Collateral Circulation in Moyamoya Disease
| Autor: | Lian Duan, Desheng Li, Zheng-Shan Zhang, Hui Wang, Wei-Zhong Yang, Cong Han, Feng Zhao, Zhiwen Liu, Xiang-Yang Bao, Peng-gang Qiao |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Collateral Circulation Infarction Posterior cerebral artery Severity of Illness Index 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences 0302 clinical medicine medicine.artery Internal medicine medicine Anterior cerebral artery Humans Moyamoya disease Child Stroke Intraparenchymal hemorrhage Aged Retrospective Studies Advanced and Specialized Nursing business.industry Brain Middle Aged medicine.disease Collateral circulation Cerebrovascular Circulation Child Preschool Middle cerebral artery Cardiology Female Neurology (clinical) Moyamoya Disease Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Stroke. 50:2708-2715 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.119.024487 |
| Popis: | Background and Purpose— Predicting the risk of stroke and determining intervention indications are highly important for patients with Moyamoya disease (MMD). Here, we evaluated a novel MMD grading system based on collateral circulation and Suzuki stage to evaluate symptoms and predict prognosis. Methods— In total, 301 idiopathic MMD patients were retrospectively analyzed between 2014 and 2016. A collateral circulation grading system with scores ranging from 1 to 12 was established: the anatomic extent of pial collateral blood flow from posterior cerebral artery to middle cerebral artery and anterior cerebral artery was scored from 1 to 6; perforator collateral and internal cerebral artery flow were scored as 6 to 1, which corresponded to Suzuki stages 1 to 6. Dynamic susceptibility contrast–magnetic resonance imaging was used to evaluate hemodynamic status. We assessed the association between the grading system and clinical characteristics. Results— We analyzed 364 symptomatic hemispheres of 301 patients (146 males, 28±16 years). Ischemic patients who presented with infarction were more likely to score P 8 points. Hemorrhagic patients who presented with intraparenchymal hemorrhage were more likely to score 8 points ( P P P =0.016) and cerebral flow ratio ( P =0.002). Encephaloduroarteriosynangiosis was performed in 348 symptomatic hemispheres. Patients who had collateral scores Conclusions— This new MMD collateral grading system correlated well with clinical symptoms, hemodynamic status, and therapeutic prognosis and may facilitate risk stratification and prognosis predictions in patients with MMD. |
| Databáze: | OpenAIRE |
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