PMID- 24866473
OWN - NLM
STAT- MEDLINE
DCOM- 20150528
LR  - 20220318
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Linking)
VI  - 156
IP  - 9
DP  - 2014 Sep
TI  - Long-term outcomes in adult patients with ischemic-type moyamoya disease 
      involving posterior circulation.
PG  - 1745-51
LID - 10.1007/s00701-014-2136-3 [doi]
AB  - BACKGROUND: The object of this study was to compare the long-term outcomes in 
      adult patients with moyamoya disease (MMD) with posterior circulation involvement 
      (PCi) treated through surgical revascularization with those in adult patients 
      without PCi. METHODS: The records of 32 consecutive adult patients with 
      ischemic-type MMD who were treated with revascularization were reviewed. Twelve 
      of these patients (38 %) had PCi at initial onset. Clinical characteristics of 
      the patients with PCi were compared to those without PCi. Neurological outcomes 
      were assessed using the modified Rankin Scale (mRS) in the preoperative and 
      postoperative follow-up periods. A five-year Kaplan-Meier stroke risk was 
      calculated. RESULTS: The frequency of presenting with infarction was 
      significantly higher among patients with PCi than among those without PCi (p = 
      0.006). mRS scores in the preoperative period were significantly higher in 
      patients with PCi than in patients without PCi (p = 0.0004). There were no 
      significant differences in mRS scores between the preoperative and postoperative 
      follow-up period in patients with PCi (p = 0.3), nor were there any between the 
      preoperative and postoperative follow-up periods in patients without PCi (p = 
      0.2). The five-year Kaplan-Meier risk of surgical morbidity and ipsilateral 
      stroke was 14.3 % in surgically treated hemispheres with PCi versus 14.9 % in 
      surgically treated hemispheres without PCi (p = 0.96). CONCLUSIONS: PCi at 
      initial onset was significantly correlated with poor outcome. Revascularization 
      for the middle cerebral artery territory in patients with PCi was effective at 
      preventing recurrent ischemic stroke.
FAU - Hishikawa, Tomohito
AU  - Hishikawa T
AD  - Department of Neurological Surgery, Dentistry and Pharmaceutical Sciences, 
      Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, 
      Okayama, 700-8558, Japan, t-hishi@md.okayama-u.ac.jp.
FAU - Tokunaga, Koji
AU  - Tokunaga K
FAU - Sugiu, Kenji
AU  - Sugiu K
FAU - Date, Isao
AU  - Date I
LA  - eng
PT  - Journal Article
DEP - 20140528
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
RN  - Moyamoya disease 1
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cerebral Angiography
MH  - Cerebral Revascularization
MH  - Diffusion Magnetic Resonance Imaging
MH  - Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infarction, Posterior Cerebral Artery/*diagnosis/mortality/*surgery
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Moyamoya Disease/*diagnosis/mortality/*surgery
MH  - Recurrence
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2014/05/29 06:00
MHDA- 2015/05/29 06:00
CRDT- 2014/05/29 06:00
PHST- 2014/02/14 00:00 [received]
PHST- 2014/05/16 00:00 [accepted]
PHST- 2014/05/29 06:00 [entrez]
PHST- 2014/05/29 06:00 [pubmed]
PHST- 2015/05/29 06:00 [medline]
AID - 10.1007/s00701-014-2136-3 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2014 Sep;156(9):1745-51. doi: 10.1007/s00701-014-2136-3. 
      Epub 2014 May 28.