Commentary

Nair et al reported a series of 5 patients with adult-onset moyamoya disease, who were postoperatively evaluated by computed tomography (CT) perfusion to assess revascularization after STA-MCA bypass. The postoperative CT perfusion demonstrated the improvement of cerebral hemodynamics as well as the patency of STA-MCA bypass in all 5 cases. Consistent with these findings, the postoperative course of all 5 patients was favorable, without recurrent stroke. The efficacy of postoperative cerebral blood flow (CBF) measurement for moyamoya disease has been reported using positron emission tomography [3] and single photon emission computed tomography [4] previously. The present series suggested that CT perfusion could be a useful tool for evaluating postoperative alteration of cerebral hemodynamics during the chronic stage after STA-MCA bypass for moyamoya disease. Alternatively, in light of the recent observations that postoperative CBF measurement is important to make an accurate diagnosis of cerebral hyperperfusion during the acute stage after STA-MCA bypass for moyamoya disease [1], [2], it would be of great interest to evaluate the usefulness of CT perfusion during the acute stage after STA-MCA bypass for moyamoya disease in the future study.