Encephalomyosynangiosis (EMS) is an indirect revascularization surgery for moyamoya disease as a way to bypass an occluded internal carotid artery and circle of Willis.
It entails dissecting strips of vascularized 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. Revascularization occurs as a result of angiogenesis driven by local hypoperfusion and ischemia 1. The deep temporal artery is the main arterial supply.
See also
- encephaloduroarteriomyosynangiosis (EDAMS): indirect revascularization using the temporalis muscle, dura, and superficial temporal artery
- encephaloduroarteriosynangiosis (EDAS): indirect revascularization using the dura and superficial temporal artery
- superficial temporal artery to middle cerebral artery (STA-MCA) bypass: direct anastomosis