Anesthetic Management for Laparoscopic Radical Colectomy in a Patient with Moyamoya Disease: Case Report

Moyamoya disease is a chronic, progressive occlusive cerebrovascular disorder characterized by bilateral stenosis or occlusion of the terminal internal carotid arteries and the development of a fine, abnormal vascular network (the "moyamoya" vessels) at the base of the brain. Its pathophysiology involves impaired cerebral autoregulation, making cerebral blood flow (CBF) pressure-dependent, along with reduced perfusion pressure and blood flow in the anterior circulation, and impaired cerebrovascular reactivity to CO₂. Anesthesia management in these patients is challenging due to the high risk of cerebral ischemia or hemorrhage. We report the successful anesthetic management of a patient with Moyamoya disease and a history of hemiparesis who underwent laparoscopic radical colectomy for colon cancer without neurological deterioration.