| ObjectiveThrough retrospective analysis of our hospital's latest cases of moyamoya disease and its main clinical manifestations and types,to compare the differences between the results of CTA and TCD to DSA in cerebral vascular stenosis,To observe the therapeutic effect of drug therapy and surgical revascularization for moyamoya disease,and to provide reference for the screening,diagnosis and treatment of moyamoya disease.Materials and methodsThis study is a retrospective analysis of patients with moyamoya disease from January 2010 to December 2016 from the Department of Neurology and Neurosurgery of the Second Affiliated Hospital of Guangzhou Medical University,the general information,the type of first onset and clinical manifestations,DSA,MRA,CTA,TCD imaging data,and treatment of these patients were investigated.Then sum up the general characteristics of moyamoya disease in this region,and compare the CTA and TCD images with DSA images,to examine the effect of CTA and TCD on the preliminary screening of moyamoya disease.And through outpatient visits and telephone visits,to evaluate the prognosis of patients with surgical revascularization and conservative treatment.Results1.In this group of 76 cases,the onset of the disease was as follows: ischemic type 47 cases,accounting for 62%(including cerebral infarction in 30 cases,TIA in 17 cases),Hemorrhagic type 29 cases,accounting for 38%;headache,nausea and vomiting,disturbance of consciousness in hemorrhagic type was significantly higher than that of ischemic type patients(P<0.05),muscle weakness in ischemic type was significantly higher than that of hemorrhagic type patients(P<0.05);2?CTA had no significant difference in the degree of vascular stenosis compared with DSA(?2=2.397,p=0.302,p>0.05).The effect of TCD on the degree of stenosis has no significantly different compared with DSA(?2=4.290,p=0.117,p>0.05).3?Of the 76 patients in this group,3 patients died for the first time admission due to serious illness and they belong to hemorrhagic type.The remaining 73 patients,there were 10 patients with a total of 12 hemispheres underwent surgical revascularization,including 3 cerebral hemispheres for direct revascularization,4 cerebral hemispheres indirect revascularization,5 cerebral hemispheres for combined direct and indirect revascularization,63 patients without revascularization treatment.The patients underwent surgical revascularization,the first NDS 3.40 ±3.06,the last follow-up NDS 0.60±0.70,t=3.628,p=0.006,p<0.05,after revascularization treatment,patients' NDS was significantly improved.For patients who did not underwent surgical revascularization,the first NDS were 5.25±7.20,and the final follow-up NDS were 4.71±6.18,t=1.620,p=0.110,p>0.05,and no significant improvement was observed in patients in NDS who underwent Conservative treatment.Conclusion1 Whether adults or children,moyamoya disease is mainly manifested as ischemic type.2 TCD,CTA can evaluate the degree of cerebral vascular stenosis,and they can be used as a screening method for moyamoya disease.3 Surgical revascularization not only significantly improve the symptoms and neurological deficits but also improve the prognosis in patients with moyamoya disease. |
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