{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:47:17Z","timestamp":1770353237059,"version":"3.49.0"},"reference-count":66,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"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":[[2023,6,26]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>\n                      Cerebral revascularization is recommended for patients with moyamoya disease (MMD) with reduced cerebral perfusion reserve and recurrent or progressive ischemic events. The standard surgical treatment for these patients is a low-flow bypass with or without indirect revascularization. The use of intraoperative monitoring of the metabolic profile using analytes such as glucose, lactate, pyruvate, and glycerol has not yet been described during cerebral artery bypass surgery for MMD-induced chronic cerebral ischemia. The authors aimed to describe an illustrative case using intraoperative microdialysis and brain tissue oxygen partial pressure (PbtO\n                      <jats:sub>2<\/jats:sub>\n                      ) probes in a patient with MMD during direct revascularization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      The patient\u2019s severe tissue hypoxia situation was confirmed by a PbtO\n                      <jats:sub>2<\/jats:sub>\n                      :partial pressure of oxygen (PaO\n                      <jats:sub>2<\/jats:sub>\n                      ) ratio below 0.1 and anaerobic metabolism by a lactate:pyruvate ratio greater than 40. Following bypass, a rapid and sustained increase in PbtO\n                      <jats:sub>2<\/jats:sub>\n                      up to normal values (PbtO\n                      <jats:sub>2<\/jats:sub>\n                      :PaO\n                      <jats:sub>2<\/jats:sub>\n                      ratio between 0.1 and 0.35) and the normalization of cerebral energetic metabolism with a lactate\/pyruvate ratio less than 20 was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The results show a quick improvement of regional cerebral hemodynamics due to the direct anastomosis procedure, reducing the incidence of subsequent ischemic stroke in pediatric and adult patients immediately.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23104","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T02:16:36Z","timestamp":1687832196000},"source":"Crossref","is-referenced-by-count":1,"title":["Metabolism changes during direct revascularization in moyamoya disease: illustrative case"],"prefix":"10.3171","volume":"5","author":[{"given":"Fuat","family":"Arikan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Neurotraumatology Neurosurgery Research Unit (UNINN), Vall d\u2018Hebron Research Institute (VHIR), Barcelona, Spain; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivette","family":"Chocron","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Vall d\u2019Hebron University Hospital, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Calvo-Rubio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"G\u00e1ndara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Neurotraumatology Neurosurgery Research Unit (UNINN), Vall d\u2018Hebron Research Institute (VHIR), Barcelona, Spain; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Moyamoya disease: a summary","volume":"26","author":"Burke GM","year":"2009","unstructured":"Burke GM, Burke AM, Sherma AK, Hurley MC, Batjer HH, Bendok BR. Moyamoya disease: a summary. Neurosurg Focus. 2009;26(4):E11.19335127"},{"key":"b2","series-title":"Neuropathology","first-page":"S61","article-title":"Moyamoya disease","volume":"20","author":"Fukui M","year":"2000","unstructured":"Fukui M, Kono S, Sueishi K, Ikezaki K. Moyamoya disease. Neuropathology. 2000;20(Suppl):S61\u2013S64.11037190"},{"key":"b3","series-title":"Neurosurgery","first-page":"S116","article-title":"Advances and surgical considerations in the treatment of moyamoya disease","volume":"74","author":"Arias EJ","year":"2014","unstructured":"Arias EJ, Derdeyn CP, Dacey RG Jr, Zipfel GJ. Advances and surgical considerations in the treatment of moyamoya disease. Neurosurgery. 2014;74(Suppl 1):S116\u2013S125.24402480"},{"issue":"4","key":"b4","series-title":"Pediatr Neurol","first-page":"321","article-title":"Long-term outcomes of pediatric moyamoya disease monitored to adulthood","volume":"18","author":"Imaizumi T","year":"1998","unstructured":"Imaizumi T, Hayashi K, Saito K, Osawa M, Fukuyama Y. Long-term outcomes of pediatric moyamoya disease monitored to adulthood. Pediatr Neurol. 1998;18(4):321\u2013325.9588527"},{"issue":"6","key":"b5","series-title":"Stroke","first-page":"1170","article-title":"Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease","volume":"28","author":"Ishikawa T","year":"1997","unstructured":"Ishikawa T, Houkin K, Kamiyama H, Abe H. Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease. Stroke. 1997;28(6):1170\u20131173.9183345"},{"issue":"1","key":"b6","series-title":"Pediatr Neurosurg","first-page":"14","article-title":"Long-term outcomes of pediatric moyamoya disease treated by encephalo-duro-arterio-synangiosis","volume":"36","author":"Isono M","year":"2002","unstructured":"Isono M, Ishii K, Kamida T, Inoue R, Fujiki M, Kobayashi H. Long-term outcomes of pediatric moyamoya disease treated by encephalo-duro-arterio-synangiosis. Pediatr Neurosurg. 2002;36(1):14\u201321.11818741"},{"issue":"1","key":"b7","series-title":"J Neurosurg","first-page":"84","article-title":"Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease","volume":"77","author":"Karasawa J","year":"1992","unstructured":"Karasawa J, Touho H, Ohnishi H, Miyamoto S, Kikuchi H. Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease. J Neurosurg. 1992;77(1):84\u201389.1607976"},{"issue":"2","key":"b8","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Long-term outcome of superficial temporal artery-middle cerebral artery bypass for patients with moyamoya disease in the US","volume":"24","author":"Mesiwala AH","year":"2008","unstructured":"Mesiwala AH, Sviri G, Fatemi N, Britz GW, Newell DW. Long-term outcome of superficial temporal artery-middle cerebral artery bypass for patients with moyamoya disease in the US. Neurosurg Focus. 2008;24(2):E15.18275291"},{"issue":"5","key":"b9","series-title":"Stroke","first-page":"1415","article-title":"Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial","volume":"45","author":"Miyamoto S","year":"2014","unstructured":"Miyamoto S, Yoshimoto T, Hashimoto N,  Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial. Stroke. 2014;45(5):1415\u20131421.24668203"},{"issue":"4","key":"b10","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Cerebral hemodynamics as a predictor of stroke in adult patients with moyamoya disease: a prospective observational study","volume":"26","author":"Zipfel GJ","year":"2009","unstructured":"Zipfel GJ, Sagar J, Miller JP,  Cerebral hemodynamics as a predictor of stroke in adult patients with moyamoya disease: a prospective observational study. Neurosurg Focus. 2009;26(4):E6.19335132"},{"issue":"4","key":"b11","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Surgical management of moyamoya disease: a review","volume":"26","author":"Baaj AA","year":"2009","unstructured":"Baaj AA, Agazzi S, Sayed ZA, Toledo M, Spetzler RF, van Loveren H. Surgical management of moyamoya disease: a review. Neurosurg Focus. 2009;26(4):E7.19335133"},{"issue":"5","key":"b12","series-title":"J Neurosurg","first-page":"927","article-title":"Clinical outcome after 450 revascularization procedures for moyamoya disease. Clinical article","volume":"111","author":"Guzman R","year":"2009","unstructured":"Guzman R, Lee M, Achrol A,  Clinical outcome after 450 revascularization procedures for moyamoya disease. Clinical article. J Neurosurg. 2009;111(5):927\u2013935.19463046"},{"issue":"5","key":"b13","series-title":"Neurosurg Focus","first-page":"e4","article-title":"Multiple combined indirect procedure for the surgical treatment of children with moyamoya disease. A comparison with single indirect anastomosis and direct anastomosis","volume":"5","author":"Matsushima T","year":"1998","unstructured":"Matsushima T, Inoue T, Ikezaki K,  Multiple combined indirect procedure for the surgical treatment of children with moyamoya disease. A comparison with single indirect anastomosis and direct anastomosis. Neurosurg Focus. 1998;5(5):e4.17112207"},{"issue":"3","key":"b14","series-title":"Neurosurgery","first-page":"401","article-title":"Surgical treatment of moyamoya disease in pediatric patients\u2014comparison between the results of indirect and direct revascularization procedures","volume":"31","author":"Matsushima T","year":"1992","unstructured":"Matsushima T, Inoue T, Suzuki SO, Fujii K, Fukui M, Hasuo K. Surgical treatment of moyamoya disease in pediatric patients\u2014comparison between the results of indirect and direct revascularization procedures. Neurosurgery. 1992;31(3):401\u2013405.1407421"},{"issue":"1","key":"b15","series-title":"Neurol Res","first-page":"66","article-title":"EC-IC bypass improves chronic ischemia in a patient with moyamoya disease secondary to sickle cell disease: an in vivo microdialysis study","volume":"19","author":"Mendelowitsch A","year":"1997","unstructured":"Mendelowitsch A, Sekhar LN, Clemente R, Shuaib A. EC-IC bypass improves chronic ischemia in a patient with moyamoya disease secondary to sickle cell disease: an in vivo microdialysis study. Neurol Res. 1997;19(1):66\u201370."},{"issue":"1","key":"b16","series-title":"Skull Base","first-page":"15","article-title":"Surgical management of moyamoya syndrome","volume":"15","author":"Smith ER","year":"2005","unstructured":"Smith ER, Scott RM. Surgical management of moyamoya syndrome. Skull Base. 2005;15(1):15\u201326.16148981"},{"issue":"3","key":"b17","series-title":"Neurosurg Clin N Am","first-page":"585","article-title":"Cerebral revascularization for moyamoya disease in adults","volume":"12","author":"Srinivasan J","year":"2001","unstructured":"Srinivasan J, Britz GW, Newell DW. Cerebral revascularization for moyamoya disease in adults. Neurosurg Clin N Am. 2001;12(3):585\u2013594, ix.11390316"},{"issue":"4","key":"b18","series-title":"Neurosurg Focus","first-page":"E8","article-title":"Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass","volume":"26","author":"Starke RM","year":"2009","unstructured":"Starke RM, Komotar RJ, Connolly ES. Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass. Neurosurg Focus. 2009;26(4):E8.19335134"},{"issue":"2","key":"b19","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions","volume":"24","author":"Veeravagu A","year":"2008","unstructured":"Veeravagu A, Guzman R, Patil CG, Hou LC, Lee M, Steinberg GK. Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions. Neurosurg Focus. 2008;24(2):E16.18275292"},{"issue":"1","key":"b20","series-title":"Skull Base","first-page":"27","article-title":"Moyamoya disease in adults: the role of cerebral revascularization","volume":"15","author":"Zipfel GJ","year":"2005","unstructured":"Zipfel GJ, Fox DJ Jr, Rivet DJ. Moyamoya disease in adults: the role of cerebral revascularization. Skull Base. 2005;15(1):27\u201341.16148982"},{"issue":"4","key":"b21","series-title":"Neurocirugia (Astur: Engl Ed)","first-page":"170","article-title":"Revascularization experience and results in ischaemic cerebrovascular disease: moyamoya disease and carotid occlusion","volume":"29","author":"Arikan F","year":"2018","unstructured":"Arikan F, Rubiera M, Serena J,  Revascularization experience and results in ischaemic cerebrovascular disease: moyamoya disease and carotid occlusion. Neurocirugia (Astur: Engl Ed). 2018;29(4):170\u2013186.29550248"},{"issue":"3","key":"b22","series-title":"Neurosurgery","first-page":"302","article-title":"Rapid resolution of brain ischemic hypoxia after cerebral revascularization in moyamoya disease","volume":"76","author":"Arikan F","year":"2015","unstructured":"Arikan F, Vilalta J, Torne R, Noguer M, Lorenzo-Bosquet C, Sahuquillo J. Rapid resolution of brain ischemic hypoxia after cerebral revascularization in moyamoya disease. Neurosurgery. 2015;76(3):302\u2013312, discussion 312.25584958"},{"issue":"1","key":"b23","series-title":"No Shinkei Geka","first-page":"23","article-title":"Long-term follow-up angiography of moyamoya disease\u2014cases followed from childhood to adolescence","volume":"14","author":"Takahashi A","year":"1986","unstructured":"Takahashi A, Fujiwara S, Suzuki J. Long-term follow-up angiography of moyamoya disease\u2014cases followed from childhood to adolescence. Article in Japanese. No Shinkei Geka. 1986;14(1):23\u201329.3951660"},{"issue":"4","key":"b24","series-title":"Neurol Clin","first-page":"729","article-title":"Is extracranial-intracranial bypass surgery effective in certain patients?","volume":"24","author":"Amin-Hanjani S","year":"2006","unstructured":"Amin-Hanjani S, Charbel FT. Is extracranial-intracranial bypass surgery effective in certain patients? Neurol Clin. 2006;24(4):729\u2013743.16935199"},{"key":"b25","series-title":"Clin Neurol Neurosurg","first-page":"S238","article-title":"Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan","volume":"99","author":"Fukui M","year":"1997","unstructured":"Fukui M. Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 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(Suppl 2):S238\u2013S240.9409446"},{"issue":"6","key":"b26","series-title":"Surg Neurol","first-page":"569","article-title":"Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system","volume":"65","author":"Hoshino T","year":"2006","unstructured":"Hoshino T, Katayama Y, Sakatani K, Kano T, Murata Y. Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system. Surg Neurol. 2006;65(6):569\u2013576.16720176"},{"issue":"3","key":"b27","series-title":"J Neurosurg","first-page":"397","article-title":"Effect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease","volume":"93","author":"Kawaguchi S","year":"2000","unstructured":"Kawaguchi S, Okuno S, Sakaki T. Effect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease. J Neurosurg. 2000;93(3):397\u2013401.10969936"},{"issue":"3","key":"b28","series-title":"J Neurosurg","first-page":"515","article-title":"Monitoring of brain tissue oxygenation during aneurysm surgery: prediction of procedure-related ischemic events","volume":"98","author":"J\u00f6dicke A","year":"2003","unstructured":"J\u00f6dicke A, H\u00fcbner F, B\u00f6ker DK. Monitoring of brain tissue oxygenation during aneurysm surgery: prediction of procedure-related ischemic events. J Neurosurg. 2003;98(3):515\u2013523.12650422"},{"issue":"4","key":"b29","series-title":"J Neurosurg Anesthesiol","first-page":"328","article-title":"Intraoperative monitoring of brain tissue oxygenation during arteriovenous malformation resection","volume":"26","author":"Arikan F","year":"2014","unstructured":"Arikan F, Vilalta J, Noguer M, Olive M, Vidal-Jorge M, Sahuquillo J. Intraoperative monitoring of brain tissue oxygenation during arteriovenous malformation resection. J Neurosurg Anesthesiol. 2014;26(4):328\u2013341.24492516"},{"issue":"9","key":"b30","series-title":"Intensive Care Med","first-page":"1517","article-title":"Consensus statement from the 2014 International Microdialysis Forum","volume":"41","author":"Hutchinson PJ","year":"2015","unstructured":"Hutchinson PJ, Jalloh I, Helmy A,  Consensus statement from the 2014 International Microdialysis Forum. Intensive Care Med. 2015;41(9):1517\u20131528.26194024"},{"issue":"3","key":"b31","series-title":"Neurosurgery","first-page":"701","article-title":"Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery","volume":"47","author":"Reinstrup P","year":"2000","unstructured":"Reinstrup P, St\u00e5hl N, Mellerg\u00e5rd P, Uski T, Ungerstedt U, Nordstr\u00f6m CH. Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery. Neurosurgery. 2000;47(3):701\u2013710.10981758"},{"issue":"7","key":"b32","series-title":"PLoS One","first-page":"e102540","article-title":"Lactate and the lactate-to-pyruvate molar ratio cannot be used as independent biomarkers for monitoring brain energetic metabolism: a microdialysis study in patients with traumatic brain injuries","volume":"9","author":"Sahuquillo J","year":"2014","unstructured":"Sahuquillo J, Merino MA, S\u00e1nchez-Guerrero A,  Lactate and the lactate-to-pyruvate molar ratio cannot be used as independent biomarkers for monitoring brain energetic metabolism: a microdialysis study in patients with traumatic brain injuries. PLoS One. 2014;9(7):e102540.25025772"},{"issue":"5","key":"b33","series-title":"Metabolites","first-page":"393","article-title":"Monitoring neurochemistry in traumatic brain injury patients using microdialysis integrated with biosensors: a review","volume":"12","author":"Zimphango C","year":"2022","unstructured":"Zimphango C, Alimagham FC, Carpenter KLH, Hutchinson PJ, Hutter T. Monitoring neurochemistry in traumatic brain injury patients using microdialysis integrated with biosensors: a review. Metabolites. 2022;12(5):393.35629896"},{"issue":"4","key":"b1","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Moyamoya disease: a summary","volume":"26","author":"Burke GM","year":"2009","unstructured":"Burke GM, Burke AM, Sherma AK, Hurley MC, Batjer HH, Bendok BR. Moyamoya disease: a summary. Neurosurg Focus. 2009;26(4):E11.19335127"},{"key":"b2","series-title":"Neuropathology","first-page":"S61","article-title":"Moyamoya disease","volume":"20","author":"Fukui M","year":"2000","unstructured":"Fukui M, Kono S, Sueishi K, Ikezaki K. Moyamoya disease. Neuropathology. 2000;20(Suppl):S61\u2013S64.11037190"},{"key":"b3","series-title":"Neurosurgery","first-page":"S116","article-title":"Advances and surgical considerations in the treatment of moyamoya disease","volume":"74","author":"Arias EJ","year":"2014","unstructured":"Arias EJ, Derdeyn CP, Dacey RG Jr, Zipfel GJ. Advances and surgical considerations in the treatment of moyamoya disease. Neurosurgery. 2014;74(Suppl 1):S116\u2013S125.24402480"},{"issue":"4","key":"b4","series-title":"Pediatr Neurol","first-page":"321","article-title":"Long-term outcomes of pediatric moyamoya disease monitored to adulthood","volume":"18","author":"Imaizumi T","year":"1998","unstructured":"Imaizumi T, Hayashi K, Saito K, Osawa M, Fukuyama Y. Long-term outcomes of pediatric moyamoya disease monitored to adulthood. Pediatr Neurol. 1998;18(4):321\u2013325.9588527"},{"issue":"6","key":"b5","series-title":"Stroke","first-page":"1170","article-title":"Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease","volume":"28","author":"Ishikawa T","year":"1997","unstructured":"Ishikawa T, Houkin K, Kamiyama H, Abe H. Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease. Stroke. 1997;28(6):1170\u20131173.9183345"},{"issue":"1","key":"b6","series-title":"Pediatr Neurosurg","first-page":"14","article-title":"Long-term outcomes of pediatric moyamoya disease treated by encephalo-duro-arterio-synangiosis","volume":"36","author":"Isono M","year":"2002","unstructured":"Isono M, Ishii K, Kamida T, Inoue R, Fujiki M, Kobayashi H. Long-term outcomes of pediatric moyamoya disease treated by encephalo-duro-arterio-synangiosis. Pediatr Neurosurg. 2002;36(1):14\u201321.11818741"},{"issue":"1","key":"b7","series-title":"J Neurosurg","first-page":"84","article-title":"Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease","volume":"77","author":"Karasawa J","year":"1992","unstructured":"Karasawa J, Touho H, Ohnishi H, Miyamoto S, Kikuchi H. Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease. J Neurosurg. 1992;77(1):84\u201389.1607976"},{"issue":"2","key":"b8","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Long-term outcome of superficial temporal artery-middle cerebral artery bypass for patients with moyamoya disease in the US","volume":"24","author":"Mesiwala AH","year":"2008","unstructured":"Mesiwala AH, Sviri G, Fatemi N, Britz GW, Newell DW. Long-term outcome of superficial temporal artery-middle cerebral artery bypass for patients with moyamoya disease in the US. Neurosurg Focus. 2008;24(2):E15.18275291"},{"issue":"5","key":"b9","series-title":"Stroke","first-page":"1415","article-title":"Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial","volume":"45","author":"Miyamoto S","year":"2014","unstructured":"Miyamoto S, Yoshimoto T, Hashimoto N,  Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial. Stroke. 2014;45(5):1415\u20131421.24668203"},{"issue":"4","key":"b10","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Cerebral hemodynamics as a predictor of stroke in adult patients with moyamoya disease: a prospective observational study","volume":"26","author":"Zipfel GJ","year":"2009","unstructured":"Zipfel GJ, Sagar J, Miller JP,  Cerebral hemodynamics as a predictor of stroke in adult patients with moyamoya disease: a prospective observational study. Neurosurg Focus. 2009;26(4):E6.19335132"},{"issue":"4","key":"b11","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Surgical management of moyamoya disease: a review","volume":"26","author":"Baaj AA","year":"2009","unstructured":"Baaj AA, Agazzi S, Sayed ZA, Toledo M, Spetzler RF, van Loveren H. Surgical management of moyamoya disease: a review. Neurosurg Focus. 2009;26(4):E7.19335133"},{"issue":"5","key":"b12","series-title":"J Neurosurg","first-page":"927","article-title":"Clinical outcome after 450 revascularization procedures for moyamoya disease. Clinical article","volume":"111","author":"Guzman R","year":"2009","unstructured":"Guzman R, Lee M, Achrol A,  Clinical outcome after 450 revascularization procedures for moyamoya disease. Clinical article. J Neurosurg. 2009;111(5):927\u2013935.19463046"},{"issue":"5","key":"b13","series-title":"Neurosurg Focus","first-page":"e4","article-title":"Multiple combined indirect procedure for the surgical treatment of children with moyamoya disease. A comparison with single indirect anastomosis and direct anastomosis","volume":"5","author":"Matsushima T","year":"1998","unstructured":"Matsushima T, Inoue T, Ikezaki K,  Multiple combined indirect procedure for the surgical treatment of children with moyamoya disease. A comparison with single indirect anastomosis and direct anastomosis. Neurosurg Focus. 1998;5(5):e4.17112207"},{"issue":"3","key":"b14","series-title":"Neurosurgery","first-page":"401","article-title":"Surgical treatment of moyamoya disease in pediatric patients\u2014comparison between the results of indirect and direct revascularization procedures","volume":"31","author":"Matsushima T","year":"1992","unstructured":"Matsushima T, Inoue T, Suzuki SO, Fujii K, Fukui M, Hasuo K. Surgical treatment of moyamoya disease in pediatric patients\u2014comparison between the results of indirect and direct revascularization procedures. Neurosurgery. 1992;31(3):401\u2013405.1407421"},{"issue":"1","key":"b15","series-title":"Neurol Res","first-page":"66","article-title":"EC-IC bypass improves chronic ischemia in a patient with moyamoya disease secondary to sickle cell disease: an in vivo microdialysis study","volume":"19","author":"Mendelowitsch A","year":"1997","unstructured":"Mendelowitsch A, Sekhar LN, Clemente R, Shuaib A. EC-IC bypass improves chronic ischemia in a patient with moyamoya disease secondary to sickle cell disease: an in vivo microdialysis study. Neurol Res. 1997;19(1):66\u201370."},{"issue":"1","key":"b16","series-title":"Skull Base","first-page":"15","article-title":"Surgical management of moyamoya syndrome","volume":"15","author":"Smith ER","year":"2005","unstructured":"Smith ER, Scott RM. Surgical management of moyamoya syndrome. Skull Base. 2005;15(1):15\u201326.16148981"},{"issue":"3","key":"b17","series-title":"Neurosurg Clin N Am","first-page":"585","article-title":"Cerebral revascularization for moyamoya disease in adults","volume":"12","author":"Srinivasan J","year":"2001","unstructured":"Srinivasan J, Britz GW, Newell DW. Cerebral revascularization for moyamoya disease in adults. Neurosurg Clin N Am. 2001;12(3):585\u2013594, ix.11390316"},{"issue":"4","key":"b18","series-title":"Neurosurg Focus","first-page":"E8","article-title":"Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass","volume":"26","author":"Starke RM","year":"2009","unstructured":"Starke RM, Komotar RJ, Connolly ES. Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass. Neurosurg Focus. 2009;26(4):E8.19335134"},{"issue":"2","key":"b19","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions","volume":"24","author":"Veeravagu A","year":"2008","unstructured":"Veeravagu A, Guzman R, Patil CG, Hou LC, Lee M, Steinberg GK. Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions. Neurosurg Focus. 2008;24(2):E16.18275292"},{"issue":"1","key":"b20","series-title":"Skull Base","first-page":"27","article-title":"Moyamoya disease in adults: the role of cerebral revascularization","volume":"15","author":"Zipfel GJ","year":"2005","unstructured":"Zipfel GJ, Fox DJ Jr, Rivet DJ. Moyamoya disease in adults: the role of cerebral revascularization. Skull Base. 2005;15(1):27\u201341.16148982"},{"issue":"4","key":"b21","series-title":"Neurocirugia (Astur: Engl Ed)","first-page":"170","article-title":"Revascularization experience and results in ischaemic cerebrovascular disease: moyamoya disease and carotid occlusion","volume":"29","author":"Arikan F","year":"2018","unstructured":"Arikan F, Rubiera M, Serena J,  Revascularization experience and results in ischaemic cerebrovascular disease: moyamoya disease and carotid occlusion. Neurocirugia (Astur: Engl Ed). 2018;29(4):170\u2013186.29550248"},{"issue":"3","key":"b22","series-title":"Neurosurgery","first-page":"302","article-title":"Rapid resolution of brain ischemic hypoxia after cerebral revascularization in moyamoya disease","volume":"76","author":"Arikan F","year":"2015","unstructured":"Arikan F, Vilalta J, Torne R, Noguer M, Lorenzo-Bosquet C, Sahuquillo J. Rapid resolution of brain ischemic hypoxia after cerebral revascularization in moyamoya disease. Neurosurgery. 2015;76(3):302\u2013312, discussion 312.25584958"},{"issue":"1","key":"b23","series-title":"No Shinkei Geka","first-page":"23","article-title":"Long-term follow-up angiography of moyamoya disease\u2014cases followed from childhood to adolescence","volume":"14","author":"Takahashi A","year":"1986","unstructured":"Takahashi A, Fujiwara S, Suzuki J. Long-term follow-up angiography of moyamoya disease\u2014cases followed from childhood to adolescence. Article in Japanese. No Shinkei Geka. 1986;14(1):23\u201329.3951660"},{"issue":"4","key":"b24","series-title":"Neurol Clin","first-page":"729","article-title":"Is extracranial-intracranial bypass surgery effective in certain patients?","volume":"24","author":"Amin-Hanjani S","year":"2006","unstructured":"Amin-Hanjani S, Charbel FT. Is extracranial-intracranial bypass surgery effective in certain patients? Neurol Clin. 2006;24(4):729\u2013743.16935199"},{"key":"b25","series-title":"Clin Neurol Neurosurg","first-page":"S238","article-title":"Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan","volume":"99","author":"Fukui M","year":"1997","unstructured":"Fukui M. Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 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(Suppl 2):S238\u2013S240.9409446"},{"issue":"6","key":"b26","series-title":"Surg Neurol","first-page":"569","article-title":"Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system","volume":"65","author":"Hoshino T","year":"2006","unstructured":"Hoshino T, Katayama Y, Sakatani K, Kano T, Murata Y. Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system. Surg Neurol. 2006;65(6):569\u2013576.16720176"},{"issue":"3","key":"b27","series-title":"J Neurosurg","first-page":"397","article-title":"Effect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease","volume":"93","author":"Kawaguchi S","year":"2000","unstructured":"Kawaguchi S, Okuno S, Sakaki T. Effect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease. J Neurosurg. 2000;93(3):397\u2013401.10969936"},{"issue":"3","key":"b28","series-title":"J Neurosurg","first-page":"515","article-title":"Monitoring of brain tissue oxygenation during aneurysm surgery: prediction of procedure-related ischemic events","volume":"98","author":"J\u00f6dicke A","year":"2003","unstructured":"J\u00f6dicke A, H\u00fcbner F, B\u00f6ker DK. Monitoring of brain tissue oxygenation during aneurysm surgery: prediction of procedure-related ischemic events. J Neurosurg. 2003;98(3):515\u2013523.12650422"},{"issue":"4","key":"b29","series-title":"J Neurosurg Anesthesiol","first-page":"328","article-title":"Intraoperative monitoring of brain tissue oxygenation during arteriovenous malformation resection","volume":"26","author":"Arikan F","year":"2014","unstructured":"Arikan F, Vilalta J, Noguer M, Olive M, Vidal-Jorge M, Sahuquillo J. Intraoperative monitoring of brain tissue oxygenation during arteriovenous malformation resection. J Neurosurg Anesthesiol. 2014;26(4):328\u2013341.24492516"},{"issue":"9","key":"b30","series-title":"Intensive Care Med","first-page":"1517","article-title":"Consensus statement from the 2014 International Microdialysis Forum","volume":"41","author":"Hutchinson PJ","year":"2015","unstructured":"Hutchinson PJ, Jalloh I, Helmy A,  Consensus statement from the 2014 International Microdialysis Forum. Intensive Care Med. 2015;41(9):1517\u20131528.26194024"},{"issue":"3","key":"b31","series-title":"Neurosurgery","first-page":"701","article-title":"Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery","volume":"47","author":"Reinstrup P","year":"2000","unstructured":"Reinstrup P, St\u00e5hl N, Mellerg\u00e5rd P, Uski T, Ungerstedt U, Nordstr\u00f6m CH. Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery. Neurosurgery. 2000;47(3):701\u2013710.10981758"},{"issue":"7","key":"b32","series-title":"PLoS One","first-page":"e102540","article-title":"Lactate and the lactate-to-pyruvate molar ratio cannot be used as independent biomarkers for monitoring brain energetic metabolism: a microdialysis study in patients with traumatic brain injuries","volume":"9","author":"Sahuquillo J","year":"2014","unstructured":"Sahuquillo J, Merino MA, S\u00e1nchez-Guerrero A,  Lactate and the lactate-to-pyruvate molar ratio cannot be used as independent biomarkers for monitoring brain energetic metabolism: a microdialysis study in patients with traumatic brain injuries. PLoS One. 2014;9(7):e102540.25025772"},{"issue":"5","key":"b33","series-title":"Metabolites","first-page":"393","article-title":"Monitoring neurochemistry in traumatic brain injury patients using microdialysis integrated with biosensors: a review","volume":"12","author":"Zimphango C","year":"2022","unstructured":"Zimphango C, Alimagham FC, Carpenter KLH, Hutchinson PJ, Hutter T. Monitoring neurochemistry in traumatic brain injury patients using microdialysis integrated with biosensors: a review. Metabolites. 2022;12(5):393.35629896"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/5\/26\/article-CASE23104.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/5\/26\/article-CASE23104.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/5\/26\/article-CASE23104.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:29:25Z","timestamp":1770301765000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/5\/26\/article-CASE23104.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,26]]},"references-count":66,"journal-issue":{"issue":"26"},"URL":"https:\/\/doi.org\/10.3171\/case23104","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,26]]}}}