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Clinical and Hemodynamic Features in Moyamoya Disease with Intracranial Aneurysms

Haogeng Sun1, Rui Tian1, Zhiyuan Yu1

  • 1Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.

World Neurosurgery
|October 31, 2020
PubMed
Abstract

Insights

Patients with moyamoya disease (MMD) and intracranial aneurysms (IAs) exhibit distinct clinical and hemodynamic profiles compared to those without IAs. Circle of Willis aneurysms are associated with older age and advanced MMD stages.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Background:

  • Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
  • Intracranial aneurysms (IAs) can occur in patients with MMD, influencing clinical presentation and management.
  • Understanding the specific characteristics of MMD patients with IAs is crucial for tailored treatment strategies.

Purpose of the Study:

  • To compare clinical and hemodynamic features of MMD patients with and without intracranial aneurysms.
  • To differentiate between patients with circle of Willis (CoW) aneurysms and peripheral aneurysms in the context of MMD.
  • To investigate the relationship between aneurysm location and disease severity in MMD.

Main Methods:

  • Retrospective single-center study of MMD patients between May 2012 and December 2017.
  • Classification of IAs into Circle of Willis (CoW) or peripheral aneurysms based on anatomical location.
  • Collection and analysis of clinical characteristics, hemodynamic parameters, Suzuki stage, and CT perfusion data.

Main Results:

  • 31 MMD patients had IAs, while 279 did not.
  • MMD patients with IAs showed more severe neurological dysfunction, advanced Suzuki stage, and less hemodynamic dysfunction.
  • Circle of Willis aneurysms were found in 17 patients, peripheral aneurysms in 13. Patients with CoW aneurysms were older with more advanced Suzuki stages.

Conclusions:

  • MMD patients with IAs possess distinct clinical and hemodynamic profiles compared to those without.
  • Circle of Willis and peripheral aneurysms may arise at different MMD stages, influencing location, hemorrhage type, and treatment.
  • Further research into the distinct characteristics of IA subtypes in MMD is warranted.
Keywords:
AneurysmCerebral hemodynamicsMoyamoya diseasePerfusionRevascularization

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