Clinical characteristics and leptomeningeal collateral status in pediatric and adult patients with ischemic moyamoya disease.
Adolescent
Adult
Angiography, Digital Subtraction
Brain Infarction
/ epidemiology
Brain Ischemia
/ etiology
Child
Child, Preschool
Collateral Circulation
Humans
Ischemic Attack, Transient
/ epidemiology
Meninges
/ blood supply
Middle Aged
Moyamoya Disease
/ complications
Neurosurgical Procedures
Posterior Cerebral Artery
/ physiopathology
Retrospective Studies
Treatment Outcome
adult
leptomeningeal collateral
moyamoya disease
pediatric
Journal
CNS neuroscience & therapeutics
ISSN: 1755-5949
Titre abrégé: CNS Neurosci Ther
Pays: England
ID NLM: 101473265
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
08
01
2019
revised:
13
03
2019
accepted:
14
03
2019
entrez:
26
12
2019
pubmed:
26
12
2019
medline:
29
6
2021
Statut:
ppublish
Résumé
Previous studies have found significant differences in clinical characteristics between pediatric and adult moyamoya disease (MMD) patients, but few studies have focused on the factors underlying these differences. We aimed to investigate the differences in leptomeningeal collateral (LMC) status between pediatric and adult MMD patients and to analyze the effects of LMCs on clinical characteristics and therapeutic prognosis. We retrospectively analyzed 214 MMD patients from January 2014 to January 2016. Clinical characteristics and LMC status were compared between the pediatric and adult patients. LMC status was graded as good or poor depending on the retrograde flow from the posterior cerebral artery (PCA) on digital subtraction angiography (DSA). A total of 83 pediatric and 131 adult (1:1.6) MMD patients were analyzed. Pediatric patients were more likely to experience a transient ischemic attack (81%), whereas adult patients were more likely to experience infarction (51%). Regarding the different MMD stages (the early, medium, and advanced stages corresponded to Suzuki stages 1-2, 3-4, and 5-6, respectively), the prevalence of good LMC status was higher for pediatric patients than for adult patients in the early stage (P = 0.047) and the medium stage (P = 0.001), but there were no differences between these patient groups in the advanced stage (P = 0.547). Worse postoperative angiographic outcomes (P = 0.017) were found in adult patients than in pediatric patients in the medium stage. Poor LMC status had strong correlations with infarction (P < 0.001 and P = 0.017) and poor postoperative outcomes (P = 0.003 and P = 0.043) in both pediatric and adult patients. Pediatric MMD patients have greater patency and a greater ability to establish good LMC status than adult patients, and poor LMC status has a strong correlation with severe clinical symptoms and poor postoperative outcomes. LMC status may be an important factor in the differences in clinical characteristics and prognosis between pediatric and adult MMD patients.
Identifiants
pubmed: 31875482
doi: 10.1111/cns.13130
pmc: PMC6930821
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
14-20Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.
Références
Stroke. 2002 Jun;33(6):1497-500
pubmed: 12052981
Brain Dev. 2011 Mar;33(3):229-34
pubmed: 20932697
N Engl J Med. 2009 Mar 19;360(12):1226-37
pubmed: 19297575
J Stroke Cerebrovasc Dis. 2014 Sep;23(8):2018-2022
pubmed: 25088172
Lancet Neurol. 2011 Oct;10(10):909-21
pubmed: 21939900
Ann Neurol. 2010 Jul;68(1):92-101
pubmed: 20582955
Stroke. 2001 Sep;32(9):2179-84
pubmed: 11546914
Childs Nerv Syst. 2015 Mar;31(3):389-98
pubmed: 25378261
World Neurosurg. 2016 Jun;90:530-538.e3
pubmed: 26806063
Arterioscler Thromb Vasc Biol. 2011 Aug;31(8):1748-56
pubmed: 21617137
Nature. 1992 Oct 29;359(6398):843-5
pubmed: 1279431
Stroke. 2010 Oct;41(10):2316-22
pubmed: 20829514
Cerebrovasc Dis. 2009;28(3):258
pubmed: 19602877
Neurol Med Chir (Tokyo). 2012;52(5):245-66
pubmed: 22870528
Ann Neurol. 2013 Aug;74(2):241-8
pubmed: 23536377
J Cereb Blood Flow Metab. 1985 Mar;5(1):79-85
pubmed: 3919037
CNS Neurosci Ther. 2020 Jan;26(1):14-20
pubmed: 31875482
AJNR Am J Neuroradiol. 2015 Dec;36(12):2285-91
pubmed: 26471754
Stroke. 1986 Jan-Feb;17(1):117-22
pubmed: 3945975
AJNR Am J Neuroradiol. 1997 May;18(5):837-45
pubmed: 9159360
Stroke. 2001 Dec 1;32(12):2768-73
pubmed: 11739971
J Stroke. 2016 Jan;18(1):2-11
pubmed: 26846755
J Appl Physiol (1985). 2005 Nov;99(5):1872-9
pubmed: 16024519
Arch Neurol. 1969 Mar;20(3):288-99
pubmed: 5775283
Blood Vessels. 1991;28(1-3):183-9
pubmed: 2001469
Gerontology. 1988;34(4):157-64
pubmed: 3181764
Neurol Med Chir (Tokyo). 2012;52(5):295-8
pubmed: 22688065
J Neuroradiol. 2014 Oct;41(4):234-42
pubmed: 24388564