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Clinical Features and Outcomes of Intracranial Aneurysm Associated with Moyamoya Disease

Journal of Clinical Neurology 2020년 16권 4호 p.624 ~ 632
김성한, 장창기, 박은경, 심규원, 김동석, 정준호, 김용배, 이재환, 박건영,
소속 상세정보
김성한 ( Kim Sung-Han ) - Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Neurosurgery
장창기 ( Jang Chang-Ki ) - Yonsei University College of Medicine Yongin Severance Hospital Department of Neurosurgery
박은경 ( Park Eun-Kyung ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatric Neurosurgery
심규원 ( Shim Kyu-Won ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatric Neurosurgery
김동석 ( Kim Dong-Seok ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatric Neurosurgery
정준호 ( Chung Joon-Ho ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
김용배 ( Kim Yong-Bae ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
이재환 ( Lee Jae-Whan ) - Yonsei University College of Medicine Yongin Severance Hospital Department of Neurosurgery
박건영 ( Park Keun-Young ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery

Abstract


Background and Purpose: Moyamoya disease (MMD) is a rare form of intracranial stenoocclusive disease that can be associated with intracranial aneurysms. We evaluated the clinical features and outcomes of MMD-associated aneurysms while focusing on their locations.

Methods: Between January 1998 and December 2018 there were 1,302 adult and pediatric patients diagnosed as MMD at a single institution. These patients included 38 with 44 MMD-associated aneurysms. The MMD-associated aneurysms were classified into two groups based on their locations: major-artery aneurysms and non-major-artery aneurysms. The clinical and radiological data for patients with MMD-associated aneurysms were reviewed retrospectively.

Results: The 44 MMD-associated aneurysms comprised 28 in major arteries and 16 in nonmajor arteries. All of the major-artery aneurysms were initially unruptured lesions, and follow-up angiography showed that 23 (82.1%) had an improved or stable status and 5 (17.9%) had a worse status. The non-major-artery aneurysms comprised 10 ruptured and 6 unruptured lesions, and follow-up angiography showed that 11 (68.8%) had improved or were stable and 5 (31.2%) had worsened. At the latest follow-up, there were four cases of unfavorable outcome: two initial hemorrhagic insults, one treatment-related morbidity, and one repeated-hemorrhage case.

Conclusions: MMD-associated aneurysms occurred in 3.3% of the MMD cohort in this study, of which 63.6% were major-artery aneurysms and 36.4% were non-major-artery aneurysms. The major-artery group included 17.9% that became angiographically worse, while 31.2% were growing or hemorrhaging in the non-major-artery group.

키워드

moyamoya disease; aneurysm; pseudoaneurysm; outcome

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