Endoscope-integrated indocyanine green video angiography and the detection of the fragile periventricular collaterals associated with moyamoya disease: illustrative cases.

endoscopic surgery hemorrhagic moyamoya disease indocyanine green periventricular collateral

Journal

Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676

Informations de publication

Date de publication:
01 Aug 2022
Historique:
received: 26 05 2022
accepted: 20 06 2022
entrez: 11 9 2022
pubmed: 12 9 2022
medline: 12 9 2022
Statut: epublish

Résumé

Hemorrhagic moyamoya disease (MMD) and the fragile periventricular collaterals are known to have a causal relationship. Digital subtraction angiography and magnetic resonance angiography have shown the presence of fragile periventricular moyamoya vessels. However, dynamic fragile periventricular moyamoya vessels have never been observed under direct vision. The authors treated two patients with hemorrhagic MMD: a 42-year-old man with intraventricular hemorrhage and a 47-year-old woman with intracerebral hemorrhage. Endoscope-integrated indocyanine green video angiography (EICG angiography) could visualize the dynamic fragile periventricular collaterals. In particular, EICG angiography enabled visualization of invisible moyamoya vessels buried in the subependyma and characterization of the blood flow in the moyamoya vessels located inside the lateral ventricles and hematoma cavity. EICG angiography can confirm the fragile periventricular collaterals associated with MMD by direct visualization. The high spatial resolution and real-time imaging can help to avoid accidental hemorrhage in and after evacuation of hemorrhage in patients with MMD.

Sections du résumé

BACKGROUND BACKGROUND
Hemorrhagic moyamoya disease (MMD) and the fragile periventricular collaterals are known to have a causal relationship. Digital subtraction angiography and magnetic resonance angiography have shown the presence of fragile periventricular moyamoya vessels. However, dynamic fragile periventricular moyamoya vessels have never been observed under direct vision.
OBSERVATIONS METHODS
The authors treated two patients with hemorrhagic MMD: a 42-year-old man with intraventricular hemorrhage and a 47-year-old woman with intracerebral hemorrhage. Endoscope-integrated indocyanine green video angiography (EICG angiography) could visualize the dynamic fragile periventricular collaterals. In particular, EICG angiography enabled visualization of invisible moyamoya vessels buried in the subependyma and characterization of the blood flow in the moyamoya vessels located inside the lateral ventricles and hematoma cavity.
LESSONS CONCLUSIONS
EICG angiography can confirm the fragile periventricular collaterals associated with MMD by direct visualization. The high spatial resolution and real-time imaging can help to avoid accidental hemorrhage in and after evacuation of hemorrhage in patients with MMD.

Identifiants

pubmed: 36088561
doi: 10.3171/CASE22237
pii: CASE22237
pmc: PMC9706336
doi:
pii:

Types de publication

Journal Article

Langues

eng

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Auteurs

Hiroyuki Koizumi (H)

Departments of1Neurosurgery and.
2Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

Takuichiro Hide (T)

Departments of1Neurosurgery and.

Daisuke Yamamoto (D)

Departments of1Neurosurgery and.

Yuri Hyakutake (Y)

Departments of1Neurosurgery and.

Hajime Handa (H)

Departments of1Neurosurgery and.

Hideto Komai (H)

Departments of1Neurosurgery and.

Yasushi Asari (Y)

2Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

Toshihiro Kumabe (T)

Departments of1Neurosurgery and.

Classifications MeSH