Although stroke in children is rarely reported, the facts show that more and more children sufer moyamoya which can cause strokes, especially in children.
What is Moyamoya
Moyamoya  is a progressive disease blockage in one or two instema carotid arteries (large blood vessels in the brain) or blood vessel branches, mainly on one or both sides of the brain. This blockage could be related to other blood vessels. During radiological examination, the brain’s blood vessels will show a collection of white smoke.
Moyamoya was first discovered in Japan in 1957 by Takeuchi and Shimizu. This disease affects many Asia people, and many suffered by women. It ratio about 1: 1.65 (male: female). In terms of age, the disease is more pronounced in the age of puberty and less than 10 years.
The cause of moyamoya is still not certain. but many studies conclude that immune factors play a major role in the development of this disease. found in several inflammatory events in the head and neck of the moyamoya patients.
The disease is also associated with Human Leucocyte antigen (HLA, a protein that plays a role in immune response) and other diseases such as neurofibromatosis (Peripheral nervous vessel disease), meningitis (inflammation of the lining of the brain) and anemia. This disease can also be triggered by radiation in patients in primary brain tumors or head injury.
some symptoms include:
- lose consciousness suddenly
- decreased cognition
- seizures, or has moved out of control in the hands and feet.
- these symptoms will be more visible when the patient had deficiency of carbon dioxide (CO2). This can happen when people with activities like crying, blowing instruments, coughing or straining.
Other symptoms that arise include:
- A thickening of the intima layer due to accumulation of fat
- Depletion occurs in the muscle layer (media) of the brain blood vessels and outer layers.
- Changes occur in cardiac blood vessels, kidneys and other organs.
The fact is what led experts to conclude that this disease is a systemic vascular disease.
Moyamoya Medicinal Treatment
This disease is usually accompanied by increasing of aneurysm in the brain blood flow and hemodynamic stress. Aneurysms and will cause collateral brain blood vessels dilate and then broke. That is why in adult moyamoya patients who had severe bleeding in the head, they will be diagnosed with aneurysms (widening of blood vessels of the brain). If not immediately treated with surgery, 73% of patients will experience a great decline and even death within 2 years.
In some cases patients can be diagnosed as having moyamoya vascular abnormalities AVM (arteriovenous malformation) in which there bypas between arteries and veins.
The diagnosis can be done by entering a substance into the blood vessel angiography. Usually patients do not need a total drugged, so still conscious but do not feel pain.
Treatment with how thin the blood proved to be ineffective. The only way is to do surgery. Surgery performed on the patient’s condition at that time.
If the patient is in a state of consciousness decreases rapidly, then performed surgery to save lives of patients. Patients who come to the state of emergency, the operation will be done re vascular (granting or returning brain blood flow). This surgery can be done by connecting the blood vessels in the scalp directly with the brain blood vessels. or directly connect the blood vessels of the scalp or head to the surface muscles of the brain.
This type of surgery is very safe to do so with the help of medical equipment such as the use of increasingly sophisticated ultrasound (USG) and recording equipment intra operative brain (EEG).
Patients who had declared cured will continue to monitor his blood pressure. Further stroke is very small will certainly happen. there are only about 1-2 cases of advanced strokes that occurred after 10 to 20 years after revascularization surgery.
Disease stroke in children is still rare. But not impossible, will continue to do research to find the most effective way to heal moyamoya.