Cerebral infarction due to moyamoya disease in young adults.

Bruno, Askiel; Adams, Harold P.; Biller, José; Rezai, Karim; Cornell, Steven H.; Aschenbrener, Carol A.

doi:10.1161/01.str.19.7.826

Cited by 74 publications

(33 citation statements)

References 31 publications

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“…Whereas some authors have reported similar presentation characteristics in North American patients, 45 others have noted distinct differences from Asian populations. 1,2,57 In children, the most common presentation is cerebral ischemia. In the Scott and colleagues' 45 study of 143 pediatric patients with MMD in North America, nearly all of the patients presented with symptoms of either stroke or TIA; similar findings were revealed in European studies.…”

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confidence: 99%

Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions

Veeravagu¹,

Guzman²,

Patil³

et al. 2008

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116

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✓Neurosurgical interventions for moyamoya disease (MMD) in pediatric patients include direct, indirect, and combined revascularization procedures. Each technique has shown efficacy in the treatment of pediatric MMD; however, no single study has demonstrated the superiority of one technique over another. In this review, the authors explore the various studies focused on the use of these techniques for MMD in the pediatric population. They summarize the results of each study to clearly depict the clinical outcomes achieved at each institution that had utilized direct, indirect, or combined techniques. In certain studies, multiple techniques were used, and the clinical or radiological outcomes were compared accordingly. Direct techniques have been shown to aid a reduction in perioperative strokes and provide immediate revascularization to ischemic areas; however, these procedures are technically challenging, and not all pediatric patients are appropriate candidates. Indirect techniques have also shown efficacy in the pediatric population but may require a longer period for revascularization to occur and perfusion deficits to be reversed. The authors concluded that the clinical efficacy of one technique over another is still unclear, as most studies have had small populations and the same outcome measures have not been applied. Authors who compared direct and indirect techniques noted approximately equal clinical outcomes with differences in radiological findings. Additional, larger studies are needed to determine the advantages and disadvantages of the different techniques for the pediatric age group.

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mentioning

confidence: 99%

Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions

Veeravagu¹,

Guzman²,

Patil³

et al. 2008

FOC

116

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“…Although no completed randomized clinical trials have addressed the benefit of surgical revascularization, the dismal prognosis of moyamoya disease [2][3][4]7,8,21,23,31,33,[41][42][43] and a large number of case series demonstrating an improved outcome in surgically treated patients have provided evidence in support of revascularization procedures in a select group of patients. 4,[7][8][9][10][11]16,17,25,29,30,32,34,40,43 Currently, the Ministry of Health and Welfare of Japan reports that bypass surgery is indicated when there are 1) repeated clinical symptoms due to apparent cerebral ischemia and (2) decreased regional cerebral blood flow, vascular response, and perfusion reserve.…”

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confidence: 99%

Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass

Starke¹,

Komotar²,

Connolly³

2009

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Moyamoya disease is a chronic cerebrovascular occlusive disorder that results in severe morbidity and death. There is much controversy surrounding the optimal treatment for adult patients with the disorder. There have been no randomized trials to assess the efficacy of any single surgical treatment, and existing case series suffer from inadequate power, selection bias, and inherent differences in patient characteristics. In this article the authors review the literature concerning the optimal surgical treatment of adult patients with moyamoya disease.

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“…In the non-Japanese population, adult moyamoya disease is extremely rare and commonly causes intracerebral haemor rhage [3]. Carpopedal spasm has not been reported before in association with moya moya disease.…”

Section: Discussionmentioning

confidence: 96%