論文 - 杉生　憲志

Neurology: Reflections on the past millennium as we enter the next

Koji Tokunaga, Kazushi Kinugasa, Toshinari Meguro, Kenji Sugiu, Hiroyuki Nakashima, Shinya Mandai, Takashi Ohmoto

Journal of Clinical Neuroscience   7 ( 1 )   1 - 2   2000年

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Churchill Livingstone  

DOI： 10.1054/jocn.1999.0148

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Ribbon enchephalo-duro-arterio-myo-synangiosis for moyamoya disease

Kazushi Kinugasa, Shinya Mandai, Koji Tokunaga, Ichiro Kamata, Kenji Sugiu, Akira Handa, Takashi Ohmoto

Surgical Neurology   41 ( 6 )   455 - 461   1994年

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In patients with advanced moyamoya disease, reconstructive surgery alone may not prevent the deterioration of blood flow in the territory of the anterior cerebral artery. These types of surgery include superficial temporal artery-to-middle cerebral artery anastomosis and encephalo-duro-arterio-myo-synangiosis (EDAMS). Bilateral encephalo-duro-arterio-synangiosis (EDAS) gradually reduced the transient ischemic attacks in one of our patients who experienced motor weakness in the left extremities. After surgery, however, persistent bilateral attacks still occurred in the patient's legs. In a subsequent maneuver, we inserted the pedicle of the galea on both sides into the interhemispheric fissure, which induced marked vascularization in the territory of the anterior cerebral artery, and the attacks disappeared. Since then, we have combined this "ribbon" technique with EDAMS to treat eight patients with moyamoya disease. Postoperative angiograms showed widespread collateral circulation on the ischemic brain surface in six patients undergoing ribbon EDAS or EDAMS. Postoperative measurements of cerebral blood flow revealed improved circulation in the frontal region in four patients. The clinical results were excellent in six patients, and good in one, and we lost follow-up in one. The ribbon EDAMS procedure is effective on moyamoya disease with symptomatic cerebral ischemia of the anterior circulation. © 1994.

DOI： 10.1016/0090-3019(94)90007-8

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