{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:47:28Z","timestamp":1772110048879,"version":"3.50.1"},"reference-count":12,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Introduction:<\/i><\/b> Surgical revascularization prevents cerebral ischemic attack by improving cerebral blood flow (CBF) in both adult and pediatric patients with moyamoya disease (MMD). Uneven hemodynamic changes, including local cerebral hyperperfusion and remote ischemia, can cause delayed intracerebral hemorrhage and perioperative infarctions in adult MMD patients, but the characteristic hemodynamic pattern among pediatric MMD patients after revascularization surgery is poorly understood. <b><i>Methods:<\/i><\/b> This study included 16 consecutive pediatric MMD patients (age, 6\u201316 years; mean age, 11.3) undergoing superficial temporal artery-middle cerebral artery anastomosis combined with encephalo-duro-myo-synangiosis on 21 affected hemispheres. Perioperative management was conducted by aspirin administration and strict blood pressure control (110\u2013130 mm Hg). We prospectively performed N-isopropyl-p-[<sup>123<\/sup>I] iodoamphetamine single-photon emission computed tomography on postoperative days (POD) 1 and 7 and analyzed the temporal changes in perioperative hemodynamics. <b><i>Results:<\/i><\/b> Four patients (19.0%, 4\/21) exhibited immediate CBF improvement from POD 1, which was classified as \u201cimmediate redistribution pattern.\u201d In contrast, 9 (42.9%, 9\/21) demonstrated transient hemispheric global hypoperfusion at POD 1 and subsequent CBF improvement at POD 7, which was defined as \u201ctransient hypoperfusion pattern.\u201d Although 8 patients, including 4 with \u201ctransient hypoperfusion pattern\u201d (44.4, 4\/9), developed mild transient neurological deterioration in the acute stage, it resolved in all 21 patients, and there were no permanent neurological deficits. <b><i>Discussion\/Conclusions:<\/i><\/b> This study revealed that the \u201ctransient hypoperfusion pattern\u201d after revascularization surgery is relatively common among pediatric MMD patients, and its outcome is favorable under strict perioperative management. <\/jats:p>","DOI":"10.1159\/000520801","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T22:00:36Z","timestamp":1640124036000},"page":"453-460","source":"Crossref","is-referenced-by-count":10,"title":["Transient Global Cerebral Hypoperfusion as a Characteristic Cerebral Hemodynamic Pattern in the Acute Stage after Combined Revascularization Surgery for Pediatric Moyamoya Disease: N-Isopropyl-P-[<sup>123<\/sup>I] Iodoamphetamine Single-Photon Emission Computed Tomography Study"],"prefix":"10.1159","volume":"51","author":[{"given":"Atsushi","family":"Kanoke","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0991-0516","authenticated-orcid":false,"given":"Miki","family":"Fujimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1099-303X","authenticated-orcid":false,"given":"Ryosuke","family":"Tashiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3411-2900","authenticated-orcid":false,"given":"Teiji","family":"Tominaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.52.245"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00014"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-007-0551-y"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000132205"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2008.02.031"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2007.07.077"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3171\/2010.4.PEDS09478"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1159\/000336765"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-009-0184-6"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(95)00475-0"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s007010050035"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3171\/2014.8.JNS132413"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/520801","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/520801","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:32:59Z","timestamp":1745422379000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000520801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,21]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,7,1]]},"published-print":{"date-parts":[[2022,7,5]]}},"URL":"https:\/\/doi.org\/10.1159\/000520801","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.17306471","asserted-by":"subject"}]},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,21]]}}}