目的 :间接脑血管重建术治疗烟雾病。方法 :2 1例经DSA或MRA证实为原发性烟雾病。手术采用脑 硬脑膜 颞浅动脉敷贴术 (EDSA) ,伴硬脑膜成形术。结果 :2 1例患者随访 6～ 2 0个月 ,平均 13 9个月 ,均未再发生脑缺血或脑出血。 15例术前有神经功能障碍的患者 ,术后恢复正常。 2 1例术后复查DSA或MRA ,除 1例MRA与术前相同外 ,其余 2 0例颅底异常血管网不同程度减少并伴侧支血管形成 (改善率达 95 2 % )。 17例术前智商低于平均水平的患者 ,术后均有提高 ,其中 10例提高 2 0 (占 5 8 8% )。结论 :EDSA伴硬脑膜成形术治疗烟雾病安全、近期有效 Objective: Indirect cerebral revascularization for the treatment of moyamoya disease. Methods: Twenty - one cases of primary moyamoya disease confirmed by DSA or MRA. Surgery was performed with epidural superficial temporal artery occlusion (EDSA) with dural plasty. Results: Twenty-one patients were followed up for 6-20 months with an average of 13.9 months. No cerebral ischemia or cerebral hemorrhage occurred. Fifteen patients with neurological dysfunction preoperatively returned to normal postoperatively. Twenty - two cases of DSA or MRA were retrospectively reviewed. All cases except one case had the same MRA as the preoperative ones. The remaining 20 cases had different degrees of skull base dysplasia with collateral vessels (95 2% improvement rate). Seventeen patients with preoperative IQ less than average were improved after surgery, of which 10 cases increased 20 (58.8%). Conclusion: EDSA with dura meningoplasty for the safety of moyamoya disease has recently been effective