ABSTRACT
Moyamoya disease is a rare progressive occlusive disease in the internal carotid arteries, along with the presence of an abnormal capillary network of vessels at the base of the brain. In moyamoya disease, the manitaining of cerebral perfusion and cerebral oxygen saturation are required to reduce complications of this disease including cerebral ischemia and cerebral hemorrhage. The authors measured regional oxygen saturation (rSO2) nonivasively by INVOS 5100 (Somanetics, USA) in patients with moyamoya disease who were scheduled for an encephalo-duro-arterio-myo synangiosis (EDAMS) operation. We therefore report our findings that deep breathing decreased rSO2 and oxygen, elevated blood pressure, and that the cerebral vasodilating drug increased rSO2.
Subject(s)
Humans , Blood Pressure , Brain , Brain Ischemia , Capillaries , Carotid Artery, Internal , Cerebral Hemorrhage , Moyamoya Disease , Oxygen , Perfusion , RespirationABSTRACT
We report a case of epidural anesthesia in a patient presenting for cesarean section with Moyamoya disease. Epidural anesthesia was performed using 0.5% bupivacaine and fentanyl 100 microgram. We used NIRS (near infrared spectroscopy) to monitor neurologic complication. A stable hemodynamic state was produced using left lateral uterine displacement, i.v. infusion of crystalloid solution and ephedrine. The patient had no neurological deficit and there was no significant intraoperative decrease in cerebral oxygenation measured by near infrared spectroscopy.
