Relationship Between Patterns Of The Collateral Circulation And Hemorrhagic Types In Adult Patients With Hemorrhagic Moyamoya Disease

ObjectiveThe study was designed to analysis the imaging characteristics of patients with hemorrhagic moyamoya disease who were confirmed in the neurosurgery of the first affiliated hospital of Nanchang university,to investigate the relationship between patterns of collateral circulation and hemorrhage types of hemorrhagic moyamoya disease,thus guiding the treatment of patients with hemorrhagic moyamoya disease,and to provide scientific basis for a good prognosis.MethodsTo collect basic imformation and imaging data of 73 cases of patients with hemorrhagic moyamoya disease who were confirmed by cerebral angiography in the neurosurgery of the first affiliated hospital of Nanchang university after the first bleeding.The hemorrhage types can be devided into three groups depending on the brain CT scan:cerebral hemorrhage,intraventricular hemorrhage,and subarachnoid hemorrhage(SAH).The patterns of collateral circulation were devided into nine groups.Type ?:the branches of the anterior cerebral artery supply the areas where the middle cerebral artery supplys;Type ?:the branches of the middle cerebral artery supply the areas where the anterior cerebral artery supplys;Type ?:the extensing anterior choroidal artery(AChA)and/or the posterior communicating artery(PComA)supply the perforating branches of ACA and MCA through the branches of PCA;Type ?:the cortical branches of the posterior cerebral artery anastomose the cortical branches of the anterior(ACA)and middle cerebral arteries(MCA);Type ?:the posterior choroidal artery(PChA)and/or the posterior pericallosal artery anastomose the cortical branches of the anterior(ACA)and/or middle cerebral arteries(MCA);Type ?:the ethmoidal artery supply the frontal cortex;Type ?:the posterior inferior cerebellar artery supply the areas where the anterior and/or middle cerebral artery supply through the posterior cerebral artery;Type ?:the middle meningeal artery and superficial temporal artery anastomose the cortical branches of ACA and MCA;Type ?:the branches of the occipital arterysupply the occipitotemporal cortex.The ?~2 Test was respectively applied in the camparison of difference in the types of collateral circulation of three different hemorrhage types.ResultsThere are statistical differences between the types of collateral circulation in different hemorrhagic types:the ststistical analysis between the hemorrhage type is related to the dominant patterns of the collateral circulation and the hemorrhage types are not related to the dominant patterns of the collateral circulation showed :?~2>3.84,P<0.05;the ststistical analysis between the hemorrhage types are not related to the dominant patterns of the collateral circulation showed:?~2<2.71,P>0.10.The results of the ststistical analysis suggested that the dominat collateral circulation of cerebral hemorrhage,intraventricular hemorrhage,and subarachnoid hemorrhage(SAH)are the Type ?,the Type ?,Type ?,respectively.ConclusionThe patterns of the collateral circulation of the Type ?,the Type ?,Type ?may be the causes of cerebral hemorrhage,intraventricular hemorrhage,and subarachnoid hemorrhage(SAH).