World neurosurgery · 2015
A Case of Moyamoya Disease with a Transient Neurologic Deterioration Associated with Subcortical Low Intensity on Fluid-Attenuated Inversion Recovery Magnetic Resonance Images After Bypass Surgery.
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Tanioka Satoru, Shiba Masato, Umeda Yasuyuki, Sano Takanori, Maeda Masayuki, Suzuki Hidenori
Аннотация
BACKGROUND: Moyamoya disease often is treated by revascularization surgery. In this report, we are the first to describe a case of moyamoya disease that repeatedly showed a transient subcortical low intensity (SCLI) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance images postoperatively.
CASE DESCRIPTION: A 59-year-old woman presenting with repeated transient ischemia underwent right superficial temporal artery to middle cerebral artery anastomosis with encephalo-duro-myo-synangiosis. After the operation, the patient had a transient neurologic deterioration. Findings on magnetic resonance imaging were not particular apart from SCLI and sulcal hyperintensity on FLAIR images, but no abnormalities in cerebral blood flow on single-photon emission computed tomography with N-isopropyl [123I]-p-iodoamphetamine and no abnormalities on electroencephalogram were found. Symptoms improved in a few days, and SCLI on FLAIR images disappeared in a few months. Thereafter, when the left-sided bypass surgery was performed, similar findings occurred in the left cerebral hemisphere.
CONCLUSIONS: The mechanisms of transient SCLI on FLAIR images remain unclear, but this finding appears to be associated with a postoperative transient neurologic deterioration.
CASE DESCRIPTION: A 59-year-old woman presenting with repeated transient ischemia underwent right superficial temporal artery to middle cerebral artery anastomosis with encephalo-duro-myo-synangiosis. After the operation, the patient had a transient neurologic deterioration. Findings on magnetic resonance imaging were not particular apart from SCLI and sulcal hyperintensity on FLAIR images, but no abnormalities in cerebral blood flow on single-photon emission computed tomography with N-isopropyl [123I]-p-iodoamphetamine and no abnormalities on electroencephalogram were found. Symptoms improved in a few days, and SCLI on FLAIR images disappeared in a few months. Thereafter, when the left-sided bypass surgery was performed, similar findings occurred in the left cerebral hemisphere.
CONCLUSIONS: The mechanisms of transient SCLI on FLAIR images remain unclear, but this finding appears to be associated with a postoperative transient neurologic deterioration.