Studying change of regional cerebral blood flow after superficial temporal artery-middle cerebral artery anastomosis during acute stage in patients with Moyamoya disease

Objective: To explore the changes of regional cerebral blood flow at the site of anastomosis of superficial temporal artery-middle cerebral artery (STA-MCA) to guide the preventive treatment of symptomatic hyperperfusion.

Methods: A total of 35 patients with Moyamoya disease were recruited from Beijing Tiantan Hospital. There were 22 males and 13 females with an average age of 29 years (range: 5 - 55). And there were 10 children. Regional cortical blood flow (rCBF) was measured by Laser Doppler flowmeter (LDF) before, after and at Day 1, 2, 3, 4, 5 and 6 postoperation of STA-MCA anastomosis. The probe of LDF was implanted adjacent to the area of anastomosis for 144 hours to record the values of rCBF.

Results: The baseline LDF values of cortical rCBF near the area of anastomosis were (69 ± 24) PU before anastomosis, (66 ± 74) PU immediately after anastomosis, (123 ± 23) PU at the conscious time after anesthesia postoperation, (297 ± 17) PU at Day 1 postoperation. And the LDF values of the following 5 days were (302 ± 31), (317 ± 26), (272 ± 46), (363 ± 54) and (367 ± 24) PU respectively.

Conclusions: As a safe and effective treatment for Moyamoya disease, STA-MCA anastomosis has great risks for symptomatic hyperperfusion. The highest risk time for hyperperfusion is identified after STA-MCA.