{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T19:52:46Z","timestamp":1790538766103,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Multiple burr hole (MBH) surgery is a simple, safe, and effective indirect technique of revascularization in moyamoya angiopathy (MM). However, it is not yet recognized as a first-line treatment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    To assess the long-term outcome and perioperative complications in a large single-center cohort of children with MM who underwent burr hole surgery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    This study is a retrospective analysis of children who underwent surgery for MM in a national reference center for pediatric stroke between 1999 and 2015. Sixty-four children (108 hemispheres, median age 7 years) were consecutively treated. The indication for revascularization was previous stroke or transient ischemic attack (TIA) or rapidly progressive disease on brain magnetic resonance imaging (MRI) and digital subtraction angiography. Children were followed with clinical examinations, telephone interviews, and MRI with any clinical recurrence of stroke or TIA used as the primary endpoint. Surgical mortality and morbidity were documented.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Sixty-four patients were operated (bilateral MBH n = 39, unilateral procedure n = 25). At a mean follow-up of 4.2 years and 270.6 patient years, 89.1% of patients had not suffered any recurrent stroke or TIA. A second surgery was required in 5 cases after unilateral revascularization, and in 3 cases after bilateral MBH. Mortality associated with the procedure was 0. Postoperative Matsushima angiographic grading was the only predictive factor of ischemic recurrence (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .036).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    In pediatric MM, MBH compares favorably to other indirect or direct revascularization techniques in children in the prevention of stroke or TIA.\n                  <\/jats:p>","DOI":"10.1093\/neuros\/nyw161","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T16:35:46Z","timestamp":1487954146000},"page":"950-956","source":"Crossref","is-referenced-by-count":41,"title":["Long-term Outcome After Multiple Burr Hole Surgery in Children With Moyamoya Angiopathy: A Single-Center Experience in 108 Hemispheres"],"prefix":"10.1227","volume":"80","author":[{"given":"Thomas","family":"Blauwblomme","sequence":"first","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"APHP, Department of Pediatric Neurosurgery, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Mathon","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris 6, Pierre et Marie Curie, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Naggara","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"INSERM U894, Department of Neuroradiology, Sainte-Anne Hospital, Paris, France"},{"name":"APHP, Department of Pediatric Neurology, French Center for Pediatric Stroke, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoelle","family":"Kossorotoff","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"APHP, Department of Pediatric Neurology, French Center for Pediatric Stroke, Necker Hospital, Paris, France"},{"name":"APHP, Department of Anesthesiology, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"APHP, Department of Pediatric Neurosurgery, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Puget","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"APHP, Department of Pediatric Neurosurgery, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Meyer","sequence":"additional","affiliation":[{"name":"APHP, Department of Anesthesiology, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Brousse","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"Reference Centre for Sickle Cell Disease, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"de Montalembert","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"Reference Centre for Sickle Cell Disease, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Brunelle","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"APHP, Department of Neuroradiology, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Zerah","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"APHP, Department of Pediatric Neurosurgery, Necker Hospital, Paris, France"},{"name":"French National Reference Centre for Pediatric Stroke, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Sainte-Rose","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Ren\u00e9 Descartes, PRES Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"APHP, Department of Pediatric Neurosurgery, Necker Hospital, Paris, 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