OBJECTS: The "re-build up" phenomenon is a pathognomonic finding induced after hyperventilation in pediatric moyamoya disease, and is closely related to ischemic attacks. However, its precise mechanism remains unknown. METHODS: In this study, MEG, MRI, and SPECT were used to clarify its mechanism in 4 children with moyamoya disease. Cerebral blood flow before and after acetazolamide administration was measured. Spontaneous magnetic brain activity was measured using a whole-head MEG system. The quantified dipole distribution was shown on 3D-MRI. RESULTS AND CONCLUSION: The original current dipoles of the "re-build up" slow waves were predominantly located in the deep cortical sulci in the area with impaired reactivity to acetazolamide. The results suggested that the re-build up waves derive from the deep cortical sulci due to the reduction in the cerebral perfusion reserve.
OBJECTS: The "re-build up" phenomenon is a pathognomonic finding induced after hyperventilation in pediatric moyamoya disease, and is closely related to ischemic attacks. However, its precise mechanism remains unknown. METHODS: In this study, MEG, MRI, and SPECT were used to clarify its mechanism in 4 children with moyamoya disease. Cerebral blood flow before and after acetazolamide administration was measured. Spontaneous magnetic brain activity was measured using a whole-head MEG system. The quantified dipole distribution was shown on 3D-MRI. RESULTS AND CONCLUSION: The original current dipoles of the "re-build up" slow waves were predominantly located in the deep cortical sulci in the area with impaired reactivity to acetazolamide. The results suggested that the re-build up waves derive from the deep cortical sulci due to the reduction in the cerebral perfusion reserve.