Headache in Caucasian patients with Moyamoya angiopathy – a systematic cohort study

Kraemer, Markus; Lee, Sie-In; Ayzenberg, Ilya; Schwitalla, Jan Claudius; Diehl, Rolf R.; Berlit, Peter; Bosche, Bert; Katsarava, Zaza; Obermann, Mark

doi:10.1177/0333102416643516

Cited by 30 publications

(40 citation statements)

References 11 publications

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“…In our study, the majority of these patients (75.5%) reported migraine-like headaches either alone or accompanied by a tension-type-like headache, and this finding is supported by other studies (5). There were no differences regarding the frequency of headache (days/month, p > 0.1) before admission, but the intensity of the headache before admission varied (AVS, p = 0.028).…”

Section: Discussionsupporting

confidence: 90%

“…Moyamoya disease (MMD), named first by Suzuki, is characterized by progressive steno-occlusion at the terminal portion of the internal carotid artery (ICA) accompanied by abnormal vascular networks (1)(2)(3). Headache is a common clinical manifestation in patients with MMD, but this is commonly underestimated in its clinical management (1,4,5). Several existing studies confirmed the high prevalence of headache in MMD, but the effect of surgical revascularization on headaches associated with MMD remains controversial (4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

“…Headache is a common clinical manifestation in patients with MMD, but this is commonly underestimated in its clinical management (1,4,5). Several existing studies confirmed the high prevalence of headache in MMD, but the effect of surgical revascularization on headaches associated with MMD remains controversial (4)(5)(6)(7)(8)(9). The precise quantifiable characteristics of HAMD and its pathology in Chinese patients remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Long-Term Outcome of Headaches Associated With Moyamoya Disease in the Chinese Population—A Cohort Study

et al. 2020

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Background: Headache associated with Moyamoya disease (HAMD) in the Chinese population is not well-described. The long-term outcome of surgical revascularization and natural course of HAMD has not been disclosed either.Methods: A headache screening questionnaire in China based on the ICHD2 and a face-to-face interview performed by an experienced neurologist were used to investigate headache characteristics and frequency and pain intensity in the 3 months before admission, and a telephone interview was used for the follow-up of a large cohort of 119 Chinese patients with HAMD.Results: Headache intensity was rated as scores of 5.9 ± 2.0 on a visual analog scale (VAS), ranging from 0 to 10, in the 3 months before admission. Forty-six patients (38.6%) were categorized as having migraine-like headaches, 29 patients (24.3%) were categorized as having tension type-like headaches, and 44 patients (36.9%) had a combination of both. The majority of patients had migraine-like headaches (n = 34, 73.9%) with a migrainous aura. Both the frequency and intensity of the headache improved significantly in patients treated with surgical revascularization (n = 96, 80.7%) or the conservative treatment (n = 23, 19.3%) in a long-term follow-up.Conclusion: HAMD frequently presented with a migraine-like headache (75.5% in total). A tension type headache was present in 60.9% of patients. The symptom of dizziness is common in patients with HAMD (60.5%), and 19 of them (26.4%) met the diagnose of vestibular migraine. Both intensity and frequency of HAMD show a trend of spontaneous remission in a long-term follow-up, and there is no difference in long-term outcomes of HAMD between surgical revascularization and conservative treatment, which indicates that the effect of bypass intervention on HAMD may be a placebo effect.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Long-Term Outcome of Headaches Associated With Moyamoya Disease in the Chinese Population—A Cohort Study

et al. 2020

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“…Typical manifestations include weakness, numbness, speech changes, and seizures, as well as headaches and dizziness. To date, headaches and dizziness associated with moyamoya have not been well-characterized in the literature -and were not well-characterized in our patient -but headaches with migrainous and tension-like properties have been reported [23,24] .…”

Section: Moyamoya Disease and Syndromementioning

confidence: 70%

Moyamoya in a Patient with Smith-Magenis Syndrome

Freeman

Deleyiannis²,

Bernard³

et al. 2017

Pediatr Neurosurg

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Occurrence of moyamoya syndrome in a patient with Smith-Magenis syndrome (SMS) has previously been reported once in a 10-year-old Asian female. We report a second case of moyamoya in a patient with SMS, in a now 25-year-old Asian female diagnosed with both conditions as a child. In addition to describing her medical and surgical history, we provide a detailed report of her omental transposition, in which the omental circulation was anastomosed to the superior thyroid artery and external jugular vein. To our knowledge, this is the first report of omental transposition for moyamoya in which omental vessels are anastomosed to vessels in the neck, as well as the second report of moyamoya in a patient with SMS.

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“…Main manifestations in childhood or early adulthood are strokes or cerebral bleedings. Often earlier transient ischemic attacks, headaches or choreatiform movements are not recognized as severe warning symptoms before disabling manifestation ( Kraemer et al, 2012a ; Kraemer et al, 2016 ; Kraemer et al, 2017 ). This “orphan disease” is more often recognized in Asians, especially in Japan and Korea.…”

Section: Introductionmentioning

confidence: 99%

Distinctive facial features in idiopathic Moyamoya disease in Caucasians: a first systematic analysis

Kraemer

Huynh

Wieczorek

et al. 2018

PeerJ

Self Cite

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BackgroundCraniofacial dysmorphic features are morphological changes of the face and skull which are associated with syndromic conditions. Moyamoya angiopathy is a rare cerebral vasculopathy that can be divided into Moyamoya syndrome, which is associated or secondary to other diseases, and into idiopathic Moyamoya disease. Facial dysmorphism has been described in rare genetic syndromes with associated Moyamoya syndrome. However, a direct relationship between idiopathic Moyamoya disease with dysmorphic facial changes is not known yet.MethodsLandmarks were manually placed on frontal photographs of the face of 45 patients with bilateral Moyamoya disease and 50 matched controls. After procrustes alignment of landmarks a multivariate, penalized logistic regression (elastic-net) was performed on geometric features derived from landmark data to classify patients against controls. Classifiers were visualized in importance plots that colorcode importance of geometric locations for the classification decision.ResultsThe classification accuracy for discriminating the total patient group from controls was 82.3% (P-value = 6.3×10−11, binomial test, a-priori chance 50.2%) for an elastic-net classifier. Importance plots show that differences around the eyes and forehead were responsible for the discrimination. Subgroup analysis corrected for body mass index confirmed a similar result.DiscussionResults suggest that there is a resemblance in faces of Caucasian patients with idiopathic Moyamoya disease and that there is a difference to matched controls. Replication of findings is necessary as it is difficult to control all residual confounding in study designs such as ours. If our results would be replicated in a larger cohort, this would be helpful for pathophysiological interpretation and early detection of the disease.

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Headache in Caucasian patients with Moyamoya angiopathy – a systematic cohort study

Cited by 30 publications

References 11 publications

Clinical Characteristics and Long-Term Outcome of Headaches Associated With Moyamoya Disease in the Chinese Population—A Cohort Study

Clinical Characteristics and Long-Term Outcome of Headaches Associated With Moyamoya Disease in the Chinese Population—A Cohort Study

Moyamoya in a Patient with Smith-Magenis Syndrome

Distinctive facial features in idiopathic Moyamoya disease in Caucasians: a first systematic analysis

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