gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Characterization of cortical vascularisation in moyamoya disease

Charakterisierung der kortikalen Vaskularisation bei Moyamoya-Erkrankung

Meeting Abstract

  • corresponding author M. Czabanka - Klinik für Neurochirurgie, Klinikum Mannheim, Universität Heidelberg
  • P. Peña-Tapia - Klinik für Neurochirurgie, Klinikum Mannheim, Universität Heidelberg
  • P. Vajkoczy - Klinik für Neurochirurgie, Klinikum Mannheim, Universität Heidelberg
  • P. Schmiedek - Klinik für Neurochirurgie, Klinikum Mannheim, Universität Heidelberg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 065

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc320.shtml

Veröffentlicht: 11. April 2007

© 2007 Czabanka et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Moyamoya disease is described as a stenoocclusive disease of cerebral arteries of the Circle of Willis with simultaneously occuring neovascularisation in the form of intracerebral and extra-intracranial collaterals. However, cortical vascularisation has not been quantified in patients before. It was the aim of this study to characterize cortical vascularisation in Moyamoya patients using intraoperative ICG videoangiography.

Methods: ICG videoangiography was performed in 10 Moyamoya patients intraoperatively before performing EC/IC-bypass and/or Encephalomyosynangiosis. In 6 patients (4 aneurysm patients, 2 tumor patients) ICG-videoangiography was performed after opening the dura and they were regarded as control patients. Cortical vascularisation was divided by hierarchy with the early filling arteries and their first branches referring to as arteries of 1st and 2nd order, respectively (macrocirculation). The same process was applied for the late filling veins and their branches (macrocirculation). Vascularisation occurring in 3rd or any following order were regarded as cortical microcirculation. Using intraoperative placement of a scale grid on the cortical surface, cortical vascularisation was assessed using CapImage software.

Results: ICG videoangiography revealed excellent visualisation of cortical arteries and veins as well as of microvascularisation in all patients. Moyamoya patients demonstrated significantly increased microvascular density as compared to control patients (Moyamoya: 18,5±2,44 cm/cm2, control: 14,08±3,68; p=0,011). No difference regarding cortical macrocirculation was quantified between both patient populations.

Conclusions: ICG videoangiography represents an excellent tool to assess cortical vascularisation intraoperatively. Moyamoya patients are characterized by a significantly increased microvascular density compared to controls. No difference regarding cortical macrocirculation was found.