Long-term natural history of hemorrhagic type moyamoya disease in 42 patients

Kobayashi, Eiichi; Saeki, Naokatsu; Oishi, Hideto; Hirai, Shinji; Yamaura, Akira

doi:10.3171/jns.2000.93.6.0976

Cited by 166 publications

(110 citation statements)

References 18 publications

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“…Intracranial hemorrhage is a common in feature in adult patients with MMDs with a mortality rate of approximately 20%, and it is the largest risk factor contributing to the poor prognosis with this entity. 22,23 Hemodynamic stress to the Moyamoya vessels has been suggested as a cause for the hemorrhagic presentation, and some reports showed Moyamoya vessels and aneurysms associated with MMD resolved after bypass surgery. 24,25 The prophylactic effect of bypass surgery against cerebral hemorrhage remains uncertain, and this issue will be clarified by a prospective, randomized trial in Japan (Japan Adult Moyamoya Trial).…”

Section: Patient Characteristics In Each Presentation Of MMDmentioning

confidence: 99%

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

Horie¹,

Morikawa²,

Nozaki³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: SWI is a high spatial resolution MR imaging technique showing magnetic inhomogeneity that could demonstrate increased oxygen extraction in focal cerebral ischemia. The aim of this study was to investigate the characteristics in the signal intensity of DMVs by using SWI and to determine whether this method could indicate the severity of the hemodynamics in MMD by evaluating the correlation between SWI stage and hemodynamics on SPECT.

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Section: Patient Characteristics In Each Presentation Of MMDmentioning

confidence: 99%

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

Horie¹,

Morikawa²,

Nozaki³

et al. 2011

AJNR Am J Neuroradiol

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“…However, in our cases, only one had a previous ischemic episode and none had ischemic lesions demonstrated on the initial MRI. In terms of the bleeding hemisphere, the predominant angiographic findings in adults have been reported as disease progression to Stage 3 according to Suzuki's angiographic criteria [15,24]. In our case 3, bleeding appeared in the hemisphere where the angiographic staging was less advanced and the regional CBF remained normal (Table).…”

Section: Discussionmentioning

confidence: 51%

“…Hemorrhagic type moyamoya disease is frequently seen in adults [1], and quite a low incidence of hemorrhage in patients aged < 16 years has been reported both in Japan [2,15] and Korea [4,14]. In adults, rebleeding is not uncommon and it could worsen the prognosis following hemorrhage [7,27].…”

Section: Discussionmentioning

confidence: 99%

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Pediatric moyamoya disease presenting with intracerebral hemorrhage—Report of three cases and review of the literature

Suyama

Yoshida

Takahata

et al. 2008

Clinical Neurology and Neurosurgery

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Intracerebral hemorrhage in patients with moyamoya disease is rare in children. We report three unique cases of pediatric moyamoya disease with hemorrhagic onset. Two 7-year-old girls and a 9-year-old girl were admitted to our hospital because of intracerebral hemorrhage associated with angiographically verified moyamoya disease. Two of them did not demonstrate either an ischemic episode or cerebral infarct on the magnetic resonance images. A decreased regional cerebral blood flow was revealed on single photon emission computed tomography in two patients, who developed cerebral infarction in the acute stage following hemorrhage. They underwent superficial temporal artery-middle cerebral artery anastomoses combined with encephalo-myo-synangiosis, and have not experienced any further ischemic episodes thereafter. Hemodynamic insufficiency associated with moyamoya disease could cause intracerebral hemorrhage even in children. Adequate management in the acute stage of hemorrhage and revascularization surgery are recommended to prevent 1 cerebral infarction, which may easily occur in pediatric patients with moyamoya disease.

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“…Most patients with hemorrhagic-onset moyamoya disease have intracerebral hemorrhage (ICH) or intraventricular hemorrhage (IVH). 6) In contrast, the clinical manifestations of hemorrhagic moyamoya disease associated with intracranial aneurysms tend to be SAH (74%) rather than ICH (34%) or IVH (29%). 5) The incidence of aneurysm rupture associated with moyamoya disease is unclear.…”

Section: Discussionmentioning

confidence: 99%

Paradoxical Association of Moyamoya Syndrome With Large Middle Cerebral Artery Aneurysm and Subarachnoid Hemorrhage -Case Report-

Endo

Fujimura

Inoue

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 69-year-old woman was admitted to our hospital because of fluctuating dysarthria during the past 2 months. Magnetic resonance imaging revealed old cerebral infarction of the left cerebral hemisphere with acute subarachnoid hemorrhage in the left sylvian fissure. Cerebral angiography showed a large saccular aneurysm, 14 mm in diameter, at the bifurcation of the left middle cerebral artery (MCA) in association with moyamoya vasculopathy with atherosclerosis, including steno-occlusive changes at the bilateral terminal internal carotid arteries and abnormal net-like vessels at the base of the brain. She underwent microsurgical neck clipping of the large aneurysm followed by superficial temporal artery-MCA anastomosis without complication. Intraoperative findings showed no evidence of aneurysm rupture, suggesting that the subarachnoid hemorrhage was due to the intrinsic pathology of moyamoya vasculopathy. The postoperative course was uneventful, and the patient was discharged without neurological deficit. Association of moyamoya syndrome with large MCA aneurysm is extremely rare, and formation of large aneurysm at the vascular territory of an occluded vessel is apparently unique.

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Long-term natural history of hemorrhagic type moyamoya disease in 42 patients

Abstract: The occurrence of rebleeding a long time after the first hemorrhagic episode was not uncommon. Furthermore, the change in which hemisphere and the type of bleeding that occurred after the first episode suggested the difficulty encountered in the prevention of repeated hemorrhage.

Cited by 166 publications

References 18 publications

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

Pediatric moyamoya disease presenting with intracerebral hemorrhage—Report of three cases and review of the literature

Paradoxical Association of Moyamoya Syndrome With Large Middle Cerebral Artery Aneurysm and Subarachnoid Hemorrhage -Case Report-

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