PedsQL Score Post Encephalo-duro-arterio-myo-synangiosis Procedure for Moyamoya Disease: A Single Center Experience

Kalra, Neeraj; Bautista, Manuel; McCullagh, Helen; Tyagi, Atul

doi:10.1016/j.wneu.2020.09.043

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Our results align with norm scores for Dutch children with a chronic health condition [43] and with another study of surgically treated children with MMD [7]. A study from the U.K. using only the parent-proxy of the PedsQl reported a lower score of 66.0 compared to the children's scores in our cohort [44]. In adults, we found a statistically significant improvement for the QOL as measured by the VAS from the EQ-5D and the MCS of the SF36 but not for the EQ-5D index nor for the PCS.…”

Section: Discussionsupporting

confidence: 89%

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Deckers

Kronenburg

Berg

et al. 2022

JCM

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Background: It remains unclear whether revascularization of moyamoya vasculopathy (MMV) has a positive effect on cognitive function. In this prospective, single-center study, we investigated the effect of revascularization on cognitive function in patients with MMV. We report clinical and radiological outcome parameters and the associations between clinical determinants and change in neurocognitive functioning. Methods: We consecutively included all MMV patients at a Dutch tertiary referral hospital who underwent pre- and postoperative standardized neuropsychological evaluation, [15O]H2O-PET (including cerebrovascular reactivity (CVR)), MRI, cerebral angiography, and completed standardized questionnaires on clinical outcome and quality of life (QOL). To explore the association between patient characteristics, imaging findings, and change in the z-scores of the cognitive domains, we used multivariable linear- and Bayesian regression analysis. Results: We included 40 patients of whom 35 (27 females, 21 children) were treated surgically. One patient died after surgery, and two withdrew from the study. TIA- and headache frequency and modified Rankin scale (mRS) improved (resp. p = 0.001, 0.019, 0.039). Eleven patients (seven children) developed a new infarct during follow-up (31%), five of which were symptomatic. CVR-scores improved significantly (p < 0.0005). The language domain improved (p = 0.029); other domains remained stable. In adults, there was an improvement in QOL. We could not find an association between change in imaging and cognitive scores. Conclusion: In this cohort of Western MMV patients, TIA frequency, headache, CVR, and mRS improved significantly after revascularization. The language domain significantly improved, while others remained stable. We could not find an association between changes in CVR and cognitive scores.

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Section: Discussionsupporting

confidence: 89%

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Deckers

Kronenburg

Berg

et al. 2022

JCM

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“…Formica et al [ 199 ] also found that specific motor and neuropsychological rehabilitative treatments provided advantages in the care of MMD patients with disorders of consciousness. In particular, psychological intervention for pediatric MMD patients is important to improve post-operative quality of life and physical, emotional, social, and school functional outcomes [ 200 ]. Choi et al [ 201 ] also confirmed the effectiveness of remote ischemic pre- and post-conditioning in reducing neurological complications and the duration of hospitalization in MMD patients undergoing STA-MCA anastomosis.…”

Section: Treatmentmentioning

confidence: 99%

Progression in Moyamoya Disease: Clinical Features, Neuroimaging Evaluation, and Treatment

Zhang

Xiao

Zhang

et al. 2022

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: Moyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive stenosis of the arteries of the circle of Willis, with the formation of the collateral vascular network at the base of the brain. Its clinical manifestations are complicated. Numerous studies have attempted to clarify the clinical features of MMD, including its epidemiology, genetic characteristics, and pathophysiology. With the development of neuroimaging techniques, various neuroimaging modalities with different advantages have deepened the understanding of MMD in structural, functional, spatial, and temporal dimensions. At present, the main treatment for MMD focuses on neurological protection, cerebral blood flow reconstruction, and neurological rehabilitation, such as pharmacological treatment, surgical revascularization, and cognitive rehabilitation. In this review, we discuss recent progress in understanding the clinical features, neuroimaging evaluation, and treatment of MMD.

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“…The possibilities of indirect BR techniques are broad [104]. Depending on the donor tissue used, the options are encephalo-myo-synangiosis (EMS) [142] when a muscle is used, encephaloduro-synangiosis (EDS) [143] with dural graft, split-duro-encephalo-synangiosis (DES) [144,145] with a split dura graft, encephalo-duro-myo-synangiosis (EDMS) [146] with dural and muscle graft, encephalo-duro-arterio-synangiosis (EDAS) [147][148][149][150] with dura and external carotid artery branch, encephalo-duro-arteriomyo-synagiosis (EDAMS) [151] with dura, an external carotid artery branch and muscle, encephalo-galeo-synangiosis (EGS) [152,153] with galea, encephalopericranium-synangiosis (EPS) [140,154,155] with pericranium, omentum transplantation [156,157] and multiple burr-hole (MBH) [158,159]. This last surgical technique consists of performing numerous burr holes (10 to 24) through the frontal, parietal and occipital bones, opening the dura and arachnoid and introducing a pericranium flap inside each burr-hole [160].…”

Section: Treatment Modalities In Moyamoya Diseasementioning

confidence: 99%

Surgical Treatment of Moyamoya Disease

Vanaclocha¹,

Saiz-Sapena²,

Vanaclocha³

2021

Moyamoya Disease - A Disease to Count on in Your Daily Practice

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Moyamoya disease is a rare cerebrovascular disease most prevalent in East Asian Countries. Thanks to the new diagnostic capabilities, the number of cases discovered has been rising steadily in the latest years, including many asymptomatic patients. But asymptomatic from the clinical point of view does not necessarily mean that there are no subjacent problems and that there will be no disease progression. Indeed, many patients harbour cognitive decline long before they start with clinical or even radiological manifestations. The only effective treatment is surgical revascularization, with all its possibilities: direct, indirect, and combined. While direct techniques are more useful in adult moyamoya patients, children seem to benefit most from indirect techniques. Additionally, indirect or combined procedures can be used as salvage procedures in case of unsatisfactory outcomes. Thus, many surgeons posit that surgical treatment should be considered in moyamoya patients, even if asymptomatic, particularly in the paediatric age group.

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PedsQL Score Post Encephalo-duro-arterio-myo-synangiosis Procedure for Moyamoya Disease: A Single Center Experience

Cited by 5 publications

References 9 publications

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study

Progression in Moyamoya Disease: Clinical Features, Neuroimaging Evaluation, and Treatment

Surgical Treatment of Moyamoya Disease

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