Japan (S.K.).
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002548:Cerebral Revascularization / Q000009:adverse effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D000077553:Edaravone; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D065386:Historically Controlled Study; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D009072:Moyamoya Disease / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D009422:Nervous System Diseases / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D013699:Temporal Arteries / Q000601:surgery; D055815:Young Adult
chemical_list: D016166:Free Radical Scavengers; D000077553:Edaravone; D000983:Antipyrine
keywords: STA-MCA bypass; free radical scavengers; moyamoya disease; neurologic deficits; phenylmethylpyrazolone; reperfusion