My child has frequent headaches. Is she/he suffering from Moyamoya?
Does your child suffer from frequent headaches or migraine? Does she/he suffer from weak limbs, sensory disorders, speech problems, visual disturbances? If so, have your child examined by a neurologist and ask for an MRI-MRA. If the suspicion of Moyamoya is confirmed, contact a Moyamoya specialist.
How is Moyamoya diagnosed?
The cloud-like Moyamoya vessels can be recognised on MRI-MRA (Magnetic Resonance Imaging and Magnetic Resonance Angiography). Examination of the brain and of its six main blood vessels confirm the suspicion of Moyamoya.
Which child requires an operation?
A child with Moyamoya symptoms who shows relevant findings with all three image-generating procedures (MRI, MRA and Angiography) will most probably require revascularisation operations. The blood circulation is reinstated as a result of this type of operative intervention. In this way, further attacks can be prevented. The child can subsequently lead a normal life again without mental and physical impairment.
What is an EC-IC (Extracranial to Intracranial) bypass?
It is a connection between two blood vessels (anastomosis) from outside (extracranial) to inside the skull (intracranial). One of the arteries – STA: Superficial temporal artery– is located under the scalp, just in front of the ear and the other (cortical artery) is located on the surface of the brain. Connecting the two arteries makes it possible for the blood to flow from the extracranial circulation to the intracranial circulation bypassing the main site of the narrowing and Moyamoya vessel formation which is located deep in the skull.
What is indirect revascularisation?
Indirect revascularisation is necessary if the STA or the cortical branch are too small for a direct anastomosis. This operative intervention involves placing either the chewing muscle (Temporalis muscle) or the bone-coverings (Galea-periosteum) directly on the brain or inverting the brain coverings (Dura) onto the brain. This encourages the formation of new blood vessels over a period of several months.
What does Moyamoya treatment consist of?
A child with Moyamoya who is symptomatic and shows decreased perfusion reserves in one or several arterial territories of the brain will certainly require revascularisation surgeries allowing for immediate and long term stroke prevention. Children can subsequently lead a normal life again without any mental or physical impairment.
Depending on the number of surgeries required, the duration of the hospital stay varies between seven and fourteen days. The first follow-up is at 6 months to one year after surgery. Thereafter regular check-ups on an annual to three-yearly basis will continue until puberty.
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