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Cerebral Revascularization Accelerates the Angiographic Staging Progression of the Operated Hemisphere in a Pediatric Patient With Moyamoya Disease
First author：Yu Le-Bao
Corresponding author：Zhang Dong
essential_information
2019-06-01
Published articles
Journal：J Craniofac Surg
Publication type: Research Article
IF(IF): 1.046
PMID: 30896520 Link To Pubmed Full text Download
Background And Purpose
Method
A total of 20 pediatric patients with bilateral MMD were included in this study. All enrolled patients were at the similar Suzuki angiographic staging on bilateral hemispheres and cerebral revascularization was performed in unilateral hemisphere. Angiographic examination was performed in the first year after the operation to evaluate the progression of the lesions.
Conclusion
Cerebral revascularization would significantly accelerate the angiographic staging progression on the treated hemisphere, while it would not cause the deterioration of the patient's condition. The progression pace was associated with Suzuki stage.
Main results
Cerebral revascularizations including direct bypass or encephaloduroarteriosynangiosis were performed in 20 hemispheres. During the follow-up, the incidence of stage progression in the operated hemisphere was significantly higher than in the contralateral side (80.0% versus 20.0%, respectively; P?=?0.036) and the interval of disease progression was significantly shorter in the operated side than in the contralateral side (mean interval time, 7.3 versus 10 months). Earlier Suzuki stage on hemisphere represented faster pace of stage progression compared with server Suzuki stage (OR?=?-0.612, P?=?0.004), while neoformative collaterals had not significant correlation with the progression pace. The leptomeningeal collaterals from the posterior circulation decreased in almost all operated hemisphere, while gradually increasing in the contralateral hemisphere. Symptoms were improved in all patients after operation.