The histopathological features of the middle cerebral artery (MCA) and superficial temporal artery (STA) from moyamoya disease (MMD) and their relationships with gender, age, angiography stage were explored. The causes and the clinical significance of vasculopathy of STA were also discussed. The clinical data and specimens of MCA and STA from 30 MMD patients were collected. Twelve samples of MCA and STA from non-MMD patients served as control group. Histopathological examination was then performed by measuring the thickness of intima and media, and statistical analysis was conducted. The MCA and STA specimens from MMD group had apparently thicker intima and thinner media than those from the control group. There was no significant pathological difference between the hemorrhage group and non-hemorrhage group, and between the males and females in MMD patients. Neither the age nor the digital subtraction angiography (DSA) stage was correlated with the thickness of intima in MCA and STA. MMD is a systemic vascular disease involving both intracranial and extracranial vessels. Preoperative external carotid arteriography, especially super-selective arteriography of the STA, benefits the selection of donor vessel.
Adult ; Angiography ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; pathology ; Moyamoya Disease ; diagnostic imaging ; pathology ; surgery ; Temporal Arteries ; diagnostic imaging ; pathology ; Tunica Intima ; diagnostic imaging ; pathology

No abstract available.
Aged ; Giant Cell Arteritis/*complications/diagnosis ; Humans ; Male ; Optic Neuropathy, Ischemic/diagnosis/*etiology ; Republic of Korea ; Temporal Arteries/diagnostic imaging ; Ultrasonography ; *Visual Acuity

OBJECTIVE: The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery. MATERIALS AND METHODS: Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant. RESULTS: SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus. CONCLUSION: Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses.
Acetazolamide/diagnostic use ; Adult ; Aged ; Brain/*radionuclide imaging ; Brain Mapping/methods ; Carotid Stenosis/surgery ; *Cerebral Revascularization ; *Cerebrovascular Circulation ; Cysteine/analogs & derivatives/diagnostic use ; Female ; Follow-Up Studies ; Humans ; Image Processing, Computer-Assisted ; Intracranial Arteriosclerosis/surgery ; Male ; Middle Aged ; Middle Cerebral Artery/*surgery ; Models, Statistical ; Organotechnetium Compounds/diagnostic use ; Predictive Value of Tests ; Radiopharmaceuticals/diagnostic use ; Temporal Arteries/*surgery ; Tomography, Emission-Computed, Single-Photon/*methods ; Treatment Outcome