PMID- 26962416
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160310
LR  - 20220408
IS  - 2005-3711 (Print)
IS  - 1598-7876 (Electronic)
IS  - 1225-8245 (Linking)
VI  - 59
IP  - 2
DP  - 2016 Mar
TI  - Recurrent Bleeding in Hemorrhagic Moyamoya Disease : Prognostic Implications of 
      the Perfusion Status.
PG  - 117-21
LID - 10.3340/jkns.2016.59.2.117 [doi]
AB  - OBJECTIVE: Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical 
      course. Furthermore, poorer clinical outcomes occur in cases of recurrent 
      bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has 
      not been investigated yet. This study evaluated the prognostic implications of 
      the perfusion status during the clinical course of adult hMMD. METHODS: This 
      retrospective study enrolled 52 adult hMMD patients between April 1995 and 
      October 2010 from a single institute. Demographic data, clinical and radiologic 
      characteristics, including hemodynamic status using single photon emission 
      computed tomography (SPECT), and follow up data were obtained via a retrospective 
      review of medical charts and imaging. Statistical analyses were performed to 
      explore potential prognostic factors. RESULTS: Hemodynamic abnormality was 
      identified in 44 (84.6%) patients. Subsequent revascularization surgery was 
      performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) 
      follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, 
      ischemic n=5, Actuarial stroke rate 5.8+/-1.4%/year). Recurrent hemorrhage was 
      associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and 
      omission of revascularization (10.218; 95%; CI=1.532-68.136). CONCLUSION: 
      Decreased basal perfusion seems to be associated with recurrent bleeding. 
      Revascularization might prevent recurrent stroke in hMMD by rectifying the 
      perfusion abnormality. A larger-sized, controlled study is required to address 
      this issue.
FAU - Jo, Kyung-Il
AU  - Jo KI
AD  - Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Korea.
FAU - Kim, Min Soo
AU  - Kim MS
AD  - Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Korea.
FAU - Yeon, Je Young
AU  - Yeon JY
AD  - Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Korea.
FAU - Kim, Jong-Soo
AU  - Kim JS
AD  - Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Korea.
FAU - Hong, Seung-Chyul
AU  - Hong SC
AD  - Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
DEP - 20160229
PL  - Korea (South)
TA  - J Korean Neurosurg Soc
JT  - Journal of Korean Neurosurgical Society
JID - 101467054
PMC - PMC4783476
OTO - NOTNLM
OT  - Cerebral hemorrhages
OT  - Cerebral revascularization
OT  - Hemodynamics
OT  - Moyamoya disease
EDAT- 2016/03/11 06:00
MHDA- 2016/03/11 06:01
PMCR- 2016/03/01
CRDT- 2016/03/11 06:00
PHST- 2015/06/12 00:00 [received]
PHST- 2015/10/08 00:00 [revised]
PHST- 2015/10/19 00:00 [accepted]
PHST- 2016/03/11 06:00 [entrez]
PHST- 2016/03/11 06:00 [pubmed]
PHST- 2016/03/11 06:01 [medline]
PHST- 2016/03/01 00:00 [pmc-release]
AID - 10.3340/jkns.2016.59.2.117 [doi]
PST - ppublish
SO  - J Korean Neurosurg Soc. 2016 Mar;59(2):117-21. doi: 10.3340/jkns.2016.59.2.117. 
      Epub 2016 Feb 29.