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Neovascularization precedes occlusion in moyamoya disease: angiographic findings in 172 pediatric patients.
- Source :
-
European neurology [Eur Neurol] 2014; Vol. 72 (5-6), pp. 299-305. Date of Electronic Publication: 2014 Oct 14. - Publication Year :
- 2014
-
Abstract
- Background: Both basal collaterals (BC) and cortical microvascularization (CM) on angiography have been suggested as moyamoya disease (MMD)-specific findings; however, it is unknown whether the vascular network represents compensatory mechanisms for vascular occlusion or aberrant active neovascularization.<br />Methods: We investigated the grade of antegrade MCA flow, the degree of BC, and the presence of CM on conventional angiography in relation to disease severity in pediatric MMD. CM was defined as enlarged and winding distal cortical arteries and categorized into anterior or posterior CM depending on their sources. Findings from basal and acetazolamide stress brain perfusion SPECT studies were also evaluated.<br />Results: A total of 172 pediatric patients with MMD were enrolled in this study. As the severity of MMD increased, the grade of antegrade MCA flow gradually diminished. While the degree of BC peaked at Suzuki stage 3-4, CM was frequently observed at early MMD stages. About two-thirds of hemispheres with normal antegrade MCA flow on angiography and normal perfusion status on SPECT had anterior and/or posterior CM. Both anterior and posterior CM gradually decreased with the advancement of MMD.<br />Conclusion: Our findings from a large cohort of angiographically confirmed pediatric MMD patients indicate that neovascularization may occur before significant hemodynamic impairment in MMD.<br /> (© 2014 S. Karger AG, Basel.)
- Subjects :
- Acetazolamide
Brain diagnostic imaging
Brain pathology
Cardiovascular Agents
Cerebral Angiography
Cerebrovascular Circulation drug effects
Cerebrovascular Circulation physiology
Child
Child, Preschool
Disease Progression
Female
Humans
Male
Microvessels diagnostic imaging
Microvessels pathology
Microvessels physiopathology
Middle Cerebral Artery diagnostic imaging
Middle Cerebral Artery pathology
Middle Cerebral Artery physiopathology
Moyamoya Disease diagnostic imaging
Moyamoya Disease pathology
Retrospective Studies
Severity of Illness Index
Stress, Physiological
Tomography, Emission-Computed, Single-Photon
Brain blood supply
Brain physiopathology
Moyamoya Disease physiopathology
Neovascularization, Pathologic
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9913
- Volume :
- 72
- Issue :
- 5-6
- Database :
- MEDLINE
- Journal :
- European neurology
- Publication Type :
- Academic Journal
- Accession number :
- 25323466
- Full Text :
- https://doi.org/10.1159/000365286