Clinical Study On Moyamoya Disease(Analysis Of 16 Cases)

Objective To analyze the clinical features, diagnosis by transcranial Doppler (TCD),magnetic resonance imaging(MRI), magnetic resonance angiography(MRA) and digital subtraction angiography (DSA) and theraphy of moyamoya disease (MMD).Methods Totally 16 MMD patients diagnosed by Shandong University Qilu Hospital from 2006 to 2007 were enrolled in this study,we reviewed their initial clinical manifestions and results of the imaging examinations.Results This study was completely composed of adult patients and the age peak was around 40 years old. Among 16 MMD patients, cerebral ischemia occurred in 15 (93.7%) patients and was shown as the commonest initial clinical manifestation. The frequency of cerebral ischemia were 100% (3/3 patients) in the age group of less than 25 years old and 92.3% (12/13 patients) in more than 25 years old group. The remaining 1 (6.25%) patients had symptoms other than cerebral ischemia or hemorrhagic stroke. In this study, none of the patients had cerebral hemorrhage. Among 12 (75%) patients were screened by using TCD at first and diagnosed by using MRA or DSA finally. Among the results of the MRI and MRA of 14 patients', the number of the infarction or hemorrhagic infarction was 12 (85.7%); the number of the bilateral stenosis of the distal internal carotid arteries (ICA) and proximum of their first branches accompanied with the prominent collateralization was 13(92.9%). Only one patient's endocarnial vessels were not found stenosis(7.1%). All of the patients were examined by DSA, the bilateral stenosis or occlusion of blood vessels in the circle of Willis was seen in 16 patients (100%), moyamoya vessels were seen in 13 patients (81.2%), the prominent collateralization was seen in 15 patients.Conclusion Ischemic stroke is the major clinical manifestation in adult MMD patients. Our study suggested that TCD should be very helpful to identify a wilder spectrum of MMD with mild or atypical symptoms. So there was a great possible of suffering MMD when occuring cerebral vascular disease recurrent cerebral infarction or venticular hemorrhage in young and adult people, they had better take the examination of MRA or DSA as soon as possible.