颞浅动脉-大脑中动脉搭桥术治疗成人烟雾病

Treatment of Moyamoya disease with superficial temporal artery-middle cerebral artery bypass in adults

目的探讨颞浅动脉-大脑中动脉（STA-MCA）搭桥术治疗成人烟雾病的效果。方法回顾性分析17例成人烟雾病患者（出血型13例,缺血型4例）的临床资料,均行STA-MCA搭桥术治疗,其中双侧STA-MCA搭桥术15例,单侧STA-MCA搭桥术2例。结果术后13例出血型患者临床症状改善,2例出现过度灌注综合征。17例随访3～36个月,13例出血型患者中,12例恢复正常或临床症状改善,1例术后突发颅内出血,预后不良;4例缺血型患者术后3例未再出现短暂性脑缺血发作,1例短暂性脑缺血发作的频率和持续时间减少。结论 STA-MCA搭桥术治疗烟雾病,可以降低出血型患者的再出血率和致残率,以及缺血型患者的短暂性脑缺血发作的发生率。

Objective To explore therapeutic effect of superficial temporal artery-middle cerebral artery （STA-MCA） bypass on Moyamoya disease and the postoperative complications in the adult patients with Moyanmoya disease. Methods The clinical data of 17 adult patients with Moyamoya disease who were treated by STA-MCA bypass from January, 2010 to July, 2014, were analyzed retrospectively. Of 17 patients by Moyamoya disease, 13 suffered from hemorrhagic Moyamoya disease and 4 from ischemic. Results STA-MCA bypasses was successfully performed in all the patients. Postoperative CT angiography or DSA showed that the patcncy of the bypass was good in all the patients. Of 2 patients suffering from excessive perfusion syndrome, 1 had suddenly intracranial hemorrhage and 1 seizures. Following-up from 3 to 36 months showed that no patients suffered from cerebral infarction and cerebral hemorrhage. One patient suffered from transient ischemic attack （TIA） after the operation, but the duration and frequency of TIA were significantly reduced compared to the preoperative. Conclusion STA-MCA bypass is a good method to treat the hemorrhagic and ischemic Moyamoya disease because it can lower＇tbe rates of the cerebral hemorrhage and disability and TIA incidence in the patients with Moyamoya disease.