Observational studyPaediatric anaesthesia2018
Cerebrovascular blood pressure autoregulation monitoring and postoperative transient ischemic attack in pediatric moyamoya vasculopathy.
Observational study in Paediatric anaesthesia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 33 citations in OpenAlex.
- Individualized autoregulation-guided arterial blood pressure management in neurocritical care.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Autoregulatory dysfunction in adult Moyamoya disease with cerebral hyperperfusion syndrome after bypass surgery.Scientific reports · 2024Article
- Cerebral autoregulation in pediatric and neonatal intensive care: A scoping review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Flow volume mismatch dramatically affects transient neurologic symptoms after direct bypass in Moyamoya disease.Neurosurgical review · 2023Article
- Perioperative Management of Pediatric Patients with Moyamoya Arteriopathy.Journal of pediatric intensive care · 2023Review
- Arterial spin labeling for moyamoya angiopathy: A preoperative and postoperative evaluation method.Translational neuroscience · 2023Article
- Spatially separate cerebral infarction in the posterior cerebral artery territory after combined revascularization of the middle cerebral artery territory in an adult patient with moyamoya disease and fetal-type posterior communicating artery: illustrative case.Journal of neurosurgery. Case lessons · 2022Article
- Paradoxical symptomatic cerebral blood flow decreases after combined revascularization surgery for patients with pediatric moyamoya disease: illustrative case.Journal of neurosurgery. Case lessons · 2022Article
- Risk factors for postoperative ischemic complications in pediatric moyamoya disease.BMC neurology · 2021Article
- The First 24 h Hemodynamic Management in NICU after Revascularization Surgery in Moyamoya Disease.Behavioural neurology · 2021Article
- Development and Validation of a Nomogram to Predict the Individual Future Stroke Risk for Adult Patients With Moyamoya Disease: A Multicenter Retrospective Cohort Study in China.Frontiers in neurology · 2021Article
- Comparison of wavelet and correlation indices of cerebral autoregulation in a pediatric swine model of cardiac arrest.Scientific reports · 2020Article
- Beyond Anesthesia Toxicity: Anesthetic Considerations to Lessen the Risk of Neonatal Neurological Injury.Anesthesia and analgesia · 2019Review
- Article
- Indirect revascularization for moyamoya disease: A pediatric neuroanesthesiology perspective.Surgical neurology international · 2018Review
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChildren with moyamoya vasculopathy are at high risk of perioperative cerebral ischemia or hyperperfusion. Maintaining blood pressure within the range of functional cerebrovascular blood pressure autoregulation might reduce the risk of perioperative neurologic injury.
aimsWe tested whether blood pressure autoregulation is associated with postoperative transient ischemic attack in a study of patients with pediatric moyamoya vasculopathy.
methodsWe conducted an observational study of 15 pediatric patients undergoing surgical revascularization with pial synangiosis. Nine patients had bilateral moyamoya and 6 had unilateral moyamoya. We measured autoregulatory vasoreactivity intraoperatively and during the first postoperative night with the hemoglobin volume index, a value derived from near-infrared spectroscopy. We also identified the optimal mean arterial blood pressure at which autoregulation was most robust in each patient.
resultsOf the 15 children monitored, 3 with bilateral moyamoya and one with unilateral moyamoya experienced a transient ischemic attack. Poorer autoregulation during surgery was associated with postoperative transient ischemic attack among those with bilateral vasculopathy (P = .048, difference in hemoglobin volume index medians: 0.023, 95% confidence interval: 0.003-0.071). This relationship was not observed with postoperative autoregulation. The optimal mean arterial blood pressure was identifiable during surgery in all monitored patients, varied among patients, and often differed between the intraoperative and postoperative periods.
conclusionDysfunctional intraoperative autoregulation may increase the risk of TIA in patients with pediatric moyamoya vasculopathy. The blood pressure range that supports autoregulation appears to vary among patients. Using autoregulation monitoring to guide individualized blood pressure goals should be studied as a potential method to reduce perioperative neurologic morbidity in pediatric patients with moyamoya.
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