Cerebral oxygenation state in childhood moyamoya disease: a near-infrared spectroscopy study

Abstract

Near-infrared spectroscopy was used to measure the relative concentration changes of oxygenated hemoglobin (HbO 2), deoxygenated hemoglobin (HbR), and total hemoglobin (t-Hb) before, during, and after hyperventilation in eight patients with childhood moyamoya disease who underwent surgery. The patients were divided into the following two groups: those with and those without re–build-up phenomenon on electroencephalography. All patients except one exhibited decreased concentrations of HbO 2 and t-Hb during hyperventilation and decreased concentrations of HbO 2 and increased concentrations of HbR after hyperventilation. The difference between the hemoglobin concentration during and after hyperventilation was significantly greater in the group with the re–build-up phenomenon than the group without it ( P <0.03, Mann-Whitney U test). The patients with the re–build-up phenomenon had lower HbO 2 and higher HbR concentrations after hyperventilation. The concentrations of HbO 2 and HbR reflect an alteration in the oxygenated blood supply and/or oxygen use. Thus, it is strongly suggested that regional cerebral hypoxia and metabolic oxygen disturbances play an important role in the occurrence of the re–build-up phenomenon. Near-infrared spectroscopy is a useful noninvasive method to evaluate the efficacy of surgical treatment in childhood moyamoya disease.