Department of Neurosurgery, The First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China.
Department of Neurosurgery, Fengcheng People's Hospital , Fengcheng, Jiangxi Province, China.
Neurol Res. 2020 Sep;42(9):767-772. doi: 10.1080/01616412.2020.1773663. Epub 2020 Jun 20.
To explore clinical features and compare of the difference between conservative treatment and surgical treatmentin prognosis of intracranial aneurysms associated with moyamoya disease (MMD).
104 patients with MMD a ssociated with intracranial aneurysms diagnosed by digital subtraction angiography (DSA) or computed tomography angiography (CTA) were retrospectively analyzed.
All patients of MMD with intracranial aneurysms had 129 aneurysms distributed at different sites. The distribution of the aneurysms was as follows: 28(21.71%) anterior communicating artery aneurysms, 21(16.28%) basilar artery aneurysms, 19(14.73%) middle cerebral artery aneurysms, 17(13.18%) posterior cerebral artery aneurysms, 12(9.30%)internal carotid artery aneurysms, 11(8.53%) posterior communicating artery aneurysms, 10(7.75%) anterior cerebral artery aneurysms, 5(3.88%) anterior choroidal artery aneurysms, 2(1.55%) moyamoya vessel aneurysms, and 4(3.1%) other location aneurysms. 82 cases (78.85%) had one aneurysm, and 21 cases (20.19%) had 2 or more aneurysms. 64 cases were treated surgically, and 40 cases were treated conservatively. 57 of 81 cases (70.37%) had a good outcome, 2 cases (2.47%) were in paralyzed, and 22 cases were died. The mortality rate was (27.16%). Death occurred in 16 (47.06%) of 34 patients with conservative treatment, and 6(12.77%) of 47 patients with surgical treatment. 7 cases (8.64%) had twice cerebral hemorrhage, and one case (1.23%) had third cerebral hemorrhage in the follow-up period. There were 5 deaths, two good outcomes, and one coma among 8 cases experienced re-hemorrhage.
Compared with conservative treatment, positive surgical treatment showed clinical significance for preventing cerebral hemorrhage and reducing mortality of MMD with intracranial aneurysms.
MMD: moyamoya disease; DSA: digital subtraction angiography; CTA: computed tomography angiography.
探讨颅内动脉瘤合并烟雾病（MMD）患者的临床特征及不同治疗方法对预后的影响。
回顾性分析 104 例经数字减影血管造影（DSA）或计算机断层血管造影（CTA）诊断为颅内动脉瘤合并 MMD 的患者。
所有颅内动脉瘤合并 MMD 患者共 129 个动脉瘤，分布于不同部位。动脉瘤的分布情况如下：前交通动脉动脉瘤 28 个（21.71%），基底动脉动脉瘤 21 个（16.28%），大脑中动脉动脉瘤 19 个（14.73%），大脑后动脉动脉瘤 17 个（13.18%），颈内动脉动脉瘤 12 个（9.30%），后交通动脉动脉瘤 11 个（8.53%），大脑前动脉动脉瘤 10 个（7.75%），脉络膜前动脉动脉瘤 5 个（3.88%），moyamoya 血管动脉瘤 2 个（1.55%），其他部位动脉瘤 4 个（3.10%）。82 例（78.85%）患者有 1 个动脉瘤，21 例（20.19%）患者有 2 个或以上动脉瘤。64 例行手术治疗，40 例行保守治疗。81 例患者中，57 例（70.37%）预后良好，2 例（2.47%）瘫痪，22 例死亡。死亡率为（27.16%）。保守治疗组 34 例患者中有 16 例（47.06%）死亡，手术治疗组 47 例患者中有 6 例（12.77%）死亡。在随访期间，有 7 例（8.64%）发生 2 次脑出血，1 例（1.23%）发生 3 次脑出血。8 例再出血患者中有 5 例死亡，2 例预后良好，1 例昏迷。
与保守治疗相比，积极的手术治疗对预防颅内动脉瘤合并 MMD 患者脑出血和降低死亡率具有临床意义。
MMD：烟雾病；DSA：数字减影血管造影；CTA：计算机断层血管造影。
