| Objective:Exploring the epidemiological and clinical characteristics of MMD in Yunnan, improve the understanding of the diagnosis and treatment of MMD in local areas.Methods:I have collected the clinical and imaging data of the patients in 79 cases from January 2011 to June 2014 in Yunnan, who had been hospitalized in Department 1 of Neurosurgery,The first hospital affiliated of Kunming medi-cal with MMD, retrospectively analyze the epidemiological characteristics, clini-cal features, radiologicalfeatures,treatment and prognosis.Results:1. The distribution of patients with moyamoya disease in Yunnan exists a regional difference. There were 32 patientsC 40.5%)in the western area of yunnan,22 patients (27.8%) in the central area of yunnan,13 patients (16.5%)in the eastern area of yunnan,10 patients (12.7%) in the southern area of yunnan and 2 patients (2.5%) in the northwest area of yunnan.2. The average age of MMD was 42.99± 11.62 years old, the peak incidence was 45 to 49 years old,there were 94 males(54.4%) and 108 females(45.6%), the ratio of female to male is 1.2:1.3. The number of the ischemic was 45 (57.0%), the number of the hemorrhagic was 34 (43.0%); The number of patients who under the age of 18 was 3 (3.8%) and over the age of 18 was 76 (96.2%);In the group the number of the ischemic who over the age of 18 was 42 (55.3%) and the number of the hemorrhagic was 34 (44.7%);In the group all of three patients(100%) who under the age of 18 were ischemic. In the group of male patients, the number of the ischemic was 19(52.8%) and the number of the hemorrhagic was 17 (47.2%);In the group of female patients, the number of the ischemic was 26(60.5%) and the number of the hemorrhagic was 17(39.5%).4. According to Suzuki staging,79 patients with MMD patients were staged, most of the patients with MMD were in Ⅲ stage (22.8%) and Ⅳ stage (27.8%); the patients with cerebral ischemia among the group were in IVstage (28.9%), Ⅱ stage (20.0%) and Ⅴ stage (17.8%), the patients with cerebral hemorrhage were in Ⅲstage (35.3%) and Ⅳstage(26.5%).5. There were 13 cases with MMD combined with intracranial aneurysm, the number of the hemorrhagic combined with intracranial aneurysm was 10(29.4%), the number of the ischemic combined with intracranial aneurysm was 3(6.7%).6.30 patients had been modified ED AS. After the operations the patients were followed up from 3 months to 2 years,28 patients(84.8%) were in good prognosis,5 patients(15.2%) in a poor prognosis; There were 40 patients did not been undergo with revascularization, follow-up for 3 months to 2 years,25 patients in good prognosis (62.5%),15 patients in poor prognosis (37.5%).Conclusion:1. The average age of MMD is 42.99±11.62 years old, the peak inci-dence is 45 to 49 years old, the ratio of female to male is 1.2:1, there is no significant difference among males and females in age. There is regional differences in MMD distribution, Western yunnan is the high-prevalence area of MMD in yunnan provin-ce, especially Lincang.2. Most of children and adults patients with MMD are manif-ested as ischemic, most of male and female patients with MMD are manifested as ischemic, there is no significant difference among males and females patients in Clinical manifestations,3. Vascular disease can affect the posterior circulation blood vessels for MMD patients, MMD patients have a high incidence of clinical symptoms in Ⅲstage and Ⅳstage,most patients with cerebral ischemia are in Ⅳstage, Ⅱ stage and Ⅴ stage, most patients with cerebral hemorrhage are in Ⅲstage and Ⅳstage.4. Improved EDAS can improve theprognosis of patients with MMD,especially for the ischemic, can make the most of patients with MMD develop clear communication in intracranial and extracranial vessel, the formation of good communication can significantly improve the prognosis of patients, Improved EDAS is suitable for popularization and application in yunnan. |
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