1 Department of Neurology, 2 Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Ann Transl Med. 2014 Aug;2(8):77. doi: 10.3978/j.issn.2305-5839.2014.08.03.
The aim of this study was to describe the clinical and radiological findings of patients with moyamoya syndrome and Graves' disease. Possible mechanisms predisposing these individuals to ischemic stroke are discussed.
We retrospectively analyzed 12 consecutive patients with both moyamoya syndrome and Graves' disease. Moyamoya vasculopathy was diagnosed by digital subtract angiography or magnetic resonance angiography (MRA). The clinical characteristics, laboratory data, vascular radiological characteristics and outcome were reported.
All patients were female and mean age was 33.33±12.65 years. Stenosis or occlusion of bilateral terminal internal carotid artery and/or proximal anterior/middle cerebral arteries was found in nine patients. Among them, three patients displayed asymmetrical stenosis. In addition, there were three patients with probable unilateral moamoya syndrome. Eleven patients presented with ischemic stroke and/or transient ischemic attack (TIA) and one with dizziness. Thyroid function tests demonstrated elevated thyroid hormone levels and suppressed thyroid stimulating hormone levels in all the patients with ischemic events. All patients received anti-thyroid therapy and two had recurrent ischemic attack after drug withdrawal.
Moyamoya syndrome associated Graves' disease often presented with asymmetric stenosis or occlusion. We hypothesize cerebrovascular hemodynamic changes due to thyrotoxicosis contribute to the ischemic events.
本研究旨在描述伴有格雷夫斯病的烟雾病患者的临床和影像学表现。讨论了使这些个体易患缺血性卒中的可能机制。
我们回顾性分析了 12 例同时患有烟雾病和格雷夫斯病的连续患者。通过数字减影血管造影或磁共振血管造影（MRA）诊断烟雾病血管病变。报告了临床特征、实验室数据、血管影像学特征和结果。
所有患者均为女性，平均年龄为 33.33±12.65 岁。9 例患者发现双侧颈内动脉终末段和/或大脑前动脉和/或大脑中动脉近端狭窄或闭塞。其中 3 例患者显示不对称性狭窄。此外，还有 3 例患者可能存在单侧烟雾病。11 例患者出现缺血性卒中和/或短暂性脑缺血发作（TIA），1 例患者出现头晕。甲状腺功能检查显示所有发生缺血事件的患者甲状腺激素水平升高，促甲状腺激素水平受抑制。所有患者均接受了抗甲状腺治疗，2 例患者在停药后再次发生缺血性发作。
伴有格雷夫斯病的烟雾病综合征常表现为不对称性狭窄或闭塞。我们假设甲状腺毒症引起的脑血管血流动力学变化导致了缺血事件。
