Ye Fei, Wu Xiaoxin, Chen Jie, Li Jiaoxing, Zhang Minghao, Sheng Wenli, Feng Hua
Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Neurosurg Rev. 2025 Feb 17;48(1):246. doi: 10.1007/s10143-025-03401-8.
Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive steno-occlusion of the internal carotid artery system and aberrant collateral vessel formation. While MMD is primarily recognized for its arterial pathology, venous changes have been less explored. In this study, we investigated cerebral venous features in MMD and their association with disease progression. A total of 129 MMD patients (219 hemispheres) and 219 control patients with intracranial aneurysms (219 healthy hemispheres) were evaluated using digital subtraction angiography. MMD patients demonstrated significantly lower venous scores (cortical, deep, and total) compared to controls, with scores further declining as the disease advanced. Additionally, MMD patients exhibited delayed cortical venous filling times, which correlated with higher Suzuki stages. Venous drainage patterns also differed, with MMD patients predominantly showing posterior drainage, whereas controls exhibited anterior drainage. These findings underscore significant venous abnormalities in MMD, suggesting that the disease affects both the arterial and venous systems, challenging the conventional view of MMD as solely an arterial disorder.
烟雾病（MMD）是一种罕见的脑血管疾病，其特征是颈内动脉系统进行性狭窄闭塞和异常侧支血管形成。虽然烟雾病主要因其动脉病变而被认识，但静脉变化的研究较少。在本研究中，我们调查了烟雾病患者的脑静脉特征及其与疾病进展的关系。使用数字减影血管造影术对129例烟雾病患者（219个半球）和219例颅内动脉瘤对照患者（219个健康半球）进行了评估。与对照组相比，烟雾病患者的静脉评分（皮质、深部和总分）显著较低，且随着疾病进展评分进一步下降。此外，烟雾病患者表现出皮质静脉充盈时间延迟，这与较高的铃木分期相关。静脉引流模式也有所不同，烟雾病患者主要表现为后引流，而对照组表现为前引流。这些发现强调了烟雾病中存在明显的静脉异常，表明该疾病同时影响动脉和静脉系统，挑战了烟雾病仅为动脉疾病的传统观点。
