모야모야병(moyamoya disease) 환자의 전신마취 하 치과 치료
DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA
상은정, 송지수, 신터전, 김영재, 김정욱, 장기택, 이상훈, 현홍근,
소속 상세정보
상은정 ( Sang Eun-Jung ) - 서울대학교 치의학대학원 소아치과학교실
송지수 ( Song Ji-Soo ) - 서울대학교 치의학대학원 소아치과학교실
신터전 ( Shin Teo-Jeon ) - 서울대학교 치의학대학원 소아치과학교실
김영재 ( Kim Young-Jae ) - 서울대학교 치의학대학원 소아치과학교실
김정욱 ( Kim Jung-Wook ) - 서울대학교 치의학대학원 소아치과학교실
장기택 ( Jang Ki-Taeg ) - 서울대학교 치의학대학원 소아치과학교실
이상훈 ( Lee Sang-Hoon ) - 서울대학교 치의학대학원 소아치과학교실
현홍근 ( Hyun Hong-Keun ) - 서울대학교 치의학대학원 소아치과학교실
Abstract
Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology.
A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation.
Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.
키워드
Moyamoya disease; Dental treatment; General anesthesia
원문 및 링크아웃 정보
등재저널 정보