gms | German Medical Science

59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Cortical vascularization in Moyamoya disease – a potential compensation mechanism for impaired cerebral blood flow

Kortikale Vaskularisierung bei der Moyamoya-Erkrankung – ein potentieller Kompensationsmechanismus für eingeschränkten zerebralen Blutfluss

Meeting Abstract

  • corresponding author M. Czabanka - Department of Neurosurgery, Klinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim
  • P. Peña-Tapia - Department of Neurosurgery, Klinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim
  • G. A. Schubert - Department of Neurosurgery, Klinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim
  • J. Woitzik - Department of Neurosurgery, Klinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim
  • P. Vajkoczy - Department of Neurosurgery, Klinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim; Department of Neurosurgery, Charité - Universitätsmedizin Berlin
  • P. Schmiedek - Department of Neurosurgery, Klinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocSO.04.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc029.shtml

Veröffentlicht: 30. Mai 2008

© 2008 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: Increased cortical microvascularization has been proposed to be a Moyamoya disease (MMD) specific characteristic. It was the aim of our study to characterize the anatomic pattern and microhemodynamics of cortical microvascularization in MMD.

Methods: Intraoperative Indocyaninegreen-Videoangiography was performed in 16 adult MMD patients, in 15 patients with atherosclerotic cerebrovascular disease (ACVD) and in 10 control patients. Cortical microvascularization and microvascular hemodynamics were categorized and analyzed according to anatomical and functional ICG-angiographic aspects. Anatomic analysis included microvascular density, microvascular diameter and microvascular surface per analyzed area. Microhemodynamic analysis included microvascular transit time, arterial microvascular transit time and venous microvascular transit time.

Results: Microvascular density and diameter were significantly increased in MMD patients (1.8±0.2 mm/mm2; 0.24±0.03 mm) compared to ACVD (1.5±0.2 mm/mm2; 0.20±0.02 mm) and controls (1.5±0.1 mm/mm2; 0.19±0.03 mm). This resulted in significantly increased microvascular surface per analyzed area in MMD (67%±13) vs. ACVD (47%±7) and controls (45%±6). Anatomic changes were paralleled by significantly increased microvascular and arterial microvascular transit time in MMD patients (11.55±3.50 sec./6.79±2.96 sec.) compared to ACVD (8.13±1.78 sec./4.34±1.30 sec.) and controls (8.04±2.16 sec/4.50±1.87 sec.).

Conclusions: Cortical microvascularization in MMD is characterized by a significantly increased microvascular density and microvascular diameter leading to increased microvasular surface. These anatomic alterations are accompanied by prolonged microvascular hemodynamics. These observations may represent a MMD specific compensation mechanism for impaired cerebral blood flow.