Doctors perform brain bypass surgery on 8-year-old twins with rare disease

Moyamoya Disease is a rare blood vessel disorder in which the carotid artery in the skull is blocked or narrowed, reducing blood flow to the brain

Doctors of Apollo Proton Cancer Centre (APCC) performed a brain bypass surgery on twin children who were diagnosed with Moyamoya Disease, a rare disorder that reduces blood flow to the brain.

The eight-year-old twin girls, who were originally from Tamil Nadu and were residing in the Netherlands, were diagnosed with Moyamoya Disease, a rare blood vessel disorder in which the carotid artery in the skull is blocked or narrowed, reducing blood flow to the brain. The condition is relatively uncommon and even rarer in identical twins, doctors said.

“Moyamoya Disease was first identified in Japan in the 1960s and is referred to as ‘puff of smoke’. The cause is not yet known,” Roopesh Kumar, senior consultant neurosurgeon, APCC, told reporters on Tuesday.

He added that if left untreated, it causes multiple strokes in children, affecting normal life. “The disease has multiple stages. It is important to pick up on the disease early to arrest its progression,” he said.

One of the twins was more symptomatic than the other. The neurosciences team examined the children using MRI brain perfusion. The findings were almost similar in both twins and the brain’s left side was more affected than the right. The doctors offered surgical intervention via a brain bypass surgery, wherein the blood supply from the skin of the head would be diverted to the brain through a window created on the skull. This would facilitate uninterrupted blood flow to the brain without the risk of developing strokes, a press release said.

The surgery, STA-MCA (superficial temporal artery to middle cerebral artery) bypass, was performed initially for the symptomatic child. The other child also underwent a similar procedure. “Moyamoya affects the brain vessels inside the skull. We have vessels beneath the skin. These vessels are very small, measuring less than 1 mm. We identify and separate them and stitch the outside blood vessels into the ones inside,” Dr. Kumar said.

The bypass surgery was performed three months ago. Consecutive scans showed improved blood circulation on the left side of the brain. The hospital said this was Asia’s first brain bypass surgery on twin children with Moyamoya Disease.