Longitudinal anterior-to-posterior shift of collateral channels in patients with moyamoya disease: an implication for its hemorrhagic onset
- 1 March 2019
- journal article
- research article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 130 (3), 884-890
- https://doi.org/10.3171/2017.9.jns172231
Abstract
This study aimed to assess longitudinal changes in the collateral channels originating from the lenticulostriate artery (LSA), posterior communicating artery (PCoA), and anterior and posterior choroidal arteries (AChA and PChA, respectively) during disease progression and/or aging. The impact of collateral channels on onset type was also examined. This study included 71 involved hemispheres in 41 patients with moyamoya disease. The disease was categorized into 6 stages according to Suzuki’s angiographic staging system. The degree of development of each moyamoya vessel was categorized into 3 grades. The LSA started to dilate in stage 2, showed the most prominent development in stage 3, and decreased in more advanced stages (p < 0.001). The AChA most notably developed in stage 3 and gradually shrank (p = 0.04). The PCoA started to dilate in stage 3 and showed the most prominent development in stage 4 (p = 0.03). The PChA started to dilate in stage 3 and showed the most prominent development in stages 4 to 5 (p < 0.001). Patient age was negatively related to LSA development (p = 0.01, R = 0.30) and was positively associated with the abnormal dilation and extension of the PCoA (p = 0.02, R = 0.28) and PChA (p < 0.001, R = 0.45). The PCoA, AChA, and PChA more distinctly developed in hemispheres with intracerebral or intraventricular hemorrhage than in hemispheres with ischemic stroke or transient ischemic attack (p < 0.001, p = 0.03, and p = 0.03, respectively). This study suggests that the collateral channels through moyamoya vessels longitudinally shift from the anterior to posterior component during disease progression and aging, which may be closely related to the onset of hemorrhagic stroke in adult moyamoya disease.Keywords
This publication has 11 references indexed in Scilit:
- Periventricular anastomosis in moyamoya disease: detecting fragile collateral vessels with MR angiographyJournal of Neurosurgery, 2016
- Significance of the Hemorrhagic Site for Recurrent BleedingStroke, 2016
- Visualization of Periventricular Collaterals in Moyamoya Disease with Flow-sensitive Black-blood Magnetic Resonance Angiography: Preliminary ExperienceNeurologia medico-chirurgica, 2015
- Guidelines for Diagnosis and Treatment of Moyamoya Disease (Spontaneous Occlusion of the Circle of Willis)Neurologia medico-chirurgica, 2012
- Evaluation of angiographic changes of the anterior choroidal and posterior communicating arteries for predicting cerebrovascular lesions in adult moyamoya diseaseJournal of Clinical Neuroscience, 2011
- Moyamoya disease: current concepts and future perspectivesThe Lancet Neurology, 2008
- Angiographic Dilatation and Branch Extension of the Anterior Choroidal and Posterior Communicating Arteries Are Predictors of Hemorrhage in Adult Moyamoya PatientsStroke, 2003
- Current state of study on moyamoya disease in JapanSurgical Neurology, 1997
- A source of haemorrhage in adult patients with moyamoya disease: The significance of tributaries from the choroidal arteryActa Neurochirurgica, 1996
- Cerebrovascular "Moyamoya" DiseaseArchives of Neurology, 1969