Revascularization Operation for Moyamoya Disease with Concurrent von Willebrand Disease

World Neurosurg. 2017 Dec:108:991.e17-991.e21. doi: 10.1016/j.wneu.2017.08.141. Epub 2017 Sep 1.

Abstract

Background: Although extracranial-intracranial (EC-IC) bypass is an effective treatment strategy for symptomatic moyamoya disease, surgeons need to be cautious regarding the possibility of postoperative hemorrhagic complications in patients with a concurrent coagulation disorder. Here, we describe a case of EC-IC bypass for moyamoya disease concurrent with von Willebrand disease type 1.

Case description: Following perioperative replacement of the von Willebrand factor, the patient showed an uneventful and uncomplicated clinical course.

Conclusion: This is the first reported case of EC-IC bypass being performed for moyamoya disease in a patient with concurrent von Willebrand disease. We emphasize the importance of appropriate management with replacement of the von Willebrand factor during the perioperative period to avoid hemorrhagic complications.

Keywords: Moyamoya disease; Revascularization; von Willebrand disease.

MeSH terms

  • Adult
  • Cerebral Angiography
  • Cerebral Revascularization / methods*
  • Coagulants / therapeutic use*
  • Factor VIII / therapeutic use*
  • Female
  • Humans
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Middle Cerebral Artery / surgery
  • Moyamoya Disease / complications
  • Moyamoya Disease / diagnostic imaging
  • Moyamoya Disease / surgery*
  • Postoperative Hemorrhage / prevention & control*
  • Temporal Arteries / surgery
  • Tomography, Emission-Computed, Single-Photon
  • von Willebrand Disease, Type 1 / complications
  • von Willebrand Disease, Type 1 / drug therapy*
  • von Willebrand Factor / therapeutic use*

Substances

  • Coagulants
  • von Willebrand Factor
  • Factor VIII