Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease

Abstract

Background The clinical features of aneurysms associated with moyamoya disease (MMD) and risk factors for the formation and rupture of aneurysms are not well defined. Aims In this study, we retrospectively analyzed clinical data of MMD patients and examined the potential risk factors for the formation and rupture of aneurysms in these patients. Methods The medical records of all MMD patients in our hospital from April 2012 to May 2019 were reviewed. The logistic regression analysis was used to determine the independent association between various potential risk factors and the presence or rupture of intracranial aneurysms in MMD patients. Results Of 2230 MMD patients, 182 (8.2%) cases had intracranial aneurysms. The mean age of onset in patients with aneurysms was 47.2 years, which was significantly higher when compared with those without aneurysms ( p < 0.001). In logistic regression analysis, age of onset remained significantly associated with the presence of intracranial aneurysms, while female gender, hypertension, diabetes mellitus, and coronary artery disease were not. Besides, intracranial aneurysms were significantly associated with intracranial hemorrhage in MMD patients (odds ratio [OR] = 5.19; 95% confidence interval [CI], 3.80–7.09). About 60% aneurysms >5 mm in size, and 62.1% aneurysms with irregularly shaped morphology were ruptured. Aneurysms located in basilar tip, collateral or moyamoya vessels were more likely to present with rupture. Conclusions Age was an important risk factor for intracranial aneurysms formation in MMD patients. Aneurysms increased the risk of intracerebral hemorrhage in MMD patients, and their ruptures were correlated with aneurysms size, location, and morphology.

Parent artery occlusion for ruptured aneurysms in moyamoya vessels or on collaterals

“…AchA, anterior choroidal artery; F, female; HH, hunt-hess grading; IH, intracerebral hemorrhage; IVH, intraventricular hemorrhage; M, male; MMD, moyamoya disease; mRS, modified Rankin scale. Although some aneurysms in MMD may regress due to a decrease in blood flow or thrombosis, others are likely to present with rupture (23,(27)(28)(29). Aneurysm rupture may be fatal [Figure 7 (case 5 in Table 2)].…”

“…Although some aneurysms in MMD may regress due to a decrease in blood flow or thrombosis, others are likely to present with rupture ( 23 , 27 – 29 ). Aneurysm rupture may be fatal [ Figure 7 (case 5 in Table 2 )].…”

Development and Validation of a Nomogram to Predict the Individual Future Stroke Risk for Adult Patients With Moyamoya Disease: A Multicenter Retrospective Cohort Study in China

“…ICH originated from the abnormal moyamoya vessels due to the developmental functional disorders of vascular endothelial cells ( 29 ). Hemorrhage sites from the posterior circulation have a higher recurrence risk than from the anterior circulation ( 30 ), and the intracranial aneurysm (IA) could increase the hemorrhagic risk for MMD patients ( 31 ). Although they were not identified as risk factors of future strokes, our study found that hemorrhagic-type MMD patients with IA showed relatively higher recurrent stroke risks than those without IA (15.2 vs. 12.0%).…”

Zerebrale Vaskulitis: ein Update zu Symptomen, Diagnostik und Therapie

“…In der Angiografie sollte auch gezielt nach Aneurysmata gesucht werden, da diese in ca. 8 % der Fälle auftreten können [24]. Typischerweise kommt es zu Grenzzoneninfarkten und Kopfschmerzen oder Hirnblutungen.…”