Retrospective Study On Clinical Manifestations And Imaging Characteristics Of87Moyamoya Disease Patients

Objective:To analyze clinical manifestation and imaging characteristics of moyamoya disease diagnosed firstly in Neurology department in Zhejiang Province recent years, so that to guide clinical practice.Methods:A retrospective analysis of first symptoms, clinical manifestations and imaging characteristics of moyamoya disease in8juveniles and79adults from2005.4-2013.4in Neurology department in the2nd Affiliated Hospital, Zhejiang University College of Medicine.Results:(1)In8juveniles with moyamoya, male:female=1:1, mean age is14.50±2.73yrs old, in79adults with moyamoya, male:female=1.08:1,mean age is41.20±11.13yrs old;(2) There are18cases with probable familiar moyamoya,10cases complicated with hyperthyroidism or subclinical hyperthyroidism;(3)About first symptom:in8juveniles cases with moyamoya,62.5%is ischemic manifestation(such as TIA, cerebral infarction), in79adults with moyamoya,54.43%is cerebral infarction,31.65%is intracranial hemorrhage;(4) CT or MRI is abnormal in75moyamoya patients, among them27are intracranial hemorrhage,44are cerebral infarction, most common lesions are still the basal ganglion, temporal lobe, parietal lobe and so on;(5)20patients with received CTA scan, and57received MRA scan,58presented with bilateral stenosis or occlusion,59cases displayed moyamoya vessels,2cases have anterior-communicating single aneurysm;(6)46moyamoya patients underwent the DSA and got definitely diagnosed, Suzuki staging system was applied to divide the patients into6stages according to different features in DSA, among45patients,42had moyamoya vessels formed,11cases had unilateral stenosis or occlusion,34had bilateral involved,5cases also had stenosis or occlusion of posterior cerebral artery. Bilateral involvement of internal carotid system occurred significantly more common than unilateral involvement.Conclusions:The peak onset age of adult with moyamoya is still40yrs old. In Neurology department, more than half of moyamoya disease patients developed ischemic stroke. MRA can help to find more moyamoya disease, which can be applied for screening. DSA is still the golden standard for moyamoya disease. Most cases have bilateral stenosis or occlusion, and some simultaneous PCA related. Moreover, hyperthyroidism may be associated with moyamoya disease. Moyamoya disease should also be taken into consideration in epilepsy patients with unknown reasons in the clinical practice.