Angiographic features and progression risk factors in children with asymptomatic moyamoya disease

ObjectiveThis study aims to explore the potential contribution of angiographic characteristics in the increased stroke risk among pediatric patients.MethodsThis study retrospectively enrolled pediatric patients with ischemic, hemorrhagic, and asymptomatic moyamoya disease. Their hemispheres were cat...

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Main Authors: Jiyuan Wang, Qian Zhang, Fei Di, Dong Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2024.1484132/full
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author Jiyuan Wang
Qian Zhang
Fei Di
Dong Zhang
Dong Zhang
Dong Zhang
author_facet Jiyuan Wang
Qian Zhang
Fei Di
Dong Zhang
Dong Zhang
Dong Zhang
author_sort Jiyuan Wang
collection DOAJ
description ObjectiveThis study aims to explore the potential contribution of angiographic characteristics in the increased stroke risk among pediatric patients.MethodsThis study retrospectively enrolled pediatric patients with ischemic, hemorrhagic, and asymptomatic moyamoya disease. Their hemispheres were categorized into five groups for the analysis of angiographic characteristics, which included Suzuki’s stage, moyamoya vessels, lenticulostriate artery, thalamotuberal artery, thalamoperforating artery, anterior choroidal arteries, posterior choroidal arteries, and posterior cerebral artery involvement.ResultsTwo hundred and nineteen pediatric patients with four hundred and thirty-eight hemispheres were enrolled. There was no significant difference in collateral dilatation between asymptomatic and hemorrhagic hemispheres. However, asymptomatic hemispheres had significantly lower incidence of posterior cerebral artery involvement and Suzuki’s stage compared to hemorrhagic (p = 0.008, p = 0.004) and ischemic hemispheres (p = 0.026, p < 0.001). Multivariate analysis revealed that Suzuki’s stage (p = 0.002, 95% CI 1.261–2.867) is a risk factor for ischemia, while age (p < 0.001, 95% CI 0.712–2.014) and posterior cerebral artery involvement (p = 0.037, 95% CI 0.087–13.377) are risk factors for hemorrhage.InterpretationAngiographic features in children with asymptomatic moyamoya disease resemble those observed in the hemorrhagic pediatric patients, indicating that greater attention should be focused on the risk of future hemorrhage in these patients, rather than on ischemia. Additionally, studies have demonstrated a correlation between posterior cerebral artery involvement and age with the incidence of hemorrhage. Monitoring angiographic characteristics may assist in tracking the transition from asymptomatic to symptomatic hemispheres.
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spelling doaj-art-382c9f9d0f0f4e60b7cb0c3b8c0c970d2024-11-15T06:13:27ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-11-011510.3389/fneur.2024.14841321484132Angiographic features and progression risk factors in children with asymptomatic moyamoya diseaseJiyuan Wang0Qian Zhang1Fei Di2Dong Zhang3Dong Zhang4Dong Zhang5Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Capital Institute of Pediatrics, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaObjectiveThis study aims to explore the potential contribution of angiographic characteristics in the increased stroke risk among pediatric patients.MethodsThis study retrospectively enrolled pediatric patients with ischemic, hemorrhagic, and asymptomatic moyamoya disease. Their hemispheres were categorized into five groups for the analysis of angiographic characteristics, which included Suzuki’s stage, moyamoya vessels, lenticulostriate artery, thalamotuberal artery, thalamoperforating artery, anterior choroidal arteries, posterior choroidal arteries, and posterior cerebral artery involvement.ResultsTwo hundred and nineteen pediatric patients with four hundred and thirty-eight hemispheres were enrolled. There was no significant difference in collateral dilatation between asymptomatic and hemorrhagic hemispheres. However, asymptomatic hemispheres had significantly lower incidence of posterior cerebral artery involvement and Suzuki’s stage compared to hemorrhagic (p = 0.008, p = 0.004) and ischemic hemispheres (p = 0.026, p < 0.001). Multivariate analysis revealed that Suzuki’s stage (p = 0.002, 95% CI 1.261–2.867) is a risk factor for ischemia, while age (p < 0.001, 95% CI 0.712–2.014) and posterior cerebral artery involvement (p = 0.037, 95% CI 0.087–13.377) are risk factors for hemorrhage.InterpretationAngiographic features in children with asymptomatic moyamoya disease resemble those observed in the hemorrhagic pediatric patients, indicating that greater attention should be focused on the risk of future hemorrhage in these patients, rather than on ischemia. Additionally, studies have demonstrated a correlation between posterior cerebral artery involvement and age with the incidence of hemorrhage. Monitoring angiographic characteristics may assist in tracking the transition from asymptomatic to symptomatic hemispheres.https://www.frontiersin.org/articles/10.3389/fneur.2024.1484132/fullmoyamoya diseaseangiographyhemorrhageischemiastroke
spellingShingle Jiyuan Wang
Qian Zhang
Fei Di
Dong Zhang
Dong Zhang
Dong Zhang
Angiographic features and progression risk factors in children with asymptomatic moyamoya disease
Frontiers in Neurology
moyamoya disease
angiography
hemorrhage
ischemia
stroke
title Angiographic features and progression risk factors in children with asymptomatic moyamoya disease
title_full Angiographic features and progression risk factors in children with asymptomatic moyamoya disease
title_fullStr Angiographic features and progression risk factors in children with asymptomatic moyamoya disease
title_full_unstemmed Angiographic features and progression risk factors in children with asymptomatic moyamoya disease
title_short Angiographic features and progression risk factors in children with asymptomatic moyamoya disease
title_sort angiographic features and progression risk factors in children with asymptomatic moyamoya disease
topic moyamoya disease
angiography
hemorrhage
ischemia
stroke
url https://www.frontiersin.org/articles/10.3389/fneur.2024.1484132/full
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