Moyamoya Disease Associated With Intracranial Aneurysm: Clinical Features, Risk Factors Of Hemorrhage And Treatment Outcomes

Objective To investigate the clinical features, risk factors for bleeding and treatment outcomes in moyamoya disease patients with intracranial aneurysms.Methods The clinical symptoms, location and size of aneurysm, treatment and the long-term follow-up results of the moyamoya disease patients with intracranial aneurysms were analyzed retrospectively.Results A total of 34 moyamoya disease patients with intracranial aneurysms(35 aneurysms) were enrolled, including 22(64.7%) in the intracranial hemorrhage group and 12(35.3%) in the non-intracranial hemorrhage group. Of the 35 intracranial aneurysms,23(main artery type 11, peripheral artery type 12) were in the intracranial hemorrhage group and 12(main artery type 11, peripheral artery type 1) were in the non-intracranial hemorrhage group. There were 29 small aneurysms and 6 medium aneurysms (all were patients with hemorrhagic moyamoya disease). The aneurysms were mainly peripheral arterial type in the intracranial hemorrhage group, and the aneurysms were mainly artery type in the non-intracranial hemorrhage group. There was significant difference in aneurysm typing between the two groups (P=0.013). Two patients did not perform encephalo-duro-arterio-synangiosis (EDAS) in the intracranial hemorrhage group, other patients and those of the non-intracranial hemorrhage group performed EDAS. Angiographical reexamination revealed that 3 patients with peripheral aneurysm disappeared, and 1 aneurysm recurred after aneurysm embolization, and the remaining aneurysms did not have any change. Long-term follow-up showed that 1 patient died of sudden cerebral hemorrhage at 1 year after procedure in the intracranial hemorrhage group, and the others did not have ischemic or hemorrhagic stroke. The modified Rankin scale scores were improved in 21 patients.Conclusion There are differences in moyamoya disease patients with intracranial aneurysm typing with different clinical manifestations. Moyamoya disease patients with intracranial aneurysms typing with different clinical manifestations. Moyamoya disease patients with intracranial aneurysms are mostly small aneurysms and they cannot temporarily be treated directly and can perform EDAS directly. Intracranial aneurysms after procedure may remain long-term stability, and some peripheral aneurysms may disappear.