Clinical efficacy of revascularization in treating ischemic Moyamoya disease of 14 cases

Objective: To investigate the methods and effects of surgical treatment for the patients with cerebral ischemic Moyamoya disease (MMD).Methods: Encephaloduroarterio-synangiosis (EDAS),superficial temporal artery-to-middle cerebral artery bypass (STA-MCA)and encephaloduroarterio-myosynangiosis (EDAMS )were performed in nineteen hemispheres of fourteen patients respectively, and the effects were followed up.Results: Operations were performed in five hemispheres of children and fourteen in adults.In children, four hemispheres were given EDAS, and 1 case got grade A,2 cases got grade B and 1 case got grade C in 12 months postoperation.One child with STA-MCA operation was grade B in three months postoperation.In adults,2 cases with EDAS operation were grade C in 12 months postoperation,4 cases with EDAMS operation were grade B in 2 cases and grade C in 2 cases in 8 to 18 months postoperation and 8 cases with STA-MCA operation were grade A in 7 cases and grade B in 1case in 3-12 months postoperation.Clinical symptoms of 12 cases were improved, and 2 cases worsened.Conclusions: EDAS is effective in children but less in adults.The direct revascularization of STA-MCA is the most effective, and the indirect revascularization is less,but EDAMS is better than EDAS in adults.