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Korean J Pediatr 2012 November;55(11) :408-413.
Published online 2012 August 31.        doi:
Indirect revascularization surgery for moyamoya disease in children and its special considerations
Kyu-Chang Wang (Wang KC), Ji Hoon Phi (Phi JH), Ji Yeoun Lee (Lee JY), Seung-Ki Kim (Kim SK), Byung-Kyu Cho (Cho BK)
Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea
Corresponding Author: Kyu-Chang Wang ,Tel: +82-2-2072-3489, Fax: +82-2-2072-0274, Email:
Copyright © 2012 by The Korean Pediatric Society
Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.
Keywords: Moyamoya disease | Child | Surgery
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