Poster Presentation: Anesthetic Implications of Moyamoya Disease: A Case Study-Anesthetic Implications of Moyamoya Disease: A Case Study

Anesthetic Implications of Moyamoya Disease: A Case Study

Pdf Summary

The document provides an overview and specific case study of Moyamoya Disease (MMD), a rare cerebrovascular disorder characterized by the progressive narrowing and stenosis of cerebral arteries, leading to significant anesthetic implications without standardized guidelines. A series of methods including searches on PubMed, EMBASE, and UpToDate were used to collect background and relevant studies.<br /><br />**Key Points:**<br />- **Introduction:** MMD necessitates careful anesthetic management due to unfamiliarity and lack of standardized guidelines for the condition.<br />- **Disease Characteristics:** MMD features progressive stenosis of the internal carotid artery and other cerebral arteries.<br />- **Recommendation for Practice:** Emphasizes maintaining blood pressure (MAP) at no lower than 85% of baseline, using intraoperative arterial lines for adults, and considering cerebral oximetry. Specific vasopressors weren't definitively recommended due to lack of evidence. Normocarbia and normothermia are suggested to minimize cerebral risks. <br /><br />A **case study of a 34-year-old female** with MMD presented for mastoidectomy highlights practical application:<br />- Preoperative arterial line and cerebral oximetry were used.<br />- Maintenance involved general endotracheal anesthesia, phenylephrine infusion for blood pressure, and IV hydromorphone for pain.<br />- The patient was extubated without new neurological symptoms and had stable consciousness postoperatively.<br /><br />**Conclusion and Critique:** The document underscores the critical need for tailored anesthetic techniques and diligent perioperative management due to the limited evidence and guidelines available. The case critique noted a potential improvement in technique by using a more balanced anesthetic approach to decrease the risk of cerebral steal.<br /><br />The document advocates for future research focusing on different anesthetic techniques and further evaluation of perioperative management strategies for MMD to fill existing knowledge gaps.

Keywords

Moyamoya Disease

cerebrovascular disorder

anesthetic management

cerebral arteries stenosis

blood pressure maintenance

cerebral oximetry

case study

perioperative management

anesthetic techniques

future research