第38回日本小児神経外科学会
The 38th Annual Meeting of the Japanese Society for Pediatric Neurosurgery

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第1日目、6月4日(金)A 会場(3階 メインホール)9:40〜10:40

特別企画 1: JSPN - KSPN joint session: 1. Moyamoya disease

Chairperson: Kyu-Chang Wang, Takayuki Inagaki

SP1-1

Regional predilection of lesions in moyamoya disease: a hypothesis on arterial branching angle

Kyu-Chang WANG, Ho Jun SEOL, Duk Chul SHIN, Yoo Seok KIM, Eun Bo SHIM, Seung-Ki KIM, Byung-Kyu CHO

Division of Pediatric Neurosurgery, Seoul National University Children's Hospital and Department of Mechanical & Mechatronics Engineering, Kangwon National University

Objective. The etiology and the reason why moyamoya disease (MMD) is limited to the major intracranial vessels remain unclear. Flow dynamics such as shear stress may be related to its luminal narrowing. This study was performed to find out the local hemodynamic factor, which concerns predominance of specific anatomic sites, such as distal internal carotid artery (ICA), in MMD.
Methods. We simulated the hemodynamics in the circle of Willis using the computational models of two-dimensional geometries of distal ICA and PCA. A finite element commercial package, ADINA (Automatic Dynamics Incremental Nonlinear Analysis) was used to simulate the blood flow in these arteries. Numerical results revealed that shear stress was relatively low at the ICA region. The distribution of shear stress was related to the predisposing area of MMD.
Conclusions. Although it remains at the level of speculation, this study shows that diminished shear stress might promote stenosis of the distal ICA, which is a major pathological region in MMD.

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