Fig. 6

Typical case 2. This is a 42-year-old female patient, who was treated for 7 months because of intermittent speech disorder and weakness of the right limb. After admission, the patient was diagnosed as moyamoya disease by DSA examination, Suzuki stage III. TCD examination showed that the PSV, EDV and MFV of the left MCA were 121.3 cm/s, 81.4 cm/s and 94.7 cm/s. The PI was 0.422. Then the patient also underwent left STA-MCA vascular anastomosis combined with EDMS. During the operation, the anastomotic stoma was full and good, and ICG fluorescein angiography showed that the bridging vessel was unobstructed. However, on the first day after the operation, motor aphasia and grade II right limb muscle strength were observed. Immediate examination of MRI showed that the DWI sequence found the new acute cerebral infarction appeared in the frontal lobe of the operative side. The patient’s condition was gradually stable after rehydration, an appropriate pressure increase, the addition of aspirin enteric-coated tablets, and the administration of edaravone and other secondary preventive drugs for stroke. On the fifth day after operation, the patient can simply answer; Right limb muscle strength grade IV; The right hand can make a fist and move against the palm, but the movement is slow, and the fine movements of the fingers have not recovered