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ANAESTHETIC MANAGEMENT OF A CHILD WITH MOYA MOYA DISEASE A RARE CASE

Moya Moya disease (MMD) is a rare cerebrovascular occlusive disorder resulting from progressive stenosis of intracranial blood vessels with secondary development of an anastomotic capillary network. Moya Moya is the Japanese term for puff of smoke appearance and it refers to the angiographic finding of a cluster of small abnormal blood vessels.
 The classic paediatric presentation in this disorder is recurrent transient ischaemic attacks (TIA) and /or completed or repeated ischemic strokes. Medical treatment aimed at decreasing ischemic symptoms by using Vasodilators and anti-coagulants. The main stay of treatment includes direct and indirect surgical revascularisation procedures.
Risk factors for peri operative complications are history of TIAs, severity of disease, intraoperative hypotension, hypercapnia, hypovolemia, and significant reduction in haematocrit and circulating blood volume.