PMID- 35901742
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230313
IS  - 1933-0693 (Electronic)
IS  - 0022-3085 (Linking)
VI  - 138
IP  - 3
DP  - 2023 Mar 1
TI  - Prediction of hemorrhagic cerebral hyperperfusion syndrome after direct bypass 
      surgery in adult nonhemorrhagic moyamoya disease: combining quantitative 
      parameters on RAPID perfusion CT with clinically related factors.
PG  - 683-692
LID - 10.3171/2022.5.JNS212838 [doi]
AB  - OBJECTIVE: The aim of this study was to identify predictive factors for 
      hemorrhagic cerebral hyperperfusion syndrome (hCHS) after direct bypass surgery 
      in adult nonhemorrhagic moyamoya disease (non-hMMD) using quantitative parameters 
      on rapid processing of perfusion and diffusion (RAPID) perfusion CT software. 
      METHODS: A total of 277 hemispheres in 223 patients with non-hMMD who underwent 
      combined bypass were retrospectively reviewed. Preoperative volumes of time to 
      maximum (Tmax) > 4 seconds and > 6 seconds were obtained from RAPID analysis of 
      perfusion CT. These quantitative parameters, along with other clinical and 
      angiographic factors, were statistically analyzed to determine the significant 
      predictors for hCHS after bypass surgery. RESULTS: Intra- or postoperative hCHS 
      occurred in 13 hemispheres (4.7%). In 7 hemispheres, subarachnoid hemorrhage 
      occurred intraoperatively, and in 6 hemispheres, intracerebral hemorrhage was 
      detected postoperatively. All hCHS occurred within the 4 days after bypass. 
      Advanced age (OR 1.096, 95% CI 1.039-1.163, p = 0.001) and a large volume of Tmax 
      > 6 seconds (OR 1.011, 95% CI 1.004-1.018, p = 0.002) were statistically 
      significant factors in predicting the risk of hCHS after surgery. The cutoff 
      values of patient age and volume of Tmax > 6 seconds were 43.5 years old (area 
      under the curve [AUC] 0.761) and 80.5 ml (AUC 0.762), respectively. CONCLUSIONS: 
      In adult patients with non-hMMD older than 43.5 years or with a large volume of 
      Tmax > 6 seconds over 80.5 ml, more prudence is required in the decision to 
      undergo bypass surgery and in postoperative management.
FAU - Pang, Chang Hwan
AU  - Pang CH
AD  - Departments of1Neurosurgery and.
FAU - Lee, Si Un
AU  - Lee SU
AD  - Departments of1Neurosurgery and.
FAU - Lee, Yongjae
AU  - Lee Y
AD  - Departments of1Neurosurgery and.
FAU - Kim, Woong-Beom
AU  - Kim WB
AD  - Departments of1Neurosurgery and.
FAU - Kwon, Min-Yong
AU  - Kwon MY
AD  - Departments of1Neurosurgery and.
FAU - Sunwoo, Leonard
AU  - Sunwoo L
AD  - 2Radiology, Seoul National University Bundang Hospital, Seoul National University 
      College of Medicine, Seongnam-si, Korea.
FAU - Kim, Tackeun
AU  - Kim T
AD  - Departments of1Neurosurgery and.
FAU - Bang, Jae Seung
AU  - Bang JS
AD  - Departments of1Neurosurgery and.
FAU - Kwon, O-Ki
AU  - Kwon OK
AD  - Departments of1Neurosurgery and.
FAU - Oh, Chang Wan
AU  - Oh CW
AD  - Departments of1Neurosurgery and.
LA  - eng
PT  - Journal Article
DEP - 20220701
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
RN  - Moyamoya disease 1
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Moyamoya Disease/surgery
MH  - Retrospective Studies
MH  - Postoperative Complications
MH  - *Cerebral Revascularization
MH  - Tomography, X-Ray Computed
MH  - Syndrome
MH  - Cerebral Angiography
MH  - Cerebrovascular Circulation
OTO - NOTNLM
OT  - bypass
OT  - hyperperfusion syndrome
OT  - intracerebral hemorrhage
OT  - moyamoya disease
OT  - vascular disorders
EDAT- 2022/07/29 06:00
MHDA- 2023/03/04 06:00
CRDT- 2022/07/28 18:25
PHST- 2021/12/13 00:00 [received]
PHST- 2022/05/04 00:00 [accepted]
PHST- 2022/07/29 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2022/07/28 18:25 [entrez]
AID - 10.3171/2022.5.JNS212838 [doi]
PST - epublish
SO  - J Neurosurg. 2022 Jul 1;138(3):683-692. doi: 10.3171/2022.5.JNS212838. Print 2023 
      Mar 1.