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Abstract Background Moyamoya disease (MMD) is a cerebrovascular disorder characterized by progressive unilateral or bilateral stenosis of the distal internal carotid artery. As hemodynamic features in MMD patients alter, the comorbidity of intracranial aneurysm (IA) is sometimes observed clinically. We aim to investigate clinical characteristics and therapeutic strategies for the comorbidity of Moyamoya disease with intracranial aneurysms (MMD-IA). Methods A total of 13 MMD-IA patients were recruited in this study and were manifested to be intracranial hemorrhage. We reviewed the surgical technique notes for all patients. Results According to the locations of an aneurysm, MMD-IA could be divided into several categories: (1) MMD-IA at a circle of Willis—aneurysms usually located at the trunk of Willis circle; (2) MMD-IA at collateral anastomosis—aneurysms located at the distal end of collateral anastomosis; and (3) MMA-IA at basal ganglia region. In this report, aneurysms in 10 patients located at Willis circle, 2 at the pericallosal artery, and 1 at the basal ganglia region. Among them, endovascular embolism was performed among 5 patients. Aneurysm clipping was conducted among 7 patients. A patient with an aneurysm at the basal ganglia region just accepted revascularization treatment. All the treatments were successful. Follow-up studies, ranging from 6 to 24 months, demonstrated all patients received satisfactory curative effects. Conclusion Diverse clinical presentations could be observed among MMD-IA patients. Individualized neurosurgical treatments should be chosen according to the locations of the aneurysm.

Background: Moyamoya disease (MMD) is a cerebrovascular disorder characterized by progressive unilateral or bilateral stenosis of the distal internal carotid artery. As hemodynamic features in MMD patients alter, the comorbidity of intracranial aneurysm (IA) is sometimes observed clinically. We aim to investigate clinical characteristics and therapeutic strategies for the comorbidity of Moyamoya disease with intracranial aneurysms (MMD-IA). Methods: A total of 13 MMD-IA patients were recruited in this study and were manifested to be intracranial hemorrhage. We reviewed the surgical technique notes for all patients. Results: According to the locations of an aneurysm, MMD-IA could be divided into several categories: (1) MMD-IA at a circle of Willis—aneurysms usually located at the trunk of Willis circle; (2) MMD-IA at collateral anastomosis—aneurysms located at the distal end of collateral anastomosis; and (3) MMA-IA at basal ganglia region. In this report, aneurysms in 10 patients located at Willis circle, 2 at the pericallosal artery, and 1 at the basal ganglia region. Among them, endovascular embolism was performed among 5 patients. Aneurysm clipping was conducted among 7 patients. A patient with an aneurysm at the basal ganglia region just accepted revascularization treatment. All the treatments were successful. Follow-up studies, ranging from 6 to 24 months, demonstrated all patients received satisfactory curative effects. Conclusion: Diverse clinical presentations could be observed among MMD-IA patients. Individualized neurosurgical treatments should be chosen according to the locations of the aneurysm. [ABSTRACT FROM AUTHOR]

Objective To explore the safety and efficacy of braided stent embolization with spring coil for middle cerebral artery wide-neck aneurysm. Methods The clinical data of 51 patients with middle cerebral artery wide-neck aneurysm treated with braided stent-assisted embolization in Nanjing First Hospital Affiliated to Nanjing Medical University from July 2016 to July 2020 were retrospectively analyzed. Results Immediate postoperative DSA showed that there were 38 cases of Raymond grade 1 dense embolism, 10 cases of Grade 2 loose embolism, and 3 cases of grade 3 partial embolism. The complications were all ruptured middle cerebral aneurysm in 6 patients. Among them, 1 case was postoperative rebleeding, 1 case was postoperative brain swelling, and 1 case was intraoperative bleeding.3 cases were ischemic related complications, including 1 case of thrombosis. With postoperative mRS score, 50patients had a good prognosis ( mRS score ≤3) . 50 patients were followed up from 6 months to 12 months after operation for annual DSA review, no recurrence. Conclusion Braided stent coils are safe and effective in the treatment of wide neck middle cerebral artery aneurysms, but the incidence of perioperative complications of ruptured aneurysms should not be ignored. [ABSTRACT FROM AUTHOR]