First autopsy analysis of a neovascularized arterial network induced by indirect bypass surgery for moyamoya disease: case report.

Abstract:

:The object of this study was to analyze the pathology of collateral vessels newly induced by indirect bypass surgery for moyamoya disease (MMD). An autopsy analysis was conducted on a 39-year-old woman with MMD who had died of a brainstem infarction. The patient had undergone bilateral indirect bypass surgeries 22 years earlier. Sufficient revascularization via bilateral external carotid arterial systems was confirmed by cerebral angiography before her death. Macroscopic observation of the operative areas revealed countless meandering vessels on the internal surface of the dura mater connected with small vessels on the brain surface and in the subpial brain tissue. Notably, microscopic analysis of these vessels revealed the characteristic 3-layer structure of an arterial wall. This autopsy analysis was the first to confirm that indirect bypass surgery had induced the formation of a new arterial network (arteriogenesis) and that this network had been maintained for more than 20 years to compensate for the chronic cerebral ischemia caused by the MMD.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Mukawa M,Nariai T,Inaji M,Tamada N,Maehara T,Matsushima Y,Ohno K,Negi M,Kobayashi D

doi

10.3171/2015.4.JNS15155

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

1211-4

issue

5

eissn

0022-3085

issn

1933-0693

journal_volume

124

pub_type

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