Purpose: To report the hemodynamic pattern in childhood moyamoya disease before and after vascular reconstruction.
Methods: We performed the xenon cerebral blood flow (CBF) study in 10 cases of moyamoya disease in last 3 year. In 6 of them, study before and after operation was obtained for comparison. Preoperative study was obtained in 2 cases and postoperative study was obtained in 2 cases. They were 5 males and 5 females with age ranging from 1 to 12 years old. We studied their regional CBF before and after acetazolamide (CCBF) using stable xenon computed tomography. The angiography study was obtained for comparison.
Result: In the routine study, the CBF and CCBF were poor in the ACA and MCA territory and well correlated to the angiography finding. However, in case of basal ganglion and posterior cerebral artery involvement, xenon CBF study was more sensitive than the angiography. On the postoperative cases, the CBF could increase to a level beyond the level of CCBF shown on the preoperative study.
Conclusion: Hemodynamic study using stable xenon computed tomography can provide an objective reference for the treatment of moyamoya disease especially in case that surgical management is considered. It is a better modality for the evaluation of surgical outcome than the conventional contrast angiography study.