Cerebral revascularization by omental graft for moyamoya disease

Abstract

Several operative procedures have previously been documented for the surgical treatment of cerebrovascular moyamoya disease (1–9). The postoperative improvement in motor or speech impairment can be attributed to improved perfusion in the middle cerebral artery (MCA) distribution following these surgical treatments. However, progressive occlusive lesions are not confined to the MCA in moyamoya disease. They also occur in the internal carotid artery (ICA), the anterior cerebral artery (ACA), and the posterior cerebral artery (PCA) (1,8). Thus cerebral ischaemia in the ACA or PCA distribution results in such symptoms as visual disturbances and motor weakness in the lower extremities in some patients with moyamoya disease. Since most of the current documented operative procedures cannot directly revascularize these regions, omental grafts were performed in 14 cases with ischaemic symptoms in the ACA or PCA areas.