Recurrent Bleeding in Hemorrhagic Moyamoya Disease : Prognostic Implications of the Perfusion Status
Journal of Korean Neurosurgical Society
;
: 117-121, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-95388
ABSTRACT
OBJECTIVE:
Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD.METHODS:
This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors.RESULTS:
Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate 5.8+/-1.4%/year). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136).CONCLUSION:
Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Perfusão
/
Tomografia Computadorizada de Emissão de Fóton Único
/
Hemorragia Cerebral
/
Revascularização Cerebral
/
Estudos Retrospectivos
/
Seguimentos
/
Acidente Vascular Cerebral
/
Hemodinâmica
/
Hemorragia
/
Doença de Moyamoya
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Humanos
Idioma:
Inglês
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2016
Tipo de documento:
Artigo
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