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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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Clinical implications of cortical microvasculature in adult Moyamoya disease

Meeting Abstract

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  • M. Czabanka - Klinik für Neurochirurgie, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin
  • P. Peña-Tapia - Neurochirurgische Klinik, Klinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg
  • G.A. Schubert - Neurochirurgische Klinik, Klinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg
  • J. Woitzik - Klinik für Neurochirurgie, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin
  • P. Horn - Klinik für Neurochirurgie, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin
  • P. Schmiedek - Neurochirurgische Klinik, Klinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg
  • P. Vajkoczy - Klinik für Neurochirurgie, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.07-06

doi: 10.3205/09dgnc158, urn:nbn:de:0183-09dgnc1585

Published: May 20, 2009

© 2009 Czabanka et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Cortical microvascular surface area (MVSA) and arterial microvascular transit time (AMVTT) have been described to be significantly increased in Moyamoya disease (MMD) patients. It was the aim of our study to investigate the clinical implications of anatomic and functional parameters of cortical microvasculature in MMD patients.

Methods: In 13 MMD patients cortical microvasculature was assessed intraoperatively using ICG-Videoangiography. Microvascular results (MVSA, AMVTT, microvascular density and diameter) were compared to clinical data obtained by digital subtraction angiography (DSA), physical examination and rCBF studies (stable Xenon-enhanced CT) prior to surgery.

Results: MVSA correlated negatively with CVRC (r =–0.636) and positively with AMVTT (r =0.576). Asymptomatic patients were characterized by increased MVSA and significantly increased AMVTT. There was a difference in total microvascular density between asymptomatic (19±0.9 cm/cm²) and symptomatic (17.5±2.2 cm/cm²) patients. No difference was observed in microvascular diameter. Further correlative studies did not show any significant correlation between MVSA vs. angiographic stages, AMVTT vs. DSA stages, AMVTT vs. CVRC and CVRC vs. DSA stages.

Conclusions: Increased MVSA is accompanied by increased AMVTT in MMD patients. Asymptomatic patients are characterized by prolonged AMVTT resulting from increased MVSA and microvascular density. Negative correlation between MVSA and CVRC indicates haemodynamic ischemia as the driving force for neovasculatory activity in MMD.