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Classification and treatment strategy for Moyamoya disease-related aneurysms

Yangchun Hu1, Xiaojian Wang1, Chao Li1

  • 1Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Jixi 218, Hefei, 230022, People's Republic of China.

Chinese Neurosurgical Journal
|December 21, 2023
PubMed
Abstract

Insights

Moyamoya disease with intracranial aneurysms (MMD-IA) presents diverse clinical features. Individualized neurosurgical treatments based on aneurysm location are crucial for successful outcomes in MMD-IA patients.

Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Neurology

Background:

  • Moyamoya disease (MMD) involves progressive stenosis of the distal internal carotid artery.
  • Hemodynamic changes in MMD can lead to the comorbidity of intracranial aneurysms (IA).
  • This study investigates the clinical characteristics and treatment of Moyamoya disease with intracranial aneurysms (MMD-IA).

Purpose of the Study:

  • To analyze the clinical presentations of MMD-IA patients.
  • To evaluate therapeutic strategies for MMD-IA.
  • To determine optimal treatment approaches based on aneurysm location.

Main Methods:

  • Retrospective review of 13 MMD-IA patients presenting with intracranial hemorrhage.
  • Analysis of surgical technique notes for all patients.
  • Categorization of aneurysms based on location: Circle of Willis, collateral anastomosis, or basal ganglia region.

Main Results:

  • Aneurysm locations included Willis circle (10 patients), pericallosal artery (2 patients), and basal ganglia (1 patient).
  • Treatments comprised endovascular embolization (5 patients) and aneurysm clipping (7 patients).
  • One patient with a basal ganglia aneurysm received revascularization; all treatments were successful with satisfactory outcomes at 6-24 months follow-up.

Conclusions:

  • MMD-IA exhibits diverse clinical presentations.
  • Treatment strategies for MMD-IA should be individualized based on specific aneurysm locations.
  • Tailored neurosurgical interventions are essential for managing MMD-IA effectively.
Keywords:
AneurysmClippingEndovascular embolismMoyamoya diseaseRevascularization

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