caa a22 4500 445329130 CHVBK 20180317142731.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s10143-011-0312-y doi (NATIONALLICENCE)springer-10.1007/s10143-011-0312-y Contralateral cerebral hemodynamic changes after unilateral direct revascularization in patients with moyamoya disease [Elektronische Daten] [Yan Ma, Meng Li, Li Jiao, Hong Zhang, Feng Ling] Direct revascularization has been used successfully to prevent strokes by improving regional cerebral blood flow (rCBF) to the affected hemisphere faster in patients with moyamoya disease (MMD). Since most literatures have focused on the rCBF changes of operative hemisphere, we evaluated the hemodynamics of nonoperative side by xenon-enhanced computed tomography (Xe-CT) and acetazolamide challenge test in patients with MMD during a short time follow-up. Fifteen MMD patients with unilateral ischemic presentations who received direct revascularization on the symptomatic hemispheres with complete hemodynamic evaluations by Xe-CT and acetazolamide challenge test were enrolled. Hemodynamic evaluations were performed 1, 3, and 6months, postoperatively. The postoperative rCBF and cerebral vascular reserve (CVR) were recorded and correlated with clinical outcome. Angiography was performed if the patient had neurological deterioration or deficits. The average follow-up time was 8.5 ± 3.5months. Three months after the ipsilateral direct revascularization, the CVR of nonoperative hemispheres (25.8 ± 8.1%) began to decrease significantly (P = 0.003). Six months later, the rCBF showed a downward trend in nonoperative hemispheres (47.4 ± 8.0ml·100g−1min−1) than the preoperative status, but the difference was not significant (P = 0.053). Three patients presented with decreased rCBF and impaired CVR in the nonoperative hemispheres. Among them, two patients were symptomatic. Unilateral direct revascularization in symptomatic hemisphere for MMD patient could induce CVR impaired in primary asymptomatic hemisphere during the short term after the surgery. Therefore, critical follow-up, especially the hemodynamic follow-up in the asymptomatic hemispheres should be performed in patients with MMD. Springer-Verlag, 2011 Moyamoya disease nationallicence Xenon nationallicence Computed tomography nationallicence Hemodynamic change nationallicence Revascularization nationallicence Ma Yan Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut Li Meng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut Jiao Li Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut Zhang Hong Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut Ling Feng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut Neurosurgical Review Springer-Verlag 34/3(2011-07-01), 347-354 0344-5607 34:3<347 2011 34 10143 https://doi.org/10.1007/s10143-011-0312-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-011-0312-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ma Yan Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut NATIONALLICENCE 700 1- Li Meng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut NATIONALLICENCE 700 1- Jiao Li Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut NATIONALLICENCE 700 1- Zhang Hong Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut NATIONALLICENCE 700 1- Ling Feng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/3(2011-07-01), 347-354 0344-5607 34:3<347 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer