Cerebral oxygenation in childhood moyamoya disease investigated with near-infrared spectrophotometry.

In children with moyamoya disease, the time courses of hemoglobin concentrations before and after hyperventilation were examined using near-infrared spectrophotometry (NIRS) to determine brain tissue oxygenation. Five patients were studied: 1 was studied both before and after surgery and 4 were studied only after surgery. Nine hemispheres of these 5 patients were examined. The oxygenated hemoglobin concentration increased immediately after beginning hyperventilation. This parameter later decreased sharply to below the prehyperventilation level and remained at the reduced level for a prolonged period. These changes in oxygenated hemoglobin concentration were similar to those previously reported in arterial blood oxygen and CO2 tension. The magnitude of variance in oxygenated hemoglobin concentration (C-HV) was significantly greater in moyamoya disease patients than in healthy controls (P < .003, Wilcoxon test). The changes of NIRS after operation were markedly more sensitive than those of electroencephalography or single-photon emission computed tomography. NIRS could be applied to cerebral oxygenation as well as cerebral hemodynamics, which may be used to better define the time sequence and pathologic processes of various childhood encephalopathies.