Moyamoya Disease Update

About this book

Moyamoya disease (MMD) is characterized by bilateral stenosis or occlusion of the distal internal carotid artery bifurcation, including its proximal branches, and an abnormal vascular network (moyamoya vessel) in the vicinity of the arterial occlusions. It is predominant in the age group less than 10 years and the most common pediatric cerebrovascular disease in East Asia but has also been found over all age groups and globally through recent advances in diagnostic imaging. The clinical presentation of MMD usually includes repeated transient ischemic attacks in children and intracranial hemorrhage in adults. The benefit of surgery for the ischemic type of MMD has been established. As much information about MMD has been accumulated for almost 10 years since publication of monograph "Moyamoya Disease" in year 1986 by Jiro Suzuki(ed), and then lastly in year 2001 by Ikezaki and Loftus(eds), it is time to update knowledge of MMD.

Written for:

Neurosurgeons

Keywords:

• MMD
• Moyamoya Disease
• cerebrovascular disease
• neurosurgery

Table of contents

Introduction
Overview (Teiji Tominaga)
Pathology (Ken-ichiro Kikuta)
Unilateral MMD (Chang Wan Oh)
Moyamoya syndrome (Michael Scott)
Epidemiology
Overview (Norihiro Suzuki)
Familial MMD (Joong-Uhn Choi)
Genetics
Overview (Akio Koizumi)
Genetic linkage study (Akio Koizumi)
SNP study (Hyun-Seung Kang)
HLA study (Myoung Hee Park)
Pathophysiology I (Protein, cell, and immunology)
Overview (Seung-Ki Kim)
bFGF and cytokines (Kiyohiro Houkin)
Ischemia/angiogenesis-related molecules and cells (Jin Hyun Kim)
Vascular smooth muscle cell-related molecules and cells (Yasushi Takagi)
Immunology (Ji Hoon Phi)
Pathophysiology II (Hemodynamics, Biomechanical aspect)
Overview (Eun Bo Shim)
Regional predilection of lesions and stages of MMD (Ho Jun Seol)
Clinical features
Overview (Yong-Seung Hwang)
Headache (Reizo Shirane)
Involuntary movement (Shigeru Nogawa)
Progression of MMD (Norihiro Suzuki)
Associated systemic arterial stenosis (Hae Il Cheong)
Associated neurosurgical diseases (Izumi Nagata)
Diagnostic evaluation 
Morphological imaging 
Overview (Young Chul Won)
Pre- Postoperative MRA (Hiyohiro Houkin)
MRI (Yukihiko Fujii)
Functional imaging 
Overview (Joji Nakagawara)
SPECT (Dong Soo Lee)
Iomazenil-SPECT (BZP-receptor) (Joji Nakagawara)
Perfusion MRI/CT (In-Won Kim)
PET (Sunao Nariai)
Electrophysiology 
EEG (Jong Hee Chae)
MEG (Nobukazu Nakasato)
Surgical technique 
Overview (Toshio Matsushima)
Anesthesia and perioperative care (Hee Soo Kim)
ACA territory reinforcement (Chae-Yong Kim)
PCA territory reinforcement (Dal Soo Kim)
Endovascular procedures (O Ki Kwon)
Surgical outcome 
Overview (Byung-Kyu Cho)
Risk factors for complication (Miki Fujimura)
Cognition and quality of life (Satoshi Kuroda)
Special consideration I 
Overview: Issues in young children and adults (Teiji Tominaga)
MMD in the young (Kyu-Chang Wang)
MMD in adult 
Management of hemorrhage (Susumu Miyamoto)
Direct bypass surgery, postsurgical hyperperfusion syndrome (Jeong Eun Kim)
Special consideration II 
Pregnancy/delivery in MMD (Jun Takahashi)
Asymptomatic MMD (Satoshi Kuroda)
Hyperthyroidism in MMD (So-Hyang Im)
Enhancer of revascularization, gene and stem cell therapies (Isao Date)
Special consideration III 
MMD in North America (Gary Steinberg)
MMD in Europe (Sainte-Rose)
MMD in Asia (Yong-Kwang Tu)
Future perspectives of MMD (Byung-Kyu Cho).