دورية أكاديمية
Clinical Course, Therapy, and Long-Term Outcomes of Children With Moyamoya Disease and Posterior Cerebral Artery Involvement.
| العنوان: | Clinical Course, Therapy, and Long-Term Outcomes of Children With Moyamoya Disease and Posterior Cerebral Artery Involvement. |
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| المؤلفون: | Wang H; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Hao F; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Feng J; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Zhang Q; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Zhang Z; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Li B; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Zhang H; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Yu X; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Han C; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China., Duan L; From the Department of Neurosurgery (H.W., F.H., J.F., Q.Z., Z.Z., B.L., H.Z., X.Y., C.H., L.D.), Chinese PLA General Hospital; and Chinese PLA Medical School (F.H.), Beijing, China. |
| المصدر: | Neurology [Neurology] 2024 Aug 13; Vol. 103 (3), pp. e209658. Date of Electronic Publication: 2024 Jul 11. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0401060 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-632X (Electronic) Linking ISSN: 00283878 NLM ISO Abbreviation: Neurology Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Minneapolis. |
| مواضيع طبية MeSH: | Moyamoya Disease*/diagnostic imaging , Moyamoya Disease*/complications , Moyamoya Disease*/surgery , Moyamoya Disease*/therapy , Posterior Cerebral Artery*/diagnostic imaging, Humans ; Male ; Child ; Female ; Retrospective Studies ; Child, Preschool ; Adolescent ; Treatment Outcome ; Cerebral Revascularization/methods ; Follow-Up Studies ; Young Adult ; Infant ; Prognosis |
| مستخلص: | Background and Objectives: Posterior cerebral artery involvement (PCAi) has been identified as an important factor related to poor prognosis in moyamoya disease (MMD). This study summarized the characteristics of children with MMD and PCAi, clarified the clinical course, identified prognostic predictors, and investigated the long-term effect of encephaloduroarteriosynangiosis for posterior circulation (EDAS-p). Methods: We retrospectively reviewed all our pediatric MMD cases with follow-up angiograms from November 2003 to December 2016. PCAi was classified as early-onset at initial diagnosis and delayed-onset after anterior circulation revascularization. Multivariable data including clinical features, radiographic findings, and surgical outcomes were analyzed. Results: Among 570 children with MMD, 246 (43.2%) had PCAi, with 176 (30.9%) classified as early-onset PCAi. During a median follow-up period of 10 years, 17.8% (70/394) of patients without initial PCAi developed delayed-onset PCAi. The median time to detection of a new PCA lesion was 15.5 (range 7-110) months from initial diagnosis, with a median age of 10.5 (3-22). Younger age at onset, familial occurrence, advanced Suzuki stages, and preoperative infarctions were predictors of delayed-onset PCAi. EDAS-p was performed on 294 hemispheres of 195 patients with PCAi. Stroke-free survival was significantly higher in the EDAS-p group than in the non-EDAS-p group (99.0% vs 90.2%; p < 0.001 [Breslow test]; p = 0.001 [log-rank test]; median follow-up: 101 months). Discussion: PCAi is not uncommon in children with MMD, underscoring the need for long-term close clinical monitoring, especially in patients with high-risk factors for PCA progression. EDAS-p may be a safe and effective procedure for preventing subsequent stroke in children with MMD and PCAi. |
| تواريخ الأحداث: | Date Created: 20240711 Date Completed: 20240711 Latest Revision: 20240711 |
| رمز التحديث: | 20240712 |
| DOI: | 10.1212/WNL.0000000000209658 |
| PMID: | 38991203 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1526-632X |
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| DOI: | 10.1212/WNL.0000000000209658 |