Robertson R L, Chavali R V, Robson C D, Barnes P D, Eldredge E A, Burrows P E, Scott R M
Department of Radiology, Children's Hospital Medical Center and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115 USA.
Pediatr Radiol. 1998 Nov;28(11):824-9. doi: 10.1007/s002470050474.
Purpose. To determine the incidence of neurologic complications of cerebral angiography in children with moyamoya syndrome (MMS) as compared to children without MMS. Materials and methods. One-hundred-ninety consecutive cerebral angiograms obtained in 152 children were evaluated. Sixty of these angiograms were obtained in 40 children with MMS. Patients underwent neurologic evaluation prior to and after the procedure. For this study, a neurologic complication was defined as any new focal neurologic deficit or alteration in mental status occurring during the procedure or within the ensuing 24 hours. Results. There were 2 neurologic complications within 24 hours of angiography, one in the MMS group and one in the non-MMS group. One patient with MMS became mute following angiography. The symptom resolved within 12 hours. One patient without MMS being examined postoperatively for residual arteriovenous malformation developed intracranial hemorrhage requiring reexploration 12 hours after the angiogram. Using a two-tail Fisher's exact test, there was no significant statistical difference in the ischemic (P = 0.3) or hemorrhagic (P = 1.0) complication rates between the group of patients with MMS and the non-MMS groups. Conclusion. The risk of a neurologic complication from cerebral angiography in children with MMS is low and not statistically different from the risk in children with other cerebrovascular disorders.
目的。确定烟雾病综合征(MMS)患儿与非MMS患儿相比,脑血管造影术神经并发症的发生率。材料与方法。对152名儿童连续进行的190次脑血管造影进行评估。其中60次造影是在40名MMS患儿中进行的。患者在手术前后均接受神经学评估。在本研究中,神经并发症定义为手术过程中或随后24小时内出现的任何新的局灶性神经功能缺损或精神状态改变。结果。血管造影术后24小时内出现2例神经并发症,1例在MMS组,1例在非MMS组。1例MMS患儿血管造影术后变得缄默。症状在12小时内缓解。1例非MMS患儿术后因残留动静脉畸形接受检查,血管造影术后12小时发生颅内出血,需要再次手术探查。采用双侧Fisher精确检验,MMS组与非MMS组之间的缺血性(P = 0.3)或出血性(P = 1.0)并发症发生率无显著统计学差异。结论。MMS患儿脑血管造影术发生神经并发症的风险较低,与其他脑血管疾病患儿的风险在统计学上无差异。