Risk Factors For Perioperative Stroke In Moyamoya Disease

Objective:Cerebral revascularization is an effective surgical treatment for moyamoya disease.However,the incidence of perioperative stroke in patients was up to 15.6%,and the prognosis of these people was bad.The purpose of this study is to analyze the risk factors for perioperative stroke of moyamoya disease in our center,so as to strengthen the perioperative management of patients and decrease the incidence of stroke.Methods:102 patients with moyamoya disease who received cerebral revascularization in the Department of Neurosurgery of Xiangya Hospital of Central South University from January 2011 to April 2021 were included.We collected data of demographic characteristics,imaging characteristics,perioperative complications and follow-up.The risk factors for perioperative stroke of moyamoya disease were analyzed by Logistic regression.Results:Among the 102 patients,the average age of onset was 28.22 years,including 63 males and 39 females,64 adults and 38 children respectively.118 sides of cerebral revascularization were performed in102 patients,including 51 combined revascularization and 67 indirect revascularization.Our study showed that the perioperative complications of moyamoya disease were 14.4%.Perioperative stroke was 6.78%,including 5 cases of ischemic stroke and 3 cases of hemorrhagic stroke and other complications include 5 cases of subdural effusion / blood and4 cases of epilepsy.Logistic regression analysis showed that higher suzuki stage,lower cerebral infarction score and white matter hyperintensities were the risk factors for perioperative stroke in moyamoya disease.Subgroup analysis revealed no significant risk factor for perioperative stroke between children and adults,or ischemic and hemorrhagic moyamoya disease.Conclusion:Higher suzuki stage,lower cerebral infarction score and white matter hyperintensities are the risk factors for perioperative stroke in moyamoya disease.We need to strictly evaluate these patients before operation and strengthen perioperative management.