What is it about?
Hyperperfusion syndrome (HPS) is a notable complication causing various neurological symptoms after superficial temporal artery (STA)-middle cerebral artery (MCA) bypass surgery for moyamoya disease (MMD). We measured the change in microvascular transit time (MVTT) after bypass surgery with intraoperative indocyanine green video angiography (ICG-VA) and demonstrated that MVTT in MMD patients was reduced significantly after bypass surgery. Patients with a ΔMVTT greater than 2.6 s tended to develop postoperative HPS. ΔMVTT can be a useful diagnostic tool for identifying patients at high risk for HPS after STA-MCA bypass surgery for MMD.
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Why is it important?
In the present study, we demonstrated for the first time that prolonged MVTT in MMD patients was reduced after bypass surgery. Although the pathogenesis of HPS in MMD is not fully clarified, the reduction in MVTT after bypass surgery suggests vasoparalysis due to long-standing vasodilation.Multivariate analysis revealed that ΔMVTT greater than 2.6 s was an independent predictor of postoperative HPS after STA-MCA bypass surgery in MMD patients. MVTT is a convenient index for identifying patients at high risk of postoperative HPS.
Perspectives
Results of the present study can contribute to improved management of patients with MMD undergoing STA-MCA bypass surgery.
Prof Hiroharu Kataoka
National Cerebral and Cardiovascular Center
Read the Original
This page is a summary of: Clinical implications of the cortical hyperintensity belt sign in fluid-attenuated inversion recovery images after bypass surgery for moyamoya disease, Journal of Neurosurgery, January 2017, Journal of Neurosurgery Publishing Group (JNSPG),
DOI: 10.3171/2015.10.jns151022.
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