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Vol 23, No 1-2 (2021)
Review paper
Published online: 2022-07-27
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Rozwój i nowe perspektywy leczenia choroby moyamoya

Zuzanna Paluch1, Michał Szymoniuk1, Adrian Borkowski2, Krzysztof Lider1, Piotr Kamieniak3
Chirurgia Polska 2021;23(1-2):34-44.

Abstract

Choroba moyamoya jest niezwykle rzadką chorobą naczyń mózgowych, występującą głównie u dzieci
i młodych dorosłych. Charakteryzuje się przewlekłym jedno- lub obustronnym zarastaniem i zwężaniem
końcowego odcinka tętnic szyjnych wewnętrznych i ich gałęzi końcowych, co prowadzi do udaru mózgu
oraz zaburzeń neurologicznych. Podstawą leczenia choroby moyamoya jest chirurgiczna rewaskularyzacja
naczyń, mająca na celu przywrócenie prawidłowego krążenia mózgowego i zmniejszenie częstości
występowania objawów klinicznych. Chirurgiczne metody rewaskularyzacji stosowane w leczeniu choroby
moyamoya obejmują techniki bezpośrednie, pośrednie oraz metody łączące techniki bezpośrednie
z pośrednimi. Pośrednie metody rewaskularyzacji są bezpieczniejszym i łatwiejszym w przeprowadzeniu
sposobem leczenia niż metody bezpośrednie, zwłaszcza u pacjentów młodszych i u pacjentów z chorobami
współistniejącymi. Metody bezpośrednie, mimo większego ryzyka powikłań w postaci udaru czy przemijającej
hiperperfuzji mózgowej, cechują się natychmiastowym przywróceniem prawidłowego przepływu
krwi w zwężonych naczyniach. Ostatnio zauważa się wyraźną przewagę stosowania metod łączonych, na
co wskazują liczne badania.

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