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Hemorrhage Risk in Moyamoya Disease with Fetal-Type Posterior Cerebral Artery: A Propensity Score-Matched Analysis
Wenjie Li1, Huan Zhu1, Meng Zhao1
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
Objective:
Patients with moyamoya disease (MMD) and fetal-type posterior cerebral arteries have not been thoroughly investigated as yet. We focused on the risk of intracranial hemorrhage in patients with MMD and fetal-type posterior cerebral arteries.
Methods:
We reviewed 2422 patients with MMD diagnosed at the Neurosurgical Department of Beijing Tiantan Hospital between May 2009 and December 2020. We classified patients into 2 groups according to whether they had a fetal-type posterior cerebral artery. After 1:1 propensity score matching, hemorrhagic tendency and Suzuki stage were compared between patients with a fetal-type posterior cerebral artery (group I) and patients without a fetal-type posterior cerebral artery (group II).
Results:
In total, 2415 patients were included in this study; 181 had fetal-type posterior cerebral arteries. Hemorrhagic events were more frequently observed in patients with fetal-type posterior cerebral artery development than in those without it (28.2% vs. 18.8%, P = 0.035). However, Suzuki stages did not differ between the 2 matched groups (4.03 vs. 4.20, P = 0.081).
Conclusions:
Hemorrhagic events occurred more frequently in patients with MMD with fetal-type posterior cerebral arteries than in those without.
Insights
Patients with moyamoya disease (MMD) and fetal-type posterior cerebral arteries face a higher risk of hemorrhagic events. This study found increased intracranial hemorrhage in MMD patients with fetal-type posterior cerebral arteries compared to those without.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Moyamoya disease (MMD) is a rare cerebrovascular disorder.
- The association between MMD and fetal-type posterior cerebral arteries (ftPCA) requires further investigation.
- Intracranial hemorrhage is a significant complication in MMD.
Approach:
- Retrospective review of 2422 MMD patients diagnosed between 2009 and 2020.
- Classification into groups based on the presence or absence of ftPCA.
- 1:1 propensity score matching to compare hemorrhagic tendency and Suzuki stage.
Key Points:
- 181 out of 2415 patients had ftPCA.
- Hemorrhagic events were significantly more frequent in patients with ftPCA (28.2%) compared to those without (18.8%).
- No significant difference in Suzuki stages was observed between the two matched groups.
Conclusions:
- Patients with MMD and ftPCA exhibit a higher incidence of hemorrhagic events.
- ftPCA may represent a risk factor for intracranial hemorrhage in MMD patients.
- Further research is warranted to elucidate the underlying mechanisms.
