Short-term Prognosis Of Unilateral Moyamoya Disease With Initial Symptom Of Cerebral Infarction By Transcranial Doppler Ultrasound

Objective:Unilateral moyamoya disease is characterized by progressive stenosis or occlusion of unilateral intracranial internal carotid artery,middle cerebral artery and anterior cerebral artery,forming a smoke vascular network.The prognosis of patients with moyamoya disease is closely related to intracranial blood flow compensa-tion.Transcranial Doppler ultrasound has the advantages of noninvasive,economical and simple.It can dynamically and intuitively display the blood flow spectrum of intracranial and neck vessels,and its application in cerebrovascular has been affirmed.In this study,TCD was used to monitor the changes of cerebral blood flow spectrum and to investigate whether TCD can be used as a prognostic indicator for unilateral moyamoya disease with cerebral infarction as the first symptom.Methods:Patients admitted to the Second Affiliated Hospital of Nanchang University in June 2019 and October 2020 who were diagnosed with unilateral moyamoya disease and met the inclusion criteria were enrolled.The patients underwent transcranial Doppler ultrasound examination and relevant neurological function assessment tables upon admission.The neurological function and the patients’ life function was assessed followed up at 3,6 and 12 months after discharge.The MRS score ≦2 was defined as having a good prognosis.The patients were divided into good prognosis group and poor prognosis group.Depend the average blood flow velocity on the healthy intracranial artery was 30% higher than that of the artery with the same name on the affected side to compare the intracranial vascular compensation between patients with good prognosis and poor prognosis.Results:1.General information: A total of 62 patients met the inclusion criteria,including 29 males and 33 females,with an average age of 50.63 years;32 patients with hypertension,12 patients with diabetes,3 patients with atrial fibrillation,and 24 patients with smoking;there was no significant statistical significance between previous disease history and patient prognosis.2.The average flow velocity of MCA on the healthy side had a better prognosis than that of patients with the average flow velocity of MCA on the affected side was greater than 30%,with statistical significance(P =0.043).There was no significant difference between the flow shunt of other vessels and the prognosis of patients(P>0.05).The presence of intracranial flow diversion signal in patients is related to the prognosis of patients at 3 months after discharge.3.When the mean flow velocity of MCA on the healthy side was greater than30%,patients had a better prognosis,and the difference was statistically significant(P=0.031).The average flow velocity of ACA on the healthy side had a better prognosis than that of patients with the average flow velocity on the affected side was greater than 30%,with statistical significance(P =0.033).There was no significant difference between shunt and prognosis in other blood vessels(P>0.05).4.The average flow velocity of ACA on the healthy side had a better prognosis than that of patients with the average flow velocity on the affected side was greater than 30%,with statistical significance(P =0.019).There was no significant difference between shunt and prognosis in other blood vessels(P>0.05).Conclusions:1.For patients with unilateral moyamoya disease whose first symptom is cerebral infarction,Whether the average blood flow velocity of the ACA 、MCA on the healthy side is 30% higher than that of the same artery on the affected side is related to the early prognosis of patients.Patients with intracranial FD conditions are likely to have a better prognosis.2.The application of TCD is significant in the prognosis of unilateral moyamoya disease patients whose first symptom is cerebral infarction.3.It is necessary to increase TCD examination in patients with unilateral moyamoya disease after cerebral infarction;...