もやもや病に対する外科的治療の改善点(<特集>もやもや病に対する外科治療) 柏木 史郎 野村 貞宏 北原 哲博 加藤 祥一 師井 淳太 山下 勝弘 日本脳卒中の外科学会 脳卒中の外科 09145508 28 2 126 129 2000-03-31 The area of revascularization using the temporal muscle and/or the superficial temporal artery is restricted to the lateral aspect of the cerebral hemisphere because these donor tissues distribute inferior to the superior temporal line. To improve the surgical result, the residual ischemic area in the superior aspect of the hemisphere should be revascularised. Dural arteries are appropriate donors for this purpose. At surgery, the dura near the middle meningeal artery was split into outer and inner layers, and the split surfaces of the outer layers were attached to the cortex. This procedure, combined with encephalo-duro-arterio synangiosis, was applied to 25 hemispheres in 18 patients with pediatric moyamoya disease (mean age, 6 years). Postoperative selective angiograms of the middle meningeal artery demonstrated effective cortical revascularization covering the superior aspect of the hemisphere. All the patients were symptom free by 1.5 years after surgery. Revascularization of the superior aspect of hemisphere is an important consideration for the improvement of surgical results. 2000-03-31 110003739638 AN10061756 JPN CJP NII-ELS 1 14 Consideration for the Improvement of Surgical Treatment of Moyamoya Disease(<Topics>Surgical Treatment for Moyamoya Disease) KASHIWAGI Shiro NOMURA Sadahiro KITAHARA Tetsuhiro KATO Shoichi MOROI Junta YAMASHITA Katushiro The Japanese Conference on Surgery for Cerebral Stroke Surgery for cerebral stroke The area of revascularization using the temporal muscle and/or the superficial temporal artery is restricted to the lateral aspect of the cerebral hemisphere because these donor tissues distribute inferior to the superior temporal line. To improve the surgical result, the residual ischemic area in the superior aspect of the hemisphere should be revascularised. Dural arteries are appropriate donors for this purpose. At surgery, the dura near the middle meningeal artery was split into outer and inner layers, and the split surfaces of the outer layers were attached to the cortex. This procedure, combined with encephalo-duro-arterio synangiosis, was applied to 25 hemispheres in 18 patients with pediatric moyamoya disease (mean age, 6 years). Postoperative selective angiograms of the middle meningeal artery demonstrated effective cortical revascularization covering the superior aspect of the hemisphere. All the patients were symptom free by 1.5 years after surgery. Revascularization of the superior aspect of hemisphere is an important consideration for the improvement of surgical results. 柏木 史郎 KASHIWAGI Shiro 山口大学医学部脳神経外科 Department of Neurosurgery, Yamaguchi University School of Medicine 野村 貞宏 NOMURA Sadahiro 山口大学医学部脳神経外科 Department of Neurosurgery, Yamaguchi University School of Medicine 北原 哲博 KITAHARA Tetsuhiro 山口大学医学部脳神経外科 Department of Neurosurgery, Yamaguchi University School of Medicine 加藤 祥一 KATO Shoichi 山口大学医学部脳神経外科 Department of Neurosurgery, Yamaguchi University School of Medicine 師井 淳太 MOROI Junta 山口大学医学部脳神経外科 Department of Neurosurgery, Yamaguchi University School of Medicine 山下 勝弘 YAMASHITA Katushiro 山口大学医学部脳神経外科 Department of Neurosurgery, Yamaguchi University School of Medicine