Lacunar infarction in adult patients with moyamoya disease
Meng Zhao1, Xiaofeng Deng1, Shuo Wang1
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China; China National Clinical Research Center for Neurological Diseases, Beijing, PR China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, PR China.
Objectives:
Lacunar infarctions in moyamoya disease have rarely been described. We aimed to evaluate the features and prognosis of adult moyamoya patients with lacunar infarction.
Patients And Methods:
We reviewed 696 consecutive moyamoya patients admitted to our hospital from 2009 to 2015 to identify patients with lacunar infarctions. We compared the clinical features and prognosis of adult moyamoya patients with lacunar infarction and those with non-lacunar infarction. Follow-up was conducted by face-to-face reviews or by a structured telephone interview. Outcome measures were recurrent stroke events and functional outcomes by modified Rankin Scale (mRS).
Results:
We identified 32 patients with lacunar infarction among 197 adult moyamoya disease patients with infarctions. Patients with lacunar infarctions demonstrated similar angiographic features with patients with non-lacunar infarctions. During a mean follow-up of 33.02±20.49months, we observed recurrent stroke events in 1 patients with lacunar infarction and 14 patients with non-lacunar infarction. The mean follow-up mRS was significantly better in the lacunar group than in the non-lacunar group (0.59±0.56 vs. 1.13±1.24; P<0.001).
Conclusion:
We identified that the moyamoya patients with lacunar infarctions had better functional outcomes comparing with patients with non-lacunar infarction after revascularization.
Insights
Moyamoya disease patients with lacunar infarctions show similar features but better outcomes post-revascularization compared to those with non-lacunar infarctions. This suggests lacunar infarctions may indicate a more favorable prognosis in moyamoya disease.
Area of Science:
- Neurology
- Cerebrovascular Diseases
- Neuroimaging
Background:
- Lacunar infarctions are infrequently documented in moyamoya disease.
- Understanding their characteristics and prognosis is crucial for patient management.
Purpose of the Study:
- To evaluate the clinical features and prognosis of adult moyamoya patients with lacunar infarction.
- To compare outcomes between moyamoya patients with and without lacunar infarction.
Main Methods:
- Retrospective review of 696 moyamoya patients (2009-2015).
- Identification and comparison of clinical features, angiographic findings, and prognosis (recurrent stroke, modified Rankin Scale) between lacunar and non-lacunar infarction groups.
- Follow-up via direct review or telephone interview.
Main Results:
- 32 lacunar infarctions identified among 197 adult moyamoya patients with infarctions.
- Similar angiographic features were observed in both groups.
- Lower recurrent stroke rate (1 vs. 14) and significantly better functional outcomes (mean mRS 0.59 vs. 1.13) in the lacunar infarction group.
Conclusions:
- Moyamoya patients with lacunar infarctions exhibit comparable angiographic features to those without.
- Lacunar infarctions in moyamoya disease are associated with better functional outcomes after revascularization.
