{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:42:14Z","timestamp":1770352934404,"version":"3.49.0"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T00:00:00Z","timestamp":1642377600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,17]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Transient neurological deficits (TNDs) develop after cerebral revascularization in patients with moyamoya disease (MMD). The authors report a rare pediatric MMD case with extensive decreased cerebral blood flow (CBF) and prolonged TNDs after combined revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 9-year-old boy presented with transient left upper limb weakness, and MMD was diagnosed. A right-sided combined surgery was performed. Two years after the surgery, frequent but transient facial (right-sided) and upper limb weakness appeared. The left internal carotid artery terminal stenosis had progressed. Therefore, a left combined revascularization was performed. The patient\u2019s motor aphasia and right upper limb weakness persisted for approximately 10 days after surgery. Magnetic resonance angiography showed that the direct bypass was patent, but extensive decreases in left CBF were observed using single photon emission tomography. With adequate fluid therapy and blood pressure control, the neurological symptoms eventually disappeared, and CBF improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The environment of cerebral hemodynamics is heterogeneous after cerebral revascularization for MMD, and the exact mechanism of CBF decreases was not identified. TNDs are significantly associated with the onset of stroke during the early postoperative period. Therefore, appropriate treatment is desired after determining complex cerebral hemodynamics using CBF studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21628","type":"journal-article","created":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T02:06:48Z","timestamp":1642385208000},"source":"Crossref","is-referenced-by-count":0,"title":["Paradoxical symptomatic cerebral blood flow decreases after combined revascularization surgery for patients with pediatric moyamoya disease: illustrative case"],"prefix":"10.3171","volume":"3","author":[{"given":"Yoshio","family":"Araki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinya","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Uda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiaki","family":"Kanamori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michihiro","family":"Kurimoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Shiba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Mamiya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Takayanagi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Nishihori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhito","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniaki","family":"Tanahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Rehabilitation Hospital, Aichi, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Sumitomo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Toyota Kosei Hospital, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuta","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"11","key":"b1","series-title":"Lancet Neurol","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/S1474-4422(08)70240-0","article-title":"Moyamoya disease: current concepts and future perspectives","volume":"7","author":"Kuroda S","year":"2008","unstructured":"Kuroda S, Houkin K. 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