Clinical and imaging characteristic analysis of hemorrhagic moyamoya disease with posterior circulation involvement / 中国脑血管病杂志

ABSTRACT

Objective To investigate the clinical and angiographic features in hemorrhagic moyamoya disease patients with the posterior circulation involvement (PCI). Methods The clinical and imaging data of 224 patients with hemorrhagic moyamoya disease from December 2002 to December 2011 were analyzed retrospectively. The patients were divided into either a PCI group (n=57)or a non-PCI group (n=167) according to whether they had PCI or not. Results (1)Suzuki staging concentrated in stageⅤandⅥin the PCI group,accounting for 42. 1%(24/57)and 40. 4%(23/57)respectively;Suzuki staging concentrated in stage Ⅲ and Ⅳ in the non-PCI group,accounting for 31. 1%(52/167)and 41. 9%(70/167)respectively. There was significant difference in the distribution of Suzuki staging between the patients of both groups (P <0. 01). (2)In the PCI group,the thalamic hemorrhage,intraventricular hemorrhage,ganglia hemorrhage,subarachnoid hemorrhage accounted for 43. 9%(26/57),38. 6%(22/57), 3. 5%(2/57),14. 0%(8/57),respectively;There was no cerebral lobe hemorrhage. In the non-PCI group, the thalamic hemorrhage,intraventricular hemorrhage,basal ganglia hemorrhage,subarachnoid hemorrhage and cerebral lobe hemorrhage accounted for 0,37. 7%(63/167),25. 1%(42/167),15. 6%(26/167),21.6 (36/167),respectively. The proportion of hemorrhage types between the PCI group and non-PCI group was significantly different(P<0. 01). (3)The dilation of anterior,posterior choroidal artery ,and patency of posterior communicating artery,posterior pericallosal artery in bleeding side accounting for 19. 3%(11/57),82. 5%(47/57),36. 8%(21/57),78. 9%(45/57)in PCI group and 36. 5%(61/167),3. 0%(5/167),68. 9%(115/167),80. 2%(134/167)in non-PCI group. The ratio of of abnormal vessels between PCI group and non-PCI group had significantly statistical difference (P<0. 01). Conclusion Hemorrhagic moyamoya with PCI is common. Suzuki staging is usually in the advanced stage of vascular staging of moyamoya disease. The thalamic hemorrhage is the main type of bleeding. Posterior choroidal artery rupture may be the main reason of hemorrhage.