21 Cases Of Moyamoya Disease Clinical And Imaging Characteristics

Objective: To analyze the clinical features and diagnostic value of brain Computerized Tomography(CT), magnetic resonance imaging(MRI), magnctic re- sonance angiography(MRA) and digital subtraction angiography(DSA).Methods: Totally 21 MMD patients diagnosed at the Second Affiliated Hospital of Dalian Medical University from July 2002 to July 2008 were enrolled in this study. The initial clinical manifestions and results of the imaging examinations were reviewed in all cases.Results:①This study was composed of 21 patients (9 male, 12 female), of which 19 cases were >18 years old(adults),2 were≤18 years;②The most common first symptom in adults was cerebral hemorrhage(CH), with a total of 13 cases (68.4%); the first symptom of other cases included cerebral infarction(CI) and transient ischemic attack(TIA) ,with a total of 6 cases (31.6%) in 2 cases≤18 years old (100%), the first symptom as cerebral infarction. In this study ,no case was found to have the first symptom of atypical cerebrovascular disease.③13 adults were found to have CH on brain CT examination at the beginning and were finally diagnosed by MRA and(or) DSA; 6 adults and 2 cases≤18 years old were found to have vascular stenosis or occlusion were on brain MRI examination at first and finally, diagnosed by MRA and(or) DSA;④In 13 cases with CT scan: 6 cases had subarachnoid hemorrhage, 4 cases had intraventricular he- morrhage, 3 cases had lobar hemorrhage, the number in 8 cases with MRI/MRA:6 cases had CI(75%) and 6 cases had bilateral stenosis of the distal internal carotid arteries(ICA) and proximum of their first branches accompanied with the prominent collateralization;⑤All patients were examined by DSA, the bilateral stenosis or occlusion of distal ICA and proximal MCA/ACA was found in 21 patients(100%) ,moyamoya vessels were found in 17 patients(80.9%),the prominent collateralization was found in 20 patients(95.2%).Conclusion:①Ischemic stroke is the major clinical manifestation in adult MMD patients;②When a patients has recurrent stroke without high blood pressure,MMD should be considered and DSA should be performal as soon as possible.