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Changing ischaemic lesion patterns in adult moyamoya disease

Cited 27 time in Web of Science Cited 35 time in Scopus
Authors
Kim, J-M; Lee, S-H; Roh, J-K
Issue Date
2008-05-03
Publisher
BMJ Publishing Group
Citation
J Neurol Neurosurg Psychiatry 2009;80:36-40
Keywords
Brain Ischemia/*etiology/physiopathology/*radionuclide imagingCerebrovascular CirculationFemaleHumansMoyamoya Disease/*complications/physiopathology/*radionuclide imaging*Severity of Illness IndexStroke/etiology/physiopathology/radionuclide imaging*Tomography, Emission-Computed, Single-Photon
Abstract
OBJECTIVES: Ischaemic stroke is a frequent manifestation in patients with adult moyamoya disease (MMD), but the relationship between the lesion pattern and disease severity has rarely been investigated. METHODS: Data were collected on a consecutive series of 65 adult patients with MMD who visited our hospital between 1999 and 2006. Among them, 32 patients with first ever ischaemic stroke were included. The ischaemic lesions were categorised by location and compared as follows: (1) cortical versus subcortical involvement and (2) anterior (fronto-temporal) versus posterior (parieto-occipital) involvement. The lesions were also compared by disease severity, as determined by the extent of intracranial artery involvement (Suzuki's grading method) and by perfusion status visualised on single photon emission computed tomography (SPECT). RESULT: Disease severity was significantly greater in patients with cortical involvement than in those with subcortical involvement (Suzuki's grade 4.17 (0.72) vs 2.70 (0.73); p<0.001). Disease severity was also significantly greater in patients with posterior involvement than in those with anterior involvement (4.50 (0.53) vs 2.83 (0.76); p<0.001). In most of the patients (83.3%) the perfusion defect area shown on SPECT was larger than the ischaemic lesion area shown on MRI. CONCLUSIONS: Patients with advanced stage adult MMD tended to have ischaemic lesions involving the cortex and posterior part of the brain and the stroke mechanism in these patients was largely associated with haemodynamic compromise. Our results suggest that the lesion pattern of ischaemic stroke may change along with the extent of arterial involvement.
ISSN
1468-330X (Electronic)
Language
English
URI
http://hdl.handle.net/10371/62019
DOI
https://doi.org/10.1136/jnnp.2008.145078
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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