ภาวะเลือดไปเลี้ยงสมองมากเกินหลังการผ่าตัด ต่อหลอดเลือดสมองในผู้ป่วยหลอดเลือดสมองโมยาโมยา

Pakapon Yangsamit; Chanon Ariyaprakai; I-sorn Phoominaonin; Atithep Mongkolratnan

Authors

Pakapon Yangsamit Division of Neurosurgery, Department of surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University
Chanon Ariyaprakai Division of Neurosurgery, Department of surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University
I-sorn Phoominaonin Division of Neurosurgery, Department of surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University
Atithep Mongkolratnan Division of Neurosurgery, Department of surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University

Keywords:

Cerebral hyperperfusion syndrome, STA-MCA bypass, Direct bypass, Moyamoya disease, Intracranial Internal carotid artery stenos

Abstract

Moyamoya disease (MMD) is a condition characterized by stenosis or occlusion of the internal carotid artery (ICA) at its bifurcation into the middle cerebral artery (MCA) and anterior cerebral artery (ACA). Patients may present with either cerebral ischemia or intracranial hemorrhage. The current standard treatment is cerebral revascularization surgery using direct bypass between the superficial temporal artery (STA) and the middle cerebral artery (MCA), often combined with indirect bypass procedures.One of the major complications of direct bypass surgery is cerebral hyperperfusion syndrome (CHS), which results from excessive cerebral blood flow following the operation. Clinical manifestations may occur immediately after surgery and include headache, seizures, neurological deficits, or altered consciousness. At present, there are still no clearly established guidelines for the diagnosis and management of CHS. Therefore, the authors reviewed the clinical manifestations, risk factors, diagnostic approaches, treatment, and prevention strategies of CHS in this article.

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