Moyamoya Angiopathy: An Underdiagnosed Cause of Ischemic Stroke in a Tunisian Pediatric Cohort.

Autor: Bouchaala W; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia., Laroussi S; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia. Electronic address: laroussi.syrine@gmail.com., Mzid Y; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia., Maaloul I; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia., Jallouli O; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia., Zouari S; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia., Ben Nsir S; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia., Mnif Z; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia., Kammoun F; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia., Triki C; Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory 'Neuropediatrie' LR19ES15 Sfax University, Sfax, Tunisia.
Jazyk: angličtina
Zdroj: Pediatric neurology [Pediatr Neurol] 2024 Jan; Vol. 150, pp. 3-9. Date of Electronic Publication: 2023 Oct 05.
DOI: 10.1016/j.pediatrneurol.2023.09.017
Abstrakt: Background: Moyamoya angiopathy is a rare cerebral vasculopathy and an underdiagnosed cause of arterial ischemic stroke in children. We aim to report the clinical and radiological presentations in a Tunisian pediatric cohort.
Methods: We identified moyamoya angiopathy in pediatric patients managed at the Child Neurology Department of Hedi Chaker Sfax University Hospital between 2008 and 2020 and reviewed their clinical and radiological data as well as their evolutionary profile.
Results: We collected 14 patients with median age 40.6 months and a female predominance (sex ratio of 0.75). An arterial ischemic stroke (AIS) revealed the disease in all patients, with the major symptom being a motor deficit. Symptoms related to a transient ischemic attack before the diagnostic consultation were reported in four patients. Carotid territory was, clinically and radiologically, the most frequently involved. Brain magnetic resonance imaging with angiography was performed in 12 patients confirming the diagnosis by revealing the development of collateral vessels. All the investigations concluded to moyamoya disease in 57.2% and moyamoya syndrome in 42.8%. The latter was related to Down syndrome in five patients and neurofibromatosis type 1 in one patient. With a mean follow-up of 2.35 years, two patients had at least two more AISs during the first two years following diagnosis and 42.8% of patients were diagnosed with vascular or poststroke epilepsy. Full recovery was noted in 14.3% of cases.
Conclusions: Moyamoya angiopathy in children is a serious condition that needs to be recognized due to the high risk of recurrent ischemic strokes.
Competing Interests: Declaration of competing interest There are no conflicts of interest.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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