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Clinical features, surgical treatment, and outcome of intracranial aneurysms associated with moyamoya disease. 2020

Peicong Ge, and Xun Ye, and Qian Zhang, and Xingju Liu, and Xiaofeng Deng, and Meng Zhao, and Jia Wang, and Rong Wang, and Yan Zhang, and Dong Zhang, and Jizong Zhao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China; Beijing Translational Engineering Center for 3D Printer in Clinical Neuroscience, Beijing, China.

The objective of this study was to elucidate the clinical features, surgical treatment, and outcome of intracranial aneurysms associated with moyamoya disease. We retrospectively reviewed a consecutive cohort of 79 moyamoya disease patients with 98 intracranial aneurysms at Beijing Tiantan Hospital. Clinical features, radiological findings, and outcomes were analyzed. Prevalence of intracranial aneurysms in patients with moyamoya disease was 3.9%. The mean age at diagnosis was 39.0 ± 12.4 years, with 1 peak distribution in patients from 40 to 50 years of age. The ratio of women to men was 1.00:1.03. Familial occurrence was 2.5%. The initial symptom was hemorrhage or ischemia in 56 (70.9%) and 23 patients (30.4%), respectively. Most patients presented with Suzuki stage 3 or 4. Seventy-nine cases had 98 aneurysms. Of the 98 aneurysms, sixteen aneurysms (16.3%) were treated by microsurgery and 7 by endovascular procedures, 13 aneurysms were conservatively managed, the remaining 62 were treated with revascularization alone. After a median nine-month angiographic follow-up, 18 aneurysms received clipped or embolized were completed occlusion, 18 aneurysms received conservative treated or coating were remained stable. Of the remaining 63 aneurysms that were treated with revascularization alone, 59 of 63 aneurysms remained stable, and 2 were obliterated, whereas 1 aneurysm ruptured during the follow-up. Hemorrhage was the most common symptom in intracranial aneurysms associated with moyamoya disease. Revascularization surgery may improve cerebral circulation, decreases hemodynamic stress and prevent the rupture of intracranial aneurysms.

UI MeSH Term Description Entries
D008297 Male Males
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009072 Moyamoya Disease A noninflammatory, progressive occlusion of the intracranial CAROTID ARTERIES and the formation of netlike collateral arteries arising from the CIRCLE OF WILLIS. Cerebral angiogram shows the puff-of-smoke (moyamoya) collaterals at the base of the brain. It is characterized by endothelial HYPERPLASIA and FIBROSIS with thickening of arterial walls. This disease primarily affects children but can also occur in adults. Cerebrovascular Moyamoya Disease,Progressive Intracranial Occlusive Arteropathy (Moyamoya),Moya-Moya Disease,Moyamoya Disease, Classic,Moyamoya Disease, Primary,Moyamoya Disease, Secondary,Moyamoya Syndrome,Classic Moyamoya Disease,Disease, Classic Moyamoya,Disease, Moya-Moya,Disease, Primary Moyamoya,Moya Moya Disease,Moyamoya Diseases, Primary,Primary Moyamoya Disease,Primary Moyamoya Diseases,Secondary Moyamoya Disease
D002532 Intracranial Aneurysm Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841) Aneurysm, Cerebral,Aneurysm, Intracranial,Basilar Artery Aneurysm,Berry Aneurysm,Brain Aneurysm,Cerebral Aneurysm,Giant Intracranial Aneurysm,Mycotic Aneurysm, Intracranial,Aneurysm, Anterior Cerebral Artery,Aneurysm, Anterior Communicating Artery,Aneurysm, Basilar Artery,Aneurysm, Middle Cerebral Artery,Aneurysm, Posterior Cerebral Artery,Aneurysm, Posterior Communicating Artery,Anterior Cerebral Artery Aneurysm,Anterior Communicating Artery Aneurysm,Middle Cerebral Artery Aneurysm,Posterior Cerebral Artery Aneurysm,Posterior Communicating Artery Aneurysm,Aneurysm, Berry,Aneurysm, Brain,Aneurysm, Giant Intracranial,Aneurysm, Intracranial Mycotic,Aneurysms, Basilar Artery,Aneurysms, Berry,Aneurysms, Brain,Aneurysms, Cerebral,Aneurysms, Giant Intracranial,Aneurysms, Intracranial,Aneurysms, Intracranial Mycotic,Artery Aneurysm, Basilar,Artery Aneurysms, Basilar,Basilar Artery Aneurysms,Berry Aneurysms,Brain Aneurysms,Cerebral Aneurysms,Giant Intracranial Aneurysms,Intracranial Aneurysm, Giant,Intracranial Aneurysms,Intracranial Aneurysms, Giant,Intracranial Mycotic Aneurysm,Intracranial Mycotic Aneurysms,Mycotic Aneurysms, Intracranial
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072700 Conservative Treatment Therapeutic approaches that are limited, gradual, or well-established as opposed to radical methods. Conservative Management,Conservative Therapy,Conservative Managements,Conservative Therapies,Conservative Treatments,Management, Conservative,Managements, Conservative,Therapies, Conservative,Therapy, Conservative,Treatment, Conservative,Treatments, Conservative

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