Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942005000300012
Brazilian Journal of Anesthesiology
Clinical Information

Anestesia em paciente portadora de doença de moyamoya: relato de caso

Anesthesia in patient with moyamoya disease: case report

Adriano Bechara de Souza Hobaika; Vera Coelho Teixeira; Marcos Guilherme Cunha Cruvinel; Alexandre Cordeiro Ulhoa

http://dx.doi.org/10.1590/S0034-70942005000300012 Braz J Anesthesiol, vol.55, n3, p.350-353, 2005
PDF Português
PDF English
Downloads: 0
Views: 715

Resumo

JUSTIFICATIVA E OBJETIVOS: A doença de moyamoya é uma vasculopatia cerebral progressiva rara, mais freqüentemente diagnosticada em populações asiáticas, mas que também vem sendo identificada no Brasil. Durante a sua vida, pacientes portadores desta doença podem ser submetidos aos mais variados tipos de procedimentos cirúrgicos. O anestesiologista deve entender a fisiopatologia da doença e instituir as medidas peri-operatórias mais adequadas, no intuito de melhorar o prognóstico destes pacientes. RELATO DO CASO: Paciente do sexo feminino, 22 anos, com insuficiência renal crônica, portadora da doença de moyamoya, submetida à intervenção cirúrgica para instalação de fístula arteriovenosa. A anestesia foi induzida com fentanil, propofol e atracúrio e mantida com sevoflurano. Durante o procedimento, a paciente foi mantida em normocapnia e normotermia. A extubação foi realizada e a paciente transferida à sala de recuperação pós-anestésica sem complicações. CONCLUSÕES: Este artigo apresenta os cuidados anestésicos dispensados a uma paciente portadora da doença de moyamoya.

Palavras-chave

ANESTESIA, Geral, DOENÇAS

Abstract

BACKGROUND AND OBJECTIVES: Moyamoya disease is an uncommon progressive cerebral vasculopathy, more frequently diagnosed among Asian individuals, but which has also been described in Brazil. Moyamoya patients may be submitted to different surgical procedures throughout their lives. Anesthesiologists must understand the pathophysiology of the disease and institute adequate perioperative measures to improve patients' prognosis. CASE REPORT: Female patient, 22 yr-old, chronic renal failure, with moyamoya disease, scheduled for surgical arterial-venous fistula installation. Anesthesia was induced with fentanyl, propofol and atracurium and maintained with sevoflurane. Patient was maintained in normocapnia and normothermia throughout the procedure. Patient was extubated and transferred to the post-anesthetic care unit without complications. CONCLUSIONS: This article describes the anaesthetic care of a moyamoya disease patient.

Keywords

ANESTHESIA, General, DISEASES

References

Fukui M, Kono S, Sueishi K. Moyamoya disease. Neuropathology. 2000;20:S61-64.

Yilmaz EY, Pritz MB, Bruno A. Moyamoya: Indiana University Medical Center experience. Arch Neurol. 2001;58:1274-1278.

Han DH, Kwon O, Byun BJ. A co-operative study: clinical characteristics of 334 Korean patients with moyamoya disease treated at neurosurgical institutes (1976-1994). Acta Neurochir. 2000;142:1263-1274.

Matsushima Y, Aoyagi M, Nariai T. Long-term intelligence outcome post-encephalo-duro-arterio-synangiosis in childhood moyamoya patients. Clin Neurol Neurosurg. 1997;99:S147-S150.

Fukui M. Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (‘moyamoya' disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan.. Clin Neurol Neurosurg. 1997;99(^s2):S238-S240.

Houkin K, Kamiyama H, Takahashi A. Combined revascularization surgery for childhood moyamoya disease: STA-MCA and encephalo-duro-arterio-myo-synangiosis. Childs Nerv Syst. 1997;13:24-29.

Yoshida Y, Yoshimoto T, Shirane R. Clinical course, surgical management, and long-term outcome of moyamoya patients with rebleeding after an episode of intracerebral hemorrhage: An extensive follow-up study. Stroke. 1999;30:2272-2276.

Ikeda H, Sasaki T, Yoshimoto T. Mapping of a familial moyamoya disease gene to chromosome 3p24. 2-p26. Am J Hum Genet. 1999;64:533-537.

Inoue TK, Ikezaki K, Sasazuki T. Linkage analysis of moyamoya disease on chromosome 6. J Child Neurol. 2000;15:179-182.

Franco CM, Fukujima MM, de Oliveira Rde C. Moyamoya disease. Report of three cases in Brazilian patients. Arq Neuropsiquiatr. 1999;57:371-376.

Yusa T, Yamashiro K. Local cortical cerebral blood flow and response to carbone dioxide during anesthesia in patients with moyamoya disease. J Anesth. 1999;13:131-135.

Iwama T, Hashimoto N, Tsukahara T. Perioperative complications in adult moyamoya disease. Acta Neurochir. 1995;132:26-31.

Sato K, Shirane R, Yoshimoto T. Perioperative factors related to the development of ischemic complications in patients with moyamoya disease. Childs Nerv Syst. 1997;13:68-72.

Malley RA, Frost EAM. Moyamoya disease. Pathophysiology and anesthetic management. J Neurosurg Anesthesiol. 1989;1:110-114.

Nomura S, Kashiwagi S, Uetsuka S. Perioperative management protocols for children with moyamoya disease. Childs Nerv Syst. 2001;17:270-274.

Newman B, Gelb AW, Lam AM. The effect of isoflurane induced hypotension on cerebral blood flow and cerebral metabolic rate for oxygen in humans. Anesthesiology. 1986;64:307-310.

Summors AC, Gupta AK, Matta BF. Dynamic cerebral autoregulation during sevoflurane anesthesia: a comparison with isoflurane. Anesth Analg. 1999;88:341-345.

Machado SB, Mendes FF, Angelini AC. Doença de moyamoya e anestesia com sevoflurano fora do centro cirúrgico. Relato de caso. Rev Bras Anestesiol. 2002;52:344-347.

Kurth CD, Uher B. Cerebral hemoglobin and optical pathlength influence near-infrared spectroscopy measurement of cerebral oxygen saturation. Anesth Analg. 1997;84:1297-1305.

5dd7ceef0e8825d23113f287 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections