• Haruto Uchino, Naoki Nakayama, Ken Kazumata, Satoshi Kuroda, and Kiyohiro Houkin.
• From the Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan (H.U., N.N., K.K., K.H.); and Department of Neurosurgery, University of Toyama, Japan (S.K.). uchinoh@hotmail.co.jp.
• Stroke. 2016 Jul 1; 47 (7): 1930-2.

Background And PurposePostoperative hyperperfusion-related transient neurological deficits (TNDs) are frequently observed in adult patients with moyamoya disease who undergo direct bypass procedures. The present study evaluated the effect of the free radical scavenger edaravone on postoperative hyperperfusion in adult moyamoya disease.MethodsThis study included 92 hemispheres in 72 adult patients who underwent direct bypass for moyamoya disease. Serial measurements of cerebral blood flow were conducted immediately after surgery and on postoperative days 2 and 7. In 40 hemispheres for 36 patients, edaravone (60 mg/d) was administered from the day of surgery to postsurgical day 7. The incidence of postoperative hyperperfusion and associated TNDs were compared with a control group that included 52 hemispheres in 36 patients.ResultsRadiological hyperperfusion was observed in 28 of 40 (70.0%) and 39 of 52 (75.0%) hemispheres in the edaravone and control groups, respectively (P=0.30). Hyperperfusion-related TND incidences were significantly lower in the edaravone group compared with the control group (12.5% versus 32.7%; P=0.024). Multivariate analysis demonstrated that edaravone administration (P=0.009) and left-sided surgery (P=0.037) were significantly correlated with hyperperfusion-related TNDs (odds ratios, 0.3 and 4.2, respectively).ConclusionsPerioperative administration of edaravone reduced the incidence of hyperperfusion-related TNDs after direct bypass procedures in adult patients with moyamoya disease.© 2016 American Heart Association, Inc.

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