PMID- 8559266
OWN - NLM
STAT- MEDLINE
DCOM- 19960227
LR  - 20161123
IS  - 0301-2603 (Print)
IS  - 0301-2603 (Linking)
VI  - 24
IP  - 1
DP  - 1996 Jan
TI  - [A case of moyamoya disease in the aged associated with cerebral embolism].
PG  - 57-61
AB  - We reported a rare case of Moyamoya disease in the aged associated with cerebral 
      embolism. A 76-year-old female was brought into our hospital by ambulance 30 min 
      after an attack of fainting. She had no past history of cerebrovascular disease. 
      On admission her consciousness level was JCS 3-IA and she showed Rt. hemiparesis 
      ECG exhibited Af tachycardia. No abnormal region was recognized on brain CT. 
      Emergency cerebral angiograms (AG) disclosed that unexpectedly she had Moyamoya 
      disease. Stenotic or occluded lesions were seen from bilateral IC terminal 
      portions to MCA and ACA, and basal moyamoya vessels were visualized. Transdural 
      anastomosis was poor and posterior circulation was the main source of collateral 
      flow. Mode of onset and neurological signs suggested that the cause of the attack 
      was Lt. MCA occlusion at its sphenoidal portion by cardiogenic embolism. 
      Superselective endovascular fibrinolysis was carried out by the use of urokinase 
      and low molecular weight Dextran and Lt. MCA was able to be recanalized. She was 
      recovered without neurological deficit. Lt. STA-MCA anastomosis and 
      encephalo-myosynangiosis was performed in the chronic stage because stenosis had 
      remained in Lt. MCA and hypo-perfusion in bilateral frontal lobes was presented 
      on SPECT. Post-operative AG demonstrated that Lt. MCA was occluded but Lt. 
      frontal lobe was supplied with plenty of blood flow from Lt. STA. During the next 
      day morning, she had another attack of fainting and showed moderate consciousness 
      disturbance and motor aphasia. No abnormal change was noticed on brain CT. 
      Emergency AG revealed that Lt. STA had become stuffed up with embolic and bypass 
      flow had disappeared. Superselective endovascular fibrinolysis was able to 
      recanalize the blood flow imperfectly, but mild motor apasia remained due to Lt. 
      frontal infarction.
FAU - Kubota, T
AU  - Kubota T
AD  - Department of Neurosurgery, Oji General Hospital.
FAU - Hirano, A
AU  - Hirano A
FAU - Kanno, K
AU  - Kanno K
LA  - jpn
PT  - Case Reports
PT  - Journal Article
PL  - Japan
TA  - No Shinkei Geka
JT  - No shinkei geka. Neurological surgery
JID - 0377015
SB  - IM
MH  - Aged
MH  - Carotid Arteries/diagnostic imaging
MH  - Cerebral Revascularization
MH  - Female
MH  - Humans
MH  - Intracranial Embolism and Thrombosis/*complications/diagnostic imaging/surgery
MH  - Moyamoya Disease/*complications/diagnostic imaging
MH  - Radiography
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
PST - ppublish
SO  - No Shinkei Geka. 1996 Jan;24(1):57-61.