Clinical Analysis Of Moyamoya Disease With Aneurysm

Objective: Statistics and analysis of the clinical characteristics of moyamoya disease with aneurysms,choice of treatment strategies and prognosis of the disease.Methods: Retrospective analysis of patients with moyamoya disease combined with aneurysm and patients with simple moyamoya disease who were diagnosed as moyamoya disease combined with aneurysm and patients with simple moyamoya disease at the Department of Neurosurgery of The First Affiliated Hospital of Wannan Medical College from September 2012 to July 2020 were retrospectively analyzed.Collect and analyze detailed clinical data of these patients by reading medical records and telephone follow-up.Results: During this period,a total of 217 patients with moyamoya disease were admitted to our hospital,of which 39 patients were combined with aneurysm,accounting for17.97% of patients with moyamoya disease.Among them,13 were male patients and 26 were female patients.The ratio of male to female was(1:2),the average The age of onset was 50.69±8.25 years(27-67 years),the total number of aneurysms was 59,and the locations were: 14(23.7%)of the basilar artery,which accounted for the largest proportion.Among 39 patients,28 cases(71.79%)had hemorrhagic events,of which subarachnoid hemorrhage was the majority,13 cases(46.4%)in total,and 7 cases(25.0%)had intraventricular hemorrhage.There were 4 cases of parenchymal hemorrhage and multiple types of hemorrhage,accounting for 14.3%.Among all patients,35 patients were successfully followed up.The follow-up results of 24 people were good(MRS <3 points),of which 20 were surgically treated and 4 were conservatively treated;11 people(31.43%)had poor results,of which 5 were surgically treated and 6 were conservatively treated.Follow-up deaths were 6 people,and the total mortality was 17.14%.Among the dead patients,3 patients were treated conservatively,and the mortality of conservative treatment was 30.0%(3/10);3 patients treated by surgery,the mortality of surgical treatment was 11.54%.Conclusion: Among the related diseases that cause intracranial hemorrhage,moyamoya disease combined with aneurysm as the main cause occasionally occurs.The aneurysm of this disease is often located in the posterior circulation,and the basilar artery is the majority.The most common type of intracranial hemorrhage in moyamoya disease with aneurysm is subarachnoid hemorrhage,and the cause of this type of hemorrhage is mainly caused by the rupture of intracranial aneurysm.The distribution of aneurysms in patients with moyamoya disease combined with aneurysms is different from that of patients with simple aneurysms.The type of bleeding in patients with moyamoya disease complicated with aneurysm is also different from that of hemorrhagic moyamoya disease.The effect of conservative treatment is uncertain,patients often experience rebleeding,and even lead to death;the prognosis of surgical treatment is better than conservative treatment.