@article{oai:niigata-u.repo.nii.ac.jp:00017340, author = {竹内, 茂和}, issue = {6}, journal = {新潟医学会雑誌, 新潟医学会雑誌}, month = {Jun}, note = {Moyamoya disease is a rare cerebrovascular occlusive disease with unknown etiology, which is progressive in clinical, CT and angiographic findings. Hemispheric blood flow in both sides is low in most patients, and cortical circulation is very slow. Regional cerebral blood flow decreases in all sites of a hemisphere by hyperventilation, but not increases by CO2 inhalation. To evaluate efficacy of the surgical treatment for patients with ischemic type of moyamoya disease, fifty-one children, four adults with the onset of childhood and twelve adults with the onset of adulthood were studied. Both direct (STA-MCA anastomosis) and indirect (EMS, EGS, EDAS) bypasses and only indirect bypasses were performed in 34 and 63 sides of children and 21 and 7 sides of adults, respectively. The average follow-up period after surgery was 10 years. Perioperatve ischemic episodes, most of which were transient, were more frequently in case of direct bypass than indirect bypass alone. Ischemic episodes after a perioperatve period developed in 3 sides of children but no sides of adults. Mental deterioration and paresis of limbs tended to improve or not to aggravate in children compared to adults. Cerebrovascular reconstructive surgery for ischemic type of moyamoya disease was effective to improve symptoms and prevent subsequent episodes. Since both direct and various indirect bypasses have advantages as well as disadvantages, each method should be applied in combination with the other.}, pages = {355--361}, title = {モヤモヤ病(ウィリス動脈輪閉塞症)の外科治療}, volume = {111}, year = {1997} }