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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2022; 09(01): 50-52
DOI: 10.1055/s-0041-1739349
Case Report

Anesthetic Management of Moyamoya Syndrome Secondary to Sickle Cell Anemia

Parmod K. Bithal 
1   Division of Neuroanesthesia, Department of Anesthesia and Perioperative Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
,
Ravees Jan 
2   Department of Anesthesia and Perioperative Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
,
Ved P. Pandey
2   Department of Anesthesia and Perioperative Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
,
Parvaiz Ahmad
2   Department of Anesthesia and Perioperative Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
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Abstract

Moyamoya disease (MMD) is caused by stenosis or occlusion of internal carotid artery in brain, thereby reducing its blood supply. To augment blood flow, brain develops abnormal anastomotic vessels with deranged carbon dioxide reactivity and tendency to bleed. Moyamoya syndrome (MMS) is the name given to MMD when the latter results from secondary to some associated disease. Occurrence of MMS secondary to sickle cell anemia (SCA) presents unique challenges to neuroanesthesiologists. Management of various physiological parameters for cerebral revascularization surgery for MMD under general anesthesia necessitates vigilant and balanced control of various physiological variables, as the manipulation of a particular physiological variable for one pathology may adversely impact the same physiological variable for the associated disease, which will result in poor outcome of the patient. Therefore, optimum outcome of MMS is determined by a watchful balancing of various physiological parameters under anesthesia.

Keywords

moyamoya syndrome - sickle cell anemia - normovolemia - normocapnia - normothermia


Publication History

Article published online:
14 November 2021

© 2021. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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