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Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management?
- Source :
- Journal of Clinical Medicine, Vol 10, Iss 2287, p 2287 (2021), Journal of Clinical Medicine
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- Whereas several studies have been so far presented about the surgical outcomes in terms of mortality and perioperative complications for elderly patients submitted to neurosurgical treatments, the management of elderly moyamoya patients is unclear. This review aims to explore the available data about the clinical manifestation, characteristics, and outcome after surgery of older patients with moyamoya arteriopathy (MA). We found only two articles strictly concerning elderly patients with MA. We have also evaluated other reported adult series of moyamoya patients, including elderly cases in their analysis. Patients with MA above 50 years old may be considered a peculiar subset in which patients are often presenting with ischemic symptoms and a higher Suzuki grade. Conservative treatment may be proposed in asymptomatic or stable cases due to their fragility and possible increase of post-operative complications, while the best surgical options in symptomatic cases are still under investigation, although we believe that a minimal invasive superficial temporal artery—middle cerebral artery bypass could be considered the treatment of choice for the immediate effect on brain perfusion with a limited rate of post-operative complications.
- Subjects :
- Pediatrics
medicine.medical_specialty
medicine.medical_treatment
internal carotid artery
Perfusion scanning
Review
Revascularization
superficial temporal artery
elderly
Asymptomatic
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine.artery
medicine
Moyamoya disease
middle cerebral artery
cerebral angiopathy
business.industry
General Medicine
Perioperative
extracranial-intracranial bypass
medicine.disease
Superficial temporal artery
moyamoya
Middle cerebral artery
Medicine
revascularization
Internal carotid artery
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 20770383
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....973869ce8f847db8e1cfc13c85304373