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Posterior circulation abnormalities in moyamoya disease : a radiological study
P N Jayakumar1, M K Vasudev, S G Srikanth
1Department of Neuroradiology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
Neurology India
|July 13, 1999
Summary
Moyamoya disease (MMD) frequently affects the posterior circulation, but typically without causing infarcts. Instead, posterior circulation hemorrhages, particularly thalamic, are observed in MMD patients.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries and the circle of Willis.
- While anterior circulation involvement is well-documented, the extent and implications of posterior circulation involvement in MMD remain less highlighted.
- Understanding the pattern of MMD in the posterior circulation is crucial for comprehensive patient management and risk assessment.
Purpose of the Study:
- To investigate the frequency and pattern of posterior circulation involvement in patients diagnosed with Moyamoya disease.
- To analyze the clinical manifestations, particularly ischemic and hemorrhagic events, associated with posterior circulation compromise in MMD.
- To evaluate the role of the posterior circulation as a collateral pathway in the context of MMD.
Main Methods:
- Retrospective analysis of 10 patients diagnosed with Moyamoya disease.
- Detailed review of neuroimaging studies (angiography, CT, MRI) to assess the involvement of posterior circulation segments.
- Clinical data review to identify ischemic events (infarcts) and hemorrhagic events (hemorrhages) within the posterior circulation territory.
Main Results:
- Posterior circulation involvement was observed in 9 out of 10 MMD patients, with 6 unilateral and 3 bilateral cases.
- The P1 segment of the posterior cerebral artery was the most commonly affected.
- No ischemic events were detected in the posterior circulation territory; however, 5 patients experienced hemorrhages (4 thalamic, 1 subarachnoid).
Conclusions:
- The posterior circulation is frequently involved in Moyamoya disease, as demonstrated by angiography.
- Ischemic events in the posterior circulation are uncommon in MMD, suggesting its role as a collateral pathway.
- Hemorrhagic complications, such as thalamic and subarachnoid hemorrhages, are significant findings in MMD patients with posterior circulation involvement.