Angiographic demonstration of cerebral revascularization after encephalo-duro-arterio-synangiosis (EDAS) performed on pediatric moyamoya patients

Abstract

For the treatment of the moyamoya disease, we developed a surgical procedure of Encephalo-duro-aterio-synangiosis (EDAS), which was conducted in 15 cases on 23 sides. As a result we obtained improvement in cerebral vascularization as well as in neurological and electroencephalographic findings in all cases. This report describes an introduction of the procedure and a review of the postoperative cerebral angiograms. Cerebral revascularization by EDAS proceeded on the following steps, and it was confirmed that efficient cerebral revascularization could be obtained 6 months after the operation in almost all cases following the steps: 1) dilatation and increase of dural artery, 2) dilatation of donor scalp artery, 3) cerebral revascularization with the development of visible fine spontaneous anastomoses between the donor scalp artery and the cerebral arteries and 4) further dilatation of the donor scalp artery and retraction of the abnormal rete vasculosum at the base of the brain.