MOYAMOYA SIGNO, SÍNDROME, ENFERMEDAD Y FENOMENO, ANGIOMIOSILVIANOSINANGIOSIS, ESTADO DEL ARTE Y REVISION DE LA LITERATURA, AÑO 2020
DOI:
https://doi.org/10.51437/nj.v26i3.163Keywords:
cirugía indirecta, bypass, silviosinangiosis, base de cráneo.Abstract
La Enfermedad de MoyaMoya, es una enfermedad de presentación rara, que afecta principalmente a la población pediátrica, se manifiesta rápidamente progresiva, es irreversible, deja grandes secuelas y si no se trata de manera idónea y efectiva, genera una gran carga de morbimortalidad.
En la historia de la medicina quedaron descritas, para su corrección quirúrgica las técnicas directas, “anastomosis vasculares” que exigían ser realizadas en grandes centros de referencia, por personal entrenado, de larga duración, presentaban morbimortalidad importante, que condicionaba una serie de barreras.
Esta enfermedad no responde a manejo médico, su tratamiento actual y definitivo es la cirugía, pero la mejor opción son las técnicas indirectas, llamadas “sinangiosis” (colgajos) que se pueden practicar de manera oportuna, son actos quirúrgicos cortos, tan eficaces como las técnicas directas, pero con menos morbimortalidad, a largo plazo.
Nuestra propuesta es adicionar a las técnicas indirectas, un flap pediculado de musculo temporal al valle silviano abierto, previa apertura de cisternas de la base y contacto directo con estructuras vasculares mayores, logrando así un bypass hacia la base del cerebro, que hasta el momento no se han descrito y complementaria la angiogénesis, ya conocida de la convexidad provista por las técnicas convencionales indirectas, logrando un aporte sanguíneo al cerebro de manera circunferencial y corrigiendo el daño subyacente primario en las grandes arterias de la base.
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