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2015 ; 2
(4
): 135-139
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Neuroendoscopic Findings of Ventricular Wall in Adult Hemorrhagic Moyamoya
Disease: Report of Two Cases
#MMPMID28663984
Yamaguchi R
; Kohga H
; Tosaka M
; Yoshimoto Y
; Ishihara S
NMC Case Rep J
2015[Oct]; 2
(4
): 135-139
PMID28663984
show ga
Moyamoya disease usually manifests as ischemic events in childhood, and as more
severe hemorrhagic events, including intraventricular hemorrhage, in adults.
Recently, the indication for neuroendoscopic surgery has been extended to
cast-formation intraventricular hematomas. However, detailed information about
the use of neuroendoscopic surgery for the treatment of intraventricular
hemorrhage associated with moyamoya disease has not been reported. We describe
two cases of intraventricular hemorrhage with moyamoya disease; one in a
62-year-old and another in a 33-year-old women who both presented with severe
neurological symptoms. Cerebral angiography revealed unilateral moyamoya disease.
Neuroendoscopic surgery to remove the intraventricular hematoma was performed via
bilateral frontal burr holes in both cases. Abnormal findings in the ventricle
were observed only in the affected side and the intact side was normal. Specific
findings of neuroendoscopic observation were dilated and tortuous vessels,
intersection vessels, black-brown macules in the subependyma, and rattan
blind-like (Japanese sudare) bleeding vessels. These characteristic
neuroendoscopic findings may be useful for the exact diagnosis and treatment of
intraventricular hemorrhage associated with moyamoya disease. Endoscopic
evacuation of the ventricular hematoma may be important for intracranial pressure
control in patients with intraventricular hemorrhage in adult moyamoya disease.