Encephalomyosynangiosis (EMS) is an indirect revascularisation surgery for moyamoya disease as a way to bypass an occluded internal carotid artery and circle of Willis.
It entails dissecting strips of vascularised temporalis muscle and subjacent galeal flap and, following craniotomy and opening the dura, laying them directly onto the pial surface of the brain. The dura is then closed over the muscle flap. Revascularisation occurs as a result of angiogenesis driven by local hypoperfusion and ischaemia 1. The deep temporal artery is the main arterial supply.
See also
- encephaloduroarteriomyosynangiosis (EDAMS): indirect revascularisation using the temporalis muscle, dura, and superficial temporal artery
- encephaloduroarteriosynangiosis (EDAS): indirect revascularisation using the dura and superficial temporal artery
- superficial temporal artery to middle cerebral artery (STA-MCA) bypass: direct anastomosis
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