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KMID : 1144020190150010040
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Journal of Korean Association for Disability and Oral Health
2019 Volume.15 No. 1 p.40 ~ p.44
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DENTAL MANAGEMENT OF PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA: CASE REPORT
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Chae Jong-Kyun
Song Ji-Soo
Shin Teo-Jeon
Hyun Hong-Keun
Kim Jung-Wook
Jang Ki-Taeg
Lee Sang-Hoon
Kim Young-Jae
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Abstract
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Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries.
A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease.
MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.
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KEYWORD
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Moyamoya disease, Dental treatment, General anesthesia
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