My surgeries with Dr. Steinberg on Oct 31 and Nov 7 this year went great. But, several days after the second, on the left side, I had some minor difficulties. I lost my ability to speak clearly, couldn't swallow, had numbness in my right hand and fingers (the small stroke that lead to my diagnosis had affected my left hand and fingers, so was a bit concerned that now, post-surgeries, my other side was misbehaving). The problems lasted for only a few minutes and I had only a few episodes, but it was frightening. (Also, I missed the dinner Jill had arranged that evening with D.J. and other moyamoya patients. Hopefully I can meet you all at the Las Vegas reunion next summer.)
Dr. Steinberg checked me out and ordered another MRI/MRA and Brain Spec Scan. When I met with Theresa a couple of days later to have the staples removed, she was able to verify that I had not had strokes or TIAs; one scan done on the MRI/MRA showed hyperperfusion; the problems I had were due to the brain readjusting to the increased blood flow - that was a relief.
Today, I found a journal article with references to other related articles that might be reassuring to others who had some similar problems shortly after surgery.
Other than one other episode of numbness in the right lip one evening, a few days after returning home from Stanford, I've been feeling great. I'm back to work with my son in our retail shop and sorting through the bills.
Like so many other posters here, I too want to say how absolutely amazing I found Dr. Steinberg, Theresa Bell-Stephens, Jill and the entire Stanford Medical Center caregivers. Thank you can't come near to expressing my gratitude.
Kim

Here's an abstract of the article:
1: Surg Neurol. 2007 Nov 6 [Epub ahead of print]

Postoperative temporary neurological deficits in adults with moyamoya disease.

Ohue S, Kumon Y, Kohno K, Watanabe H, Iwata S, Ohnishi T.

Department of Neurosurgery, Ehime University School of Medicine, Ehime 791-0295,
Japan.

BACKGROUND: Several authors have reported temporary neurologic deterioration after revascularization surgery in some patients with moyamoya disease. The present study examined the incidence and mechanisms of PONDs in adult patients with moyamoya disease. METHODS: Postoperative neurological deficits were retrospectively evaluated 1 month or less postoperatively on 32 hemispheric sides of 17 symptomatic adult patients with moyamoya disease treated surgically with
direct and/or indirect revascularization. RESULTS: Various PONDs were observed in 9 sides (28%) from 7 patients 1 month or less after surgery. Symptoms were recognized in 7 (39%) of 18 sides with ischemic onset, and 2 (14%) of 14 sides with hemorrhagic onset. Postoperative neurological deficits were usually observed 1 week or less after surgery, and resolved within 2 weeks. Postoperative neurological deficits were divided into 3 groups based on duration of symptoms:
single transient neurologic deficits in 3 sides; repeated transient neurologic
deficits in 3 sides; and continuous neurologic deficits in 3 sides. Radiologic
examinations demonstrated no ischemic changes in any patients, and subsequent focal hyperemia after surgery on 3 sides. Postoperative neurological deficits occurred more frequently in younger patients or those with poor vascular response before surgery. CONCLUSIONS: Postoperative neurological deficits frequently occur in patients with moyamoya disease, but are temporary. These deficits appear to result from focal hyperperfusion after surgery, rather than from ischemic changes.

PMID: 17996267 [PubMed - as supplied by publisher]

Related Links

    Temporary neurologic deterioration due to cerebral hyperperfusion after
superficial temporal artery-middle cerebral artery anastomosis in patients with adult-onset moyamoya disease. [Surg Neurol. 2007] PMID:17320638

    Moyamoya syndrome associated with Down syndrome: outcome after surgical revascularization. [Pediatrics. 2005] PMID:16263984

    Effects of surgical revascularization on outcome of patients with pediatric
moyamoya disease. [Stroke. 1997] PMID:9183345

    [Diagnostic value of perfusion-weighted MRI for evaluating postoperative
alteration of cerebral hemodynamics following STA-MCA anastomosis in patients with moyamoya disease] [No Shinkei Geka. 2006] PMID:16910493

    [Seizure following superficial temporal-middle cerebral artery anastomosis in patients with moyamoya disease: possible contribution of postoperative cerebral hyperperfusion] [No Shinkei Geka. 2007] PMID:17491342