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World Neurosurg ; 185: e397-e406, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38364899

RESUMO

BACKGROUND: Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by progressive stenosis of the supraclinoid internal carotid artery. As a result of chronically decreased brain perfusion, eloquent areas of the brain become hypoperfused, leading to cognitive changes in patients. Repeated infarcts and bleeds produce clinically apparent neurologic deficits. OBJECTIVES: 1) To study the functional and neuropsychological outcome in MMD after revascularization surgery. 2) To find postrevascularization correlation between functional and neuropsychological improvement and radiologic improvement. METHODS: A single-center prospective and analytic study was carried out including 21 patients with MMD during the study period from March 2021 to December 2022. Patients were evaluated and compared before and after revascularization for functional, neuropsychological, and radiologic status. RESULTS: Postoperative functional outcome in terms of modified Rankin Scale score showed improvement in 33.33% of cases (P = 0.0769). An overall improving trend was observed in different neuropsychological domains in both adult and pediatric age groups. However, the trend of neuropsychological improvement was better in adults compared with pediatric patients. Radiologic outcome in the form of the Angiographic Outcome Score (AOS) significantly improved after revascularization (P = 0.0001). There was a trend toward improvement in magnetic resonance imaging (MRI) perfusion in the middle cerebral artery and anterior cerebral artery territories, 4.7% (P = 0.075) and 9.33% (P = 0.058) respectively, compared with preoperative MRI perfusion. CONCLUSIONS: After revascularization, significant improvement occurred in functional and neuropsychological status. This result was also shown radiologically as evidenced by improvement in MRI perfusion and cerebral angiography.


Assuntos
Revascularização Cerebral , Doença de Moyamoya , Testes Neuropsicológicos , Doença de Moyamoya/cirurgia , Doença de Moyamoya/psicologia , Doença de Moyamoya/diagnóstico por imagem , Humanos , Feminino , Masculino , Adulto , Criança , Revascularização Cerebral/métodos , Adolescente , Resultado do Tratamento , Adulto Jovem , Estudos Prospectivos , Pessoa de Meia-Idade , Pré-Escolar , Imageamento por Ressonância Magnética
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