Is “unilateral” moyamoya disease different from moyamoya disease?

1996 ◽  
Vol 85 (5) ◽  
pp. 772-776 ◽  
Author(s):  
Kiyohiro Houkin ◽  
Hiroshi Abe ◽  
Tetsuyuki Yoshimoto ◽  
Akihiro Takahashi
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Moyamoya Disease ◽  
Familial Occurrence ◽  
Conventional Angiography ◽  
Content Type ◽  
Angiographic Evidence ◽  
Unilateral Moyamoya Disease ◽  
Revascularization Surgery

✓ Whether a diagnosis of moyamoya disease is justified in patients with typical angiographic evidence of moyamoya disease unilaterally and normal angiographic findings contralaterally remains controversial. In this study the authors analyzed longitudinal angiographic change, familial occurrence, and basic fibroblast growth factor (bFGF) concentration in the cerebrospinal fluid (CSF) of patients with “unilateral” moyamoya disease. Over a 10-year period, 10 cases of unilateral moyamoya disease were followed using conventional angiography or magnetic resonance angiography. Basic FGF in CSF, obtained from the subarachnoid space of the cerebral cortex during revascularization surgery, was measured in five cases. Among the 10 cases of unilateral moyamoya disease, only one pediatric case showed obvious signs of progression to typical bilateral disease. The other nine cases (including six adults and three children) remained stable throughout follow-up radiological examinations (magnetic resonance angiography) with a mean observation period of 3.5 years. There was no familial occurrence in these cases of unilateral moyamoya disease. Levels of bFGF, which are high in typical moyamoya disease, were low in these patients. The progression from unilateral moyamoya disease to the typical bilateral form of the disease appears to be infrequent. The low levels of bFGF in the CSF of these patients and the lack of familial occurrence strongly suggest that most cases of unilateral moyamoya disease, especially those found in adults, are distinct from typical bilateral moyamoya disease.

scholarly journals Assessment of Moyamoya Disease With 3.0-T Magnetic Resonance Angiography and Magnetic Resonance Imaging Versus Conventional Angiography

2011 ◽  
Vol 51 (3) ◽  
pp. 195-200 ◽  
Author(s):  
Qianna JIN ◽  
Tomoyuki NOGUCHI ◽  
Hiroyuki IRIE ◽  
Masatou KAWASHIMA ◽  
Masashi NISHIHARA ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Moyamoya Disease ◽  
Resonance Imaging ◽  
Conventional Angiography ◽  
3.0 T

Follow-up evaluation of dissecting aneurysms of the vertebrobasilar circulation by using gadolinium-enhanced magnetic resonance imaging

1997 ◽  
Vol 87 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Shinji Nagahiro ◽  
Jun-ichiro Hamada ◽  
Yuji Sakamoto ◽  
Yukitaka Ushio
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Contrast Material ◽  
Intramural Hematoma ◽  
Mr Studies ◽  
Conventional Angiography ◽  
Content Type ◽  
Vertebrobasilar Circulation ◽  
Dissecting Aneurysms

✓ The authors assessed the reliability of magnetic resonance (MR) imaging contrast enhancement for the detection and follow-up evaluation of dissecting aneurysms of the vertebrobasilar circulation. Twenty consecutively admitted patients who underwent both gadolinium-enhanced MR imaging and conventional angiography were reviewed. Enhancement of the dissecting aneurysm was seen in all but one of the 20 patients, including 10 (71%) of 14 patients examined in the chronic phases, when the T1-hyperintensity signal that corresponded to the intramural hematoma was unrecognizable. The enhanced area corresponded to the “pearl sign” or aneurysm dilation noted on the comparable angiogram. On follow-up MR studies enhancement had spontaneously disappeared in four patients at a time when comparable vertebral angiograms revealed disappearance of the aneurysm dilation. The enhancement persisted in five of nine patients examined more than 24 weeks after symptom onset; in all five patients the aneurysm dilation remained on comparable angiograms. Dynamic MR studies showed rapid and remarkable enhancements with their peaks during the immediate dynamic phase after injection of the contrast material. The authors conclude that gadolinium-enhanced MR imaging is useful for the detection and follow-up evaluation of dissecting aneurysms of the vertebrobasilar circulation.

ADDITIONAL SURGERY FOR POSTOPERATIVE ISCHEMIC SYMPTOMS IN PATIENTS WITH MOYAMOYA DISEASE

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. E195-E196 ◽  
Author(s):  
Toshiaki Hayashi ◽  
Reizo Shirane ◽  
Teiji Tominaga
Keyword(s):  
Magnetic Resonance ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Transient Ischemic Attack ◽  
Anterior Cerebral Artery ◽  
Additional Surgery ◽  
Indirect Revascularization ◽  
Ischemic Attack ◽  
Revascularization Surgery

Abstract OBJECTIVE In patients with moyamoya disease, surgery to revascularize the ischemic brain is a recommended treatment. However, there are a few patients who require additional revascularization surgery because of progression of the disease. Even patients who show no postoperative ischemic symptoms at first may experience late deterioration. We performed additional surgery for such lesions using occipital artery (OA)–posterior cerebral artery (PCA) bypass with indirect revascularization. The efficacy of the procedure is reported. METHODS We treated 3 patients with moyamoya disease who showed a transient ischemic attack after revascularization surgery. Three female patients, ranging in age from 6.0 to 35.2 years (mean age, 23.8 years) at the time of surgery, with ischemic symptoms (leg monoparesis in 2, visual impairment in 1) underwent the additional revascularization procedure. Preoperatively, all patients underwent indirect and/or direct revascularization surgery for initial treatment. All patients showed progression of the disease, especially in the PCA. OA–PCA bypass with encephalogaleodurosynangiosis and burr hole surgery were performed for postoperative ischemic symptoms. RESULTS All patients showed clinical and radiological improvement. The transient ischemic attack was improved in all 3 patients. They did not complain of transient ischemic attack in the recent follow-up period. Follow-up magnetic resonance imaging showed no additional cerebral infarction. Magnetic resonance angiography showed widening of the OA and development of peripheral collateral vessels. Postoperative single-photon emission computed tomographic studies showed marked increase of uptake in both anterior cerebral artery and PCA territories. Cerebral vasodilatory capacity evaluated by an acetazolamide test also showed marked improvement. One patient showed postoperative cerebral edema as a result of focal cerebral hyperperfusion. CONCLUSION OA–PCA anastomosis with indirect revascularization was effective for postoperative ischemia that showed symptoms in the anterior cerebral artery and PCA territories as a result of progression of a PCA lesion.

Moyamoya Disease in Three Siblings - Follow-Up Study with Magnetic Resonance Angiography (MRA)

1995 ◽  
Vol 26 (01) ◽  
pp. 33-36 ◽  
Author(s):  
M. Kikuchi ◽  
H. Hayakawa ◽  
I. Takahashi ◽  
K. Nagao ◽  
H. Hoshino ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Moyamoya Disease ◽  
Follow Up Study

Comparative performance of magnetic resonance angiography and conventional angiography in moyamoya disease

2000 ◽  
Vol 7 (2) ◽  
pp. 112-115 ◽  
Author(s):  
Naokatsu Saeki ◽  
Marcelo Nery Silva ◽  
Motoo Kubota ◽  
Jun-ichi Takanashi ◽  
Katsuo Sugita ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Moyamoya Disease ◽  
Conventional Angiography ◽  
Comparative Performance

Magnetic resonance angiography: a three-dimensional database for assessing arteriovenous malformations

1993 ◽  
Vol 79 (2) ◽  
pp. 289-293 ◽  
Author(s):  
Minesh P. Mehta ◽  
Daniel Petereit ◽  
Patrick Turski ◽  
Mark Gehring ◽  
Allan Levin ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Arteriovenous Malformations ◽  
Vascular System ◽  
Pulse Sequences ◽  
Three Dimensional ◽  
Normal Brain ◽  
Conventional Angiography ◽  
Content Type ◽  
New Family

✓ Stereotactic angiography has long been the “gold standard” in the diagnosis of patients with arteriovenous malformations (AVM's). Although orthogonal or stereoshift images may suffice in discerning the shape and location of spherical malformations, an exact analysis and assessment of most nonspherical malformations are hampered by the fact that stereotactic angiographic images compress three-dimensional (3-D) data into two-dimensional views. As a consequence, the complex 3-D shape of an AVM can never be fully and truly discerned from conventional angiography. With the recent explosion of radiosurgical techniques, more and more AVM's are being treated noninvasively. These radiosurgical techniques require 3-D visualization to maximize nidus coverage and minimize normal brain irradiation. Alternatives to stereotactic angiography are therefore desperately needed. An entire new family of pulse sequences is now available that permits visualization of the vascular system using magnetic resonance imaging. A brief technical review of magnetic resonance angiography is presented, and its potential role(s) in the assessment and radiosurgical treatment of AVM's is explored.

Durability of Aneurysm Embolization with Matrix Detachable Coils

Neurosurgery ◽  
2006 ◽  
Vol 58 (1) ◽  
pp. 51-59 ◽  
Author(s):  
David Fiorella ◽  
Felipe C. Albuquerque ◽  
Cameron G. McDougall
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Polylactic Acid ◽  
Boston Scientific ◽  
Conventional Angiography ◽  
Detachable Coils ◽  
Operative Notes ◽  
Small Aneurysms ◽  
Platinum Coils

Abstract OBJECTIVE: Matrix detachable coils (MDC; Boston Scientific/Target, Fremont, CA) are platinum coils coated with a bioabsorbable polymeric material (polyglycolic-polylactic acid). In animal models, the introduction of polyglycolic-polylactic acid-coated coils into experimental aneurysms resulted in a cellular reaction which promoted stable intra-aneurysmal scar tissue formation. The current study was undertaken to assess the durability of aneurysm occlusion after embolization with MDC. METHODS: All patients undergoing embolization were prospectively enrolled in an endovascular database at our institution. All coils used for embolization were recorded in the operative notes for the procedure. Only aneurysms embolized with 50% or greater length of MDC were included. All patients with Neuroform stents (Boston Scientific/Target, Fremont, CA) were excluded from the study. Patients were followed with conventional angiography and magnetic resonance angiography. RESULTS: During a 20-month period, 131 aneurysms were embolized with MDC. Follow up data (average, 6.9 mo; range, 1.5–22 mo) were available for 82 aneurysms (61 with conventional angiography, 21 with magnetic resonance angiography only). Of the aneurysm patients with follow-up available, 65 had small aneurysms with small necks, three were small aneurysms with wide necks, 12 were large aneurysms, and two were giant aneurysms. Overall, there were 30 (36.6%) recanalizations, 19 (23.1%) of which required retreatment. In two additional patients, retreatment was either recommended (n = 1) or attempted unsuccessfully (n = 1). Fifty–two aneurysms were unchanged or demonstrated progressive thrombosis (63.4%). The recanalization rate for small aneurysms with small necks was 26.1% (17 out of 65) with a 13.8% retreatment rate (9/65). The recanalization rate for large aneurysms was 75% (9 out of 12) with seven requiring retreatment. CONCLUSION: In the absence of Neuroform stent support, aneurysms embolized with the MDC system demonstrated a significant rate of recanalization. Many of the recanalizations were of sufficient size to warrant retreatment. The rates of recanalization observed in the present series were comparable to, or worse than, those reported for bare platinum coils.

Hemodynamic Changes after Unilateral Revascularization for Moyamoya Disease: Serial Assessment by Quantitative Magnetic Resonance Angiography

Neurosurgery ◽  
2017 ◽  
Vol 81 (1) ◽  
pp. 111-119 ◽  
Author(s):  
Tackeun Kim ◽  
Jae Seung Bang ◽  
O-Ki Kwon ◽  
Gyojun Hwang ◽  
Jeong Eun Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Moyamoya Disease ◽  
Posterior Circulation ◽  
Bypass Flow ◽  
Quantitative Magnetic Resonance ◽  
Median Proportion ◽  
Hemodynamic Improvement

Abstract BACKGROUND: Ultrasonic flow meters and quantitative magnetic resonance angiography quantitatively assess flow during hemodynamic evaluation of cerebral ischemia. Although their reliability and reproducibility have been verified, their clinical impact in moyamoya disease has rarely been reported. OBJECTIVE: To investigate flow measurement outcomes in moyamoya disease patients pre- and postoperatively through a retrospective observational study. METHODS: We evaluated 41 patients undergoing their first revascularization surgery who were followed ≥6 mo. Hemodynamic parameters were recorded preoperatively, at 1 and 6 mo postoperatively, and at the last follow-up. Demographic factors, Suzuki stage, and stroke development were also analyzed. RESULTS: Patients’ median age was 37 yr (interquartile range [IQR], 27-43), and 16 (39.0%) patients were men. During follow-up, 9 (22.0%) patients experienced postoperative stroke (4 major strokes). Hemodynamic status was improved in 34 (82.9%) patients at the 6-mo follow-up. Median intraoperative flow was 41 mL/min (IQR, 25-59). Bypass flow peaked at 6 mo (median, 67 mL/min; IQR, 35-99). At the 1- and 6-mo follow-ups, ipsilateral hemispheric flow was significantly increased. The median proportion of posterior circulation at 6 mo was 44.4%, significantly lower than the preoperative proportion (50.1%). Abundant intraoperative bypass flow was associated with hemodynamic improvement, while low contralateral hemispheric flow was related with immediate postoperative ischemic stroke. CONCLUSION: Ipsilateral hemispheric flow was increased during 6-mo follow-up, and posterior circulation flow burden was diminished. Abundant intraoperative bypass flow was associated with postoperative hemodynamic improvement. Low preoperative contralateral hemispheric flow was related with immediate postoperative ischemic stroke.

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