{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:50:46Z","timestamp":1785527446190,"version":"3.56.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"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":[[2024,3,11]]},"abstract":"\n BACKGROUND<\/jats:title>\n The treatment strategy for hemorrhagic moyamoya disease (MMD) due to a ruptured aneurysm at the distal portion of the anterior choroidal artery remains controversial. The authors successfully treated the ruptured aneurysm with neuroendoscopic hematoma evacuation, followed by endovascular coil embolization.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors encountered two patients with massive hemorrhagic MMD whose MMD had already been diagnosed and who had a periventricular anastomosis due to a ruptured aneurysm of the distal portion of the anterior choroidal artery involving the periventricular anastomosis. In both cases, neuroendoscopic hematoma evacuation was performed for hemorrhagic MMD in the acute phase, followed by endovascular coil embolization of the ruptured aneurysm in the chronic phase. In both endovascular treatments, the patient\u2019s condition was stabilized by hematoma evacuation, allowing a detailed preoperative evaluation of the anatomical findings of the vessel and functional findings of intraoperative neurophysiological monitoring using continuous monitoring of motor evoked potentials to preserve motor function.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Combination therapy can be useful for hemorrhagic MMD in patients with diagnosed MMD with a periventricular anastomosis. Additionally, a preoperative understanding of the vascular construction and intraoperative neurophysiological monitoring will aid in the successful coil embolization of aneurysms at the distal portion of the anterior choroidal artery with hemorrhagic MMD.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case23677","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T13:01:01Z","timestamp":1710162061000},"source":"Crossref","is-referenced-by-count":2,"title":["Combination of neuroendoscopic hematoma evacuation and endovascular coil embolization for a ruptured anterior choroidal artery aneurysm in patients with moyamoya disease: illustrative cases"],"prefix":"10.3171","volume":"7","author":[{"given":"Kohei","family":"Uemasu","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"},{"name":"Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"},{"name":"Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumito","family":"Sato","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideto","family":"Komai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Inukai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuichiro","family":"Hide","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Asari","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Kumabe","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Nihon Ika Daigaku Igakkai Zasshi","first-page":"160","article-title":"A case of ruptured distal anterior cerebral artery aneurysm associated with unilateral moyamoya disease","volume":"16","author":"Yamada O","year":"2020","unstructured":"Yamada O A case of ruptured distal anterior cerebral artery aneurysm associated with unilateral moyamoya disease. Nihon Ika Daigaku Igakkai Zasshi. 2020;16(3):160\u2013163."},{"issue":"4","key":"b2","series-title":"J Neurosurg","first-page":"565","article-title":"Moyamoya disease associated with aneurysm","volume":"48","author":"Kodama N","year":"1978","unstructured":"Kodama N, Suzuki J Moyamoya disease associated with aneurysm. J Neurosurg. 1978;48(4):565\u2013569."},{"issue":"5","key":"b3","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."},{"issue":"1","key":"b4","series-title":"Stroke","first-page":"37","article-title":"Significance of the hemorrhagic site for recurrent bleeding: prespecified analysis in the Japan Adult Moyamoya Trial","volume":"47","author":"Takahashi JC","year":"2016","unstructured":"Takahashi JC, Funaki T, Houkin K, Significance of the hemorrhagic site for recurrent bleeding: prespecified analysis in the Japan Adult Moyamoya Trial. Stroke. 2016;47(1):37\u201343."},{"issue":"3","key":"b5","series-title":"J Neurosurg","first-page":"777","article-title":"Angiographic features of hemorrhagic moyamoya disease with high recurrence risk: a supplementary analysis of the Japan Adult Moyamoya Trial","volume":"128","author":"Funaki T","year":"2018","unstructured":"Funaki T, Takahashi JC, Houkin K, Angiographic features of hemorrhagic moyamoya disease with high recurrence risk: a supplementary analysis of the Japan Adult Moyamoya Trial. J Neurosurg. 2018;128(3):777\u2013784."},{"issue":"5","key":"b6","series-title":"J Neurosurg Case Lessons","first-page":"CASE22237","article-title":"Endoscope-integrated indocyanine green video angiography and the detection of the fragile periventricular collaterals associated with moyamoya disease: illustrative cases","volume":"4","author":"Koizumi H","year":"2022","unstructured":"Koizumi H, Hide T, Yamamoto D, Endoscope-integrated indocyanine green video angiography and the detection of the fragile periventricular collaterals associated with moyamoya disease: illustrative cases. J Neurosurg Case Lessons. 2022;4(5):CASE22237."},{"issue":"12","key":"b7","series-title":"Neurol Res","first-page":"1097","article-title":"Neuro-endoscopic management of hemorrhagic moyamoya disease in the acute stage: single institute experience","volume":"41","author":"Mino M","year":"2019","unstructured":"Mino M, Fujimura M, Endo H, Endo T, Sato K, Tominaga T Neuro-endoscopic management of hemorrhagic moyamoya disease in the acute stage: single institute experience. Neurol Res. 2019;41(12):1097\u20131103."},{"key":"b8","series-title":"World Neurosurg","first-page":"e175","article-title":"Intracranial aneurysms in adult moyamoya disease","volume":"109","author":"Kim JH","year":"2018","unstructured":"Kim JH, Kwon TH, Kim JH, Chong K, Yoon W Intracranial aneurysms in adult moyamoya disease. World Neurosurg. 2018;109:e175\u2013e182."},{"key":"b9","series-title":"World Neurosurg","first-page":"247","article-title":"Short-term spontaneous resolution of ruptured peripheral aneurysm in moyamoya disease","volume":"126","author":"Yamada H","year":"2019","unstructured":"Yamada H, Saga I, Kojima A, Horiguchi T Short-term spontaneous resolution of ruptured peripheral aneurysm in moyamoya disease. World Neurosurg. 2019;126:247\u2013251."},{"issue":"3","key":"b10","series-title":"J Neurosurg","first-page":"637","article-title":"Treatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis","volume":"136","author":"Wiedmann MKH","year":"2021","unstructured":"Wiedmann MKH, Davidoff C, Lo Presti A, Treatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis. 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J Neuroendovasc Ther. 2013;7(3):179\u2013185."},{"key":"b13","series-title":"Clin Neurol Neurosurg","first-page":"106906","article-title":"Endovascular management of ruptured choroidal aneurysms associated with moyamoya syndrome: a two-patient case report & review of the literature","volume":"209","author":"Pathuri S","year":"2021","unstructured":"Pathuri S, Rodriguez P, Mascitelli JR Endovascular management of ruptured choroidal aneurysms associated with moyamoya syndrome: a two-patient case report & review of the literature. Clin Neurol Neurosurg. 2021;209:106906."},{"issue":"3","key":"b1","series-title":"Nihon Ika Daigaku Igakkai Zasshi","first-page":"160","article-title":"A case of ruptured distal anterior cerebral artery aneurysm associated with unilateral moyamoya disease","volume":"16","author":"Yamada O","year":"2020","unstructured":"Yamada O A case of ruptured distal anterior cerebral artery aneurysm associated with unilateral moyamoya disease. 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Stroke. 2014;45(5):1415\u20131421."},{"issue":"1","key":"b4","series-title":"Stroke","first-page":"37","article-title":"Significance of the hemorrhagic site for recurrent bleeding: prespecified analysis in the Japan Adult Moyamoya Trial","volume":"47","author":"Takahashi JC","year":"2016","unstructured":"Takahashi JC, Funaki T, Houkin K, Significance of the hemorrhagic site for recurrent bleeding: prespecified analysis in the Japan Adult Moyamoya Trial. Stroke. 2016;47(1):37\u201343."},{"issue":"3","key":"b5","series-title":"J Neurosurg","first-page":"777","article-title":"Angiographic features of hemorrhagic moyamoya disease with high recurrence risk: a supplementary analysis of the Japan Adult Moyamoya Trial","volume":"128","author":"Funaki T","year":"2018","unstructured":"Funaki T, Takahashi JC, Houkin K, Angiographic features of hemorrhagic moyamoya disease with high recurrence risk: a supplementary analysis of the Japan Adult Moyamoya Trial. 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World Neurosurg. 2018;109:e175\u2013e182."},{"key":"b9","series-title":"World Neurosurg","first-page":"247","article-title":"Short-term spontaneous resolution of ruptured peripheral aneurysm in moyamoya disease","volume":"126","author":"Yamada H","year":"2019","unstructured":"Yamada H, Saga I, Kojima A, Horiguchi T Short-term spontaneous resolution of ruptured peripheral aneurysm in moyamoya disease. World Neurosurg. 2019;126:247\u2013251."},{"issue":"3","key":"b10","series-title":"J Neurosurg","first-page":"637","article-title":"Treatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis","volume":"136","author":"Wiedmann MKH","year":"2021","unstructured":"Wiedmann MKH, Davidoff C, Lo Presti A, Treatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis. J Neurosurg. 2021;136(3):637\u2013646."},{"issue":"2","key":"b11","series-title":"Neurosurg Rev","first-page":"1127","article-title":"Location-based treatment of intracranial aneurysms in moyamoya disease: a systematic review and descriptive analysis","volume":"44","author":"Larson AS","year":"2021","unstructured":"Larson AS, Rinaldo L, Brinjikji W, Lanzino G Location-based treatment of intracranial aneurysms in moyamoya disease: a systematic review and descriptive analysis. Neurosurg Rev. 2021;44(2):1127\u20131139."},{"issue":"3","key":"b12","series-title":"J Neuroendovasc Ther","first-page":"179","article-title":"Aneurysms of ruptured distal anterior choroidal artery embolized using N-butyl cyanoacrylate: case report","volume":"7","author":"Shimizu T","year":"2013","unstructured":"Shimizu T, Naito I, Miyamoto N, Aneurysms of ruptured distal anterior choroidal artery embolized using N-butyl cyanoacrylate: case report. J Neuroendovasc Ther. 2013;7(3):179\u2013185."},{"key":"b13","series-title":"Clin Neurol Neurosurg","first-page":"106906","article-title":"Endovascular management of ruptured choroidal aneurysms associated with moyamoya syndrome: a two-patient case report & review of the literature","volume":"209","author":"Pathuri S","year":"2021","unstructured":"Pathuri S, Rodriguez P, Mascitelli JR Endovascular management of ruptured choroidal aneurysms associated with moyamoya syndrome: a two-patient case report & review of the literature. 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