Morning glory disc anomaly and its implications in moyamoya arteriopathy: a retrospective case series.

Autor:	See AP; 1Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts., LoPresti MA; 3Department of Neurosurgery, Lurie Children's Hospital, Chicago, Illinois., Treiber J; 2Department of Neurosurgery, Texas Children's Hospital, Houston, Texas; and., Thomas B; 2Department of Neurosurgery, Texas Children's Hospital, Houston, Texas; and., Karsten MB; 1Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts., Riordan CP; 1Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts., Scott RM; 1Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts., Lam SK; 3Department of Neurosurgery, Lurie Children's Hospital, Chicago, Illinois., Smith ER; 1Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2023 Mar 17, pp. 1-7. Date of Electronic Publication: 2023 Mar 17.
DOI:	10.3171/2023.2.PEDS22470
Abstrakt:	Objective: Morning glory disc anomaly (MGDA), a congenital abnormality of the optic nerve, may be associated with moyamoya arteriopathy, a cerebrovascular abnormality. In this study, the authors aimed to define the temporal evolution of cerebrovascular arteriopathy in patients with MGDA to characterize a rational strategy for screening and management over time. Methods: The records of pediatric neurosurgical patients at two academic institutions were retrospectively reviewed to identify cases of cerebral arteriopathy and MGDA, including radiographic and clinical records documenting patient outcomes of medical and surgical management. Results: Thirteen cases of moyamoya syndrome (MMS) associated with MGDA were identified in 13 children aged 0.6-17 years. The pattern of arteriopathy resembled that of non-MGDA MMS, with predominantly anterior circulation involvement. The arteriopathy lateralized with the MGDA, although 3 patients also had contralateral involvement. The overall group was followed for a median of 3.2 years. Radiological biomarkers of cerebral ischemia were applied to guide surgical decisions, and more than half of the patients (7 of 13) had evidence of stroke or progression on serial imaging. Nine patients underwent revascularization surgery, and 4 were managed medically. Conclusions: Cerebral arteriopathy observed in association with MGDA resembles MMS seen in patients without MGDA and is dynamic, with progression observed over months to years and an associated risk of cerebral ischemia that indicates a role for surgical revascularization. Radiological biomarkers may augment clinical data to identify candidates for revascularization surgery.
Databáze:	MEDLINE
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