Association of Superficial Temporal Artery Dilatation with Headache After Revascularization in Adult Moyamoya Disease.
Adult
Aged
Brain
/ diagnostic imaging
Cerebral Revascularization
Cerebrovascular Circulation
/ physiology
Female
Headache
/ diagnostic imaging
Humans
Magnetic Resonance Angiography
Male
Middle Aged
Moyamoya Disease
/ complications
Retrospective Studies
Temporal Arteries
/ diagnostic imaging
Tomography, Emission-Computed, Single-Photon
Vasodilation
Headache
Moyamoya disease
Revascularization
STA-MCA anastomosis
Superficial temporal artery
rCBF
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
24
03
2019
revised:
25
05
2019
accepted:
27
05
2019
pubmed:
4
6
2019
medline:
22
1
2020
entrez:
4
6
2019
Statut:
ppublish
Résumé
The underlying mechanisms of headache in adult moyamoya disease (MMD) are not clear. The aim of this study is to clarify the factors that are associated with headache in adult patients with MMD after superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. We retrospectively analyzed the cases of 68 adult patients with MMD: 30 with surgery and 38 without surgery. Each STA-MCA anastomosis was performed by the standard technique. Magnetic resonance angiography (MRA) and single photon emission computed tomography were performed perioperatively. We stratified the intensity and frequency of the patients' headaches into 4 ranks. Pre- and postoperative STA diameters were retrospectively measured on digital subtraction angiography (DSA) and/or MRA. In the surgery group, preoperative regional cerebral blood flow (rCBF) laterality and a postoperative rCBF increase >20% showed no significant difference between the patients with and without headache with a univariate analysis. The postoperative STA diameters of the distal branch (DSA) and main trunk (DSA/MRA) in the patients with headache were significantly larger than those of the patients without headache. The rate of postoperative increase of the STA diameters of the distal branch/main trunk was also significantly higher in the patients with headache than those without headache. A multivariate analysis showed that the standard regression coefficient β for sex, a >20% increase of postoperative rCBF, and the increase rate of the STA diameter of the distal branch shown by DSA was 0.37, 0.54, and 0.56, respectively. The results of our analyses revealed that aside from ischemia, the postoperative increase rate of the STA may be a candidate reason for headache, especially in adult patients with MMD.
Sections du résumé
BACKGROUND
BACKGROUND
The underlying mechanisms of headache in adult moyamoya disease (MMD) are not clear. The aim of this study is to clarify the factors that are associated with headache in adult patients with MMD after superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis.
METHODS
METHODS
We retrospectively analyzed the cases of 68 adult patients with MMD: 30 with surgery and 38 without surgery. Each STA-MCA anastomosis was performed by the standard technique. Magnetic resonance angiography (MRA) and single photon emission computed tomography were performed perioperatively. We stratified the intensity and frequency of the patients' headaches into 4 ranks. Pre- and postoperative STA diameters were retrospectively measured on digital subtraction angiography (DSA) and/or MRA.
RESULTS
RESULTS
In the surgery group, preoperative regional cerebral blood flow (rCBF) laterality and a postoperative rCBF increase >20% showed no significant difference between the patients with and without headache with a univariate analysis. The postoperative STA diameters of the distal branch (DSA) and main trunk (DSA/MRA) in the patients with headache were significantly larger than those of the patients without headache. The rate of postoperative increase of the STA diameters of the distal branch/main trunk was also significantly higher in the patients with headache than those without headache. A multivariate analysis showed that the standard regression coefficient β for sex, a >20% increase of postoperative rCBF, and the increase rate of the STA diameter of the distal branch shown by DSA was 0.37, 0.54, and 0.56, respectively.
CONCLUSIONS
CONCLUSIONS
The results of our analyses revealed that aside from ischemia, the postoperative increase rate of the STA may be a candidate reason for headache, especially in adult patients with MMD.
Identifiants
pubmed: 31158538
pii: S1878-8750(19)31505-0
doi: 10.1016/j.wneu.2019.05.228
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e594-e606Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.