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1.
Rev. bras. cir. cardiovasc ; 33(3): 309-311, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-958415

ABSTRACT

Abstract Moyamoya disease is a rare, idiopathic, progressive, occlusive disease of the internal carotid artery characterized by the development of collateral vasculature in the brain base. In patients with accompanying coronary artery disease, cardiopulmonary bypass posses a potential risk for perioperative cerebral ischemic complication. Herein, we report a 53-year-old male case of Moyamoya disease and coronary artery disease who was treated with off-pump coronary artery bypass grafting.


Subject(s)
Humans , Male , Middle Aged , Coronary Stenosis/complications , Coronary Artery Bypass, Off-Pump/methods , Moyamoya Disease/surgery , Angiography, Digital Subtraction/methods , Risk Factors , Treatment Outcome , Coronary Angiography/methods , Ultrasonography, Doppler/methods , Coronary Stenosis/diagnostic imaging , Moyamoya Disease/diagnostic imaging
2.
Rev. chil. neurocir ; 41(2): 116-119, nov. 2015. ilus
Article in Spanish | LILACS | ID: biblio-869731

ABSTRACT

La Enfermedad Moyamoya es una arteriopatia oclusiva progresiva de los vasos cerebrales, específicamente de la porción distal de las arterias carótidas internas, por lo general con compromiso bilateral. Esta oclusión trae como consecuencia dilatación de los vasos sanguíneos colaterales con el objetivo de convertirse en vías de circulación colateral, de donde la enfermedad adopta su nombre, debido a la apariencia angiográfica de “nube de humo” de estos pequeños vasos dilatados. Clínicamente se manifiesta como eventos cerebrovasculares isquémicos debido a la oclusión de los vasos mencionados o como eventos hemorrágicos debido a la ruptura de los pequeños vasos sanguíneos dilatados. Presentamos el caso de una paciente femenina de 38 años, que acude al hospital en estado de coma, cuya tomografía computarizada revela hemorragia intraventricular que fue tratada con derivación ventricular externa más activador de plasminógeno tisular. Posterior a su estabilización clínica se realizó angiografía cerebral diagnóstica con hallazgos compatibles con Enfermedad Moyamoya. Se decidió realizar subduro-sinangiosis con el fin de inducir la formación de circulación colateral cerebral. Debido a la baja incidencia de la Enfermedad Moyamoya en Latinoamérica, generalmente no es incluida en el diagnóstico diferencial de los eventos cerebrales vasculares, por lo que recomendamos su sospecha en pacientes jóvenes y sin factores de riesgo que debutan con este tipo de eventos cerebrales.


Moyamoya disease is a progressive occlusive disease of the cerebral vessels, specifically the distal portion of the internal carotid arteries, usually with bilateral involvement. This occlusion results in dilatation of collateral blood vessels in order to form collateral circulation pathways, from which the disease takes its name due to the angiographic appearance of “puff of smoke” of these small dilated vessels. Clinically it manifests as ischemic cerebrovascular events due to occlusion of the vessel mentioned or hemorrhagic events due to rupture of small dilated blood vessels. We report the case of a female patient of 38 years old who was admitted to the hospital in coma state, the CT scan revealed intraventricular hemorrhage that was treated with an external ventricular derivation and tissue plasminogen activator. After clinical stabilization diagnostic cerebral angiography was performed with findings consistent with Moyamoya disease. We decided to perform a subduro-sinangiosis, in order to induce the formation of cerebral collateral circulation. Due to the low incidence of Moyamoya disease in Latin America, generally it is not included in the differential diagnosis of cerebral vascular events, we recommend suspect it in young patients without risk factors who present with this type of brain events.


Subject(s)
Humans , Adult , Female , Brain Ischemia , Cerebral Hemorrhage , Cerebral Revascularization , Diagnostic Imaging , Moyamoya Disease/surgery , Moyamoya Disease/complications , Moyamoya Disease/diagnosis , Moyamoya Disease/etiology , Cerebral Ventricles/blood supply
3.
Rev. chil. neurocir ; 40(1): 75-79, jul. 2014. tab, ilus
Article in English | LILACS | ID: biblio-831388

ABSTRACT

La enfermedad de Moyamoya (EMM) se caracteriza por la estenosis progresiva y la oclusión de las arterias carótidas internas en la base del cráneo. Se observó por primera vez en 1957 por Takeuchi y Shimizu en arteriografías anormales del cerebro. Esto representa el 6 por ciento de los accidentes cerebrovasculares en los niños, y es una enfermedad cerebrovascular importante en este grupo de edad en Japón. La mayoría son casos esporádicos de la EMM, pero hay también una variante familiar que se produce en aproximadamente el 8 por ciento de las veces. El tratamiento de la EMM depende de la presentación clínica del paciente y la etapa de la enfermedad. Las opciones de tratamiento incluyen la observación y el seguimiento, el tratamiento médico y el tratamiento quirúrgico, o incluso combinaciones de ellos. En general, no existe una recomendación establecida en relación con la gestión de la enfermedad, una vez que hay una ausencia de estudios prospectivos aleatorizados con seguimiento razonable. En este artículo realizamos una revisión de la literatura acerca de la EMM, con énfasis en su tratamiento quirúrgico.


Moyamoya disease (MMD) is characterized by progressive stenosis and occlusion of the internal carotid arteries at the base of the skull. It was first observed in 1957 by Takeuchi and Shimizu in abnormal arteriograms of the brain. It accounts for 6 percent of strokes in children, and it is a major cerebrovascular disease in this age group in Japan. Most are sporadic cases of MMD, but there is also a familiar variant that occurs in approximately 8 percent of the times. The treatment of MMD depends on the patient’s clinical presentation and the stage of the disease. Treatment options include observation and monitoring, medical treatment and surgical treatment, or even combinations of them. In general, there is no established recommendation regarding the management of the disease, once there is an absence of prospective randomized trials with reasonable follow-up. In this article we perform a review on the literature about the MMD, with emphasis on its surgical treatment.


Subject(s)
Humans , Cerebral Angiography , Diagnostic Imaging , Moyamoya Disease/surgery , Moyamoya Disease/diagnosis , Moyamoya Disease/epidemiology , Moyamoya Disease/etiology , Moyamoya Disease/pathology , Magnetic Resonance Imaging , Tomography, X-Ray Computed
4.
Rev. méd. Paraná ; 67(1/2): 20-23, jan.-dez. 2009. ilus
Article in Portuguese | LILACS | ID: lil-626071

ABSTRACT

É apresentado um caso de doença de Moyamoya que ocorreu em escolar do sexo feminino e que foi submetida a tratamento cirúrgico com a técnica de pialsinangiose com sucesso pós-cirúrgico. Enfatiza-se a imprtância da revascularização cerebral com a técnica mencionada para reverter total ou parcialmente os déficits gerados pela doença e para evitar a progressão das isquemias cerebrais.


Subject(s)
Humans , Female , Child , Moyamoya Disease/surgery , Moyamoya Disease/diagnosis , Moyamoya Disease/therapy , Hypoxia-Ischemia, Brain
6.
Arch. pediatr. Urug ; 79(4): 291-302, 2008. ilus, tab
Article in Spanish | LILACS | ID: lil-567089

ABSTRACT

La enfermedad o síndrome de moyamoya es una rara afección que provoca una oclusión de las carótidas intracraneales y determina una red vascular colateral anormal en la base del cráneo y que, por su aspecto arteriográfico, hace ya más de 50 años un grupo de neurocirujanos japoneses denominaron moyamoya, y de la cual persisten muchas interrogantes sin resolver. Se realizó un estudio descriptivo y longitudinal de 19 niños con síndrome o enfermedad de moyamoya. La edad promedio de inicio fue de seis años. Del total de niños incluidos, doce debutaron en forma aguda con infarto cerebral; dos pacientes (con antecedentes de epilepsia y retraso) lo hicieron, uno con infarto y otro con hemorragia cerebral, otros dos con epilepsia y retraso, uno con trastorno del lenguaje, siendo en los dos restantes un hallazgo casual. Entretanto doce pacientes se consideraron idiopáticos (portadores de enfermedad de moyamoya) y siete asociados a enfermedades sistémicas (síndrome de moyamoya). El diagnóstico inicial se confirmó por angiorresonancia en diez casos y por arteriografía convencional en nueve. El seguimiento promedio fue de cinco años, once evidenciaron progresión clínica y ocho estabilidad, con un seguimiento promedio de siete y dos años respectivamente. Todos mostraron progresión angiográfica. En siete niños se realizaron diez cirugías de revascularización sin complicaciones y con buenos resultados clínicos y angiográficos. Dos niños fallecieron (uno por hemorragia cerebral y otro por un infarto expansivo) y catorce presentaron secuelas leves a moderadas. Resulta importante identificar los niños que se pueden beneficiar con la cirugía de revascularización, una de las pocas opciones terapéuticas para evitar la progresión y complicaciones de esta grave enfermedad.


Moyamoya's disease or syndrome is a rare illness wich causes symptoms of cerebral ischemia due to intracranial arteries' stenosis, with secondary abnormal vasculature networks at the base of the brain. Since the first description of moyamoya disease done by a group of Japanese neurosurgeons more than 50 years ago, this rare illness is still considered an intriguing disease. The clinical features, treatment, imaging findings and outcomes of a series of not Asian children with Moyamoya disease are described in this study. A total of 19 six year old patients were analyzed. The initial presentation in 12 patients was infarctions, 2 with epilepsy and mental retardation, another 2 who had personal history of epilepsy and mental retardation developed symptoms of ischemic stroke (one of them), and hemorrhagic stroke the other one; 1experienced language problems, while in the last two the diagnosis was casual. On the other hand, 12 patientes were considered idiopathic cases (moyamoya's disease) and 7 were related to systemic illnes (moyamoya's syndrome). Initial diagnosis was achieved by magnetic resonance angiography in 10 cases, and conventional angiography in 9. All patients were followed up for a mean period of 5 years. While 11 patients experienced clinical worsening of symptoms, 6 asymptomatic. However, all of them showed angiographic progression. Seven patients underwent bypass surgery with no further complications, 2 passed away and 14 remained with moderate handicaps. A number of surgical procedures have been developed for revascularization, improving the outcome of some of these patients by preventing ischemic and hemorrhagic stroke. Due to the fact that moyamoya disease is not a silent disorder and its progress cause complications, surgical revascularization should always be considered in the management of these patients.


Subject(s)
Humans , Male , Adolescent , Female , Infant, Newborn , Infant , Child, Preschool , Child , Moyamoya Disease/surgery , Moyamoya Disease/complications , Moyamoya Disease/diagnosis , Cerebral Revascularization
8.
Arq. neuropsiquiatr ; 57(4): 1036-40, dez. 1999. ilus, tab, graf
Article in Portuguese | LILACS | ID: lil-249308

ABSTRACT

A doença de mayamoya é anormalidade cerebrovascular crônica e progressiva identificada através das características angiográficas; estão presentes no quadro clínico episódios isquêmicos transitórios, cefaléia, crises convulsivas, hemiparesia, que podem desaparecer após tratamento cirúrgico. Nós descrevemos o caso de uma menina com características clássicas da doença, comparando-o em dois momentos, antes e depois da cirurgia, através de avaliações neurológicas, neuropsicológicas, e exames complementares.


Subject(s)
Humans , Male , Female , Child , Moyamoya Disease/surgery , Neuropsychological Tests , Cognition , Motor Activity , Moyamoya Disease , Postoperative Period , Preoperative Care , Tomography, Emission-Computed, Single-Photon , Treatment Outcome
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