Clinical Features, Surgical Treatment and Long-Term Outcome in Adult Patients with Moyamoya Disease in China

2012 ◽  
Vol 34 (4) ◽  
pp. 305-313 ◽  
Author(s):  
Xiang-Yang Bao ◽  
Lian Duan ◽  
De-Sheng Li ◽  
Wei-Zhong Yang ◽  
Wei-Jian Sun ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Adult Patients ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Clinical features, surgical treatment, and long-term outcome in adult patients with moyamoya disease

2009 ◽  
Vol 111 (5) ◽  
pp. 936-942 ◽  
Author(s):  
Robert M. Starke ◽  
Ricardo J. Komotar ◽  
Zachary L. Hickman ◽  
Yehuda E. Paz ◽  
Angela G. Pugliese ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Adult Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Baseline Status ◽  
Collateral Vessels

Object The object of this study was to report the clinical features, surgical treatment, and long-term outcomes in adults with moyamoya phenomenon treated at a single institution in the US. Methods Forty-three adult patients with moyamoya disease (mean age 40 ± 11 years [SD], range 18–69 years) were treated with encephaloduroarteriosynangiosis (EDAS). Neurologists examined patients pre- and postoperatively. Follow-up was obtained in person or by structured telephone interview (median 41 months, range 4–126 months). The following outcomes were collected: transient ischemic attack (TIA), infarction, graft collateralization, change in cerebral perfusion, and functional level according to the modified Rankin scale (mRS). Kaplan-Meier estimates of infarction risk were calculated for comparison of surgically treated and contralateral hemispheres. Results The majority of patients were women (65%), were Caucasian (65%), presented with ischemic symptoms (98%), and had bilateral disease (86%). Nineteen patients underwent unilateral and 24 patients bilateral EDAS (67 treated hemispheres). Collateral vessels developed in 50 (98%) of 52 hemispheres for which imaging was available and there was evidence of increased perfusion on SPECT scans in 41 (82%) of the 50 hemispheres evaluated. Periprocedural infarction (< 48 hours) occurred in 3% of the hemispheres treated. In the follow-up period patients experienced 10 TIAs, 6 infarctions, and 1 intracranial hemorrhage. Although the hemisphere selected for surgery was based upon patients' symptoms and severity of pathology, the 5-year infarction-free survival rate was 94% in the surgically treated hemispheres versus < 36% in the untreated hemispheres (p = 0.007). After controlling for age and sex, infarction was 89% less likely to occur in the surgically treated hemispheres than in the contralateral hemispheres (hazard ratio 0.11, 95% CI 0.02–0.56). Thirty-eight (88%) of 43 patients had preserved or improved mRS scores, relative to baseline status. Conclusions In this mixed-race population of North American patients, indirect bypass promoted adequate pial collateral development and increased perfusion in the majority of adult patients with moyamoya disease. Patients had low rates of postoperative TIAs, infarction, and hemorrhage, and the majority of patients had preserved or improved functional status.

Clinical Features, Surgical Treatment, and Long-Term Outcome in Pediatric Patients with Moyamoya Disease in China

2015 ◽  
Vol 39 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Xiang-Yang Bao ◽  
Lian Duan ◽  
Wei-Zhong Yang ◽  
De-Sheng Li ◽  
Wei-Jian Sun ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcome ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Pediatric Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Kaplan Meier ◽  
Favorable Clinical Outcome

Background: There was few detailed demographic and clinical data about Chinese patients with moyamoya disease. Here we describe the clinical features, surgical treatment, and long-term outcome of pediatric patients with moyamoya disease at a single institution in China. Methods: Our cohort included 288 pediatric patients with moyamoya disease. The demographic and clinical characteristics were obtained by retrospective chart review and long-term outcome was evaluated using the stroke status. Univariate and multivariate logistic regression analyses were performed to determine the risk factors for clinical outcome. The risk of subsequent stroke was determined using the Kaplan-Meier method. Results: The median age for the onset of symptoms was 8.0 years. The ratio of female to male patients was 1:1. Familial occurrence of moyamoya disease was 9.4%. The incidence of postoperative complications was 4.2%. Postoperative ischemic events were identified as predictors of unfavorable clinical outcome, while older age of symptom onset was associated with a favorable clinical outcome. The Kaplan-Meier estimate stroke risk was 5% in the first 2 years, and the 5-year-Kaplan-Meier risk of stroke was 9% after surgery for all patients treated with surgical revascularization. Overall, 86% of patients had an independent life with no significant disability. Conclusion: This long-term survey demonstrated that most surgically treated pediatric patients with MMD maintain good outcomes. Our results indicate that an early diagnosis and active intervention before the establishment of irreversible hemodynamic change are essential to achieve a favorable clinical outcome.

Clinical Features, Surgical Treatment, and Long-Term Outcome in Elderly Patients with Moyamoya Disease

2017 ◽  
Vol 100 ◽  
pp. 459-466 ◽  
Author(s):  
Peicong Ge ◽  
Qian Zhang ◽  
Xun Ye ◽  
Xingju Liu ◽  
Xiaofeng Deng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Term Outcome ◽  
Long Term Outcome

Moyamoya disease: A comparison of long term outcome of conservative and surgical treatment in India

2014 ◽  
Vol 336 (1-2) ◽  
pp. 99-102 ◽  
Author(s):  
Soumya Sundaram ◽  
P.N. Sylaja ◽  
Girish Menon ◽  
Jayanand Sudhir ◽  
E.R. Jayadevan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Moyamoya Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Conservative And Surgical Treatment

Clinical Features, Surgical Treatment, and Long-term Outcome of Adult Moyamoya Patients

Neurosurgery ◽  
2008 ◽  
Vol 62 (6) ◽  
pp. 1405
Author(s):  
Robert M. Starke ◽  
Ricardo J. Komotar ◽  
Zachary L. Hickman ◽  
Yehuda Paz ◽  
Angela Pugliese ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Features ◽  
Term Outcome ◽  
Long Term Outcome
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