Adult onset moyamoya disease: Institutional experience

Abstract

Moyamoya disease is a progressive steno-occlusive disease of bilateral carotid forks with the formation of fine collateral vascular network and is an angiographic diagnosis. We analyzed case records of 11 patients with "adult-onset moyamoya disease." Six patients presented with intracranial hemorrhage (intracerebral and/or intraventricular) and 5 with focal ischemia. Angiography revealed bilateral Internal carotid artery involvement in 8 patients and unilateral involvement in 3. Posterior cerebral artery involvement was seen in 3 patients. Saccular aneurysm involving posterior circulation was seen in only 1 patient. Although rare, adult-onset moyamoya disease should be considered as one of the causes for intracerebral and intraventricular hemorrhage in adults.

An institutional experience of 26 patients with Moyamoya disease: A study from Northwest India

“…Six out of 11 adults presented with intracranial hemorrhage in a study done by Chinchure et al . [15] In our series, 38.46% of the patients had intracranial hemorrhage.…”

“…Series from Garg et al .,[13] showed male predominance (68.2%); while study from Chinchure et al .,[15] also showed slight male predominance (six out of 11 patients). But in our study, there was a female predominance with a ratio of 3.3:1.…”

“…Singhi et al .,[14] retrospectively analyzed data of 23 patients, diagnosed with pediatric MMD in 16 years. Chinchure et al .,[15] analyzed case records of 11 patients which includes only adult onset MMD. Our study is the second largest study in India with 26 patients in the span of just 3 years including both adult and childhood onset MMD.…”

“…[17] Mugikura et al .,[18] reported high prevalence of clinical strokes and infarctions in patients diagnosed before 4 years of age, associated with advanced steno-occlusive lesions of the posterior cerebral artery (PCA). Indian study by Chinchure et al .,[15] showed three out of 11 patients with posterior circulation involvement. Jayakumar et al .,[17] in their series reported that 90% of the patients had involvement of posterior circulation.…”

“…Garg et al .,[13] reported 11 out of 44 patients with aneurysms (nine in the circle of Willis and two in the periphery), while only one case of aneurysm was found in our study as well as the study done by Chinchure et al . [15] However, one of our pediatric MMD patient with seizure alone had DVA.…”