Intracranial Aneurysms in Moyamoya Disease: Report of Ten Cases and Review of the Literature

Herreman, Fernando; Nathal, Edgar; Yasui, Nobuyuki; Yonekawa, Yasuhiro

doi:10.1159/000108503

Cited by 19 publications

(12 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conservative management may sometimes represent a treatment option. Several reports have described spontaneous disappearance of small aneurysms on collateral vessels in patients who did not exhibit repeated intracranial bleeding, [2][3][4][5] such as in our Case 3. However, this phenomenon does not always happen and careful follow up is needed.…”

Section: Discussionsupporting

confidence: 57%

“…1,[3][4][5]8,10) The former are considered to be pseudoaneurysms, with rupture frequently causing intraventricular or intracerebral hemorrhage. However, these pseudoaneurysms can gradually reduce in size and may completely disappear.…”

Section: Discussionmentioning

confidence: 99%

“…However, these pseudoaneurysms can gradually reduce in size and may completely disappear. 1,3) The latter are true aneurysms, occurring in the posterior circulation in about 50-60% of cases associated with moyamoya disease. 3,6) Increased hemodynamic stress in the posterior circulation due to oc-Neurol Med Chir (Tokyo) 51, November, 2011…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Although direct surgical clipping has been advocated for the treatment of such aneurysms, 2,4,6,12) such procedures are difficult and hazardous. Dural and arachnoid incisions may disturb collateral flow through anastomotic vessels and intraoperative compression of ischemic cerebral cortex or temporary clipping of the parent artery may result in irreversible brain damage.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ruptured Intracranial Aneurysms Associated With Moyamoya Disease -Three Case Reports-

Arai

Matsuda

Isozaki

et al. 2011

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ruptured Intracranial Aneurysms Associated With Moyamoya Disease -Three Case Reports-

Arai

Matsuda

Isozaki

et al. 2011

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

“…These aneurysms are commonly found in the arterial complex of the anterior communicating artery-ACA in patients with unilateral MMD and in the basilar artery in patients with bilateral MMD. 20 Histopathologically, the aneurysmal wall consists of endothelium with adventitial layers and a disappearance of internal elastic lamina and media, which is the same as those found in saccular aneurysms. Peripheral artery aneurysms, the second type, are responsible for parenchymatous hemorrhage.…”

Section: Pathologymentioning

confidence: 68%

Moyamoya disease: a summary

Burke

Burke²,

Sherma

et al. 2009

FOC

185

150

View full text Add to dashboard Cite

Moyamoya, meaning a “hazy puff of smoke” in Japanese, is a chronic, occlusive cerebrovascular disease involving bilateral stenosis or occlusion of the terminal portion of the internal carotid arteries (ICAs) and/or the proximal portions of the anterior cerebral arteries and middle cerebral arteries (MCAs). The Ministry of Health and Welfare of Japan has defined 4 types of moyamoya disease (MMD): ischemic, hemorrhagic, epileptic, and “other.” The ischemic type has been shown to predominate in childhood, while the hemorrhagic type is more often observed in the adult population. The highest prevalence of MMD is found in Japan, with a higher female to male ratio. Studies have shown a possible genetic association of MMD linked to chromosome 17 in Japanese cases as well as in cases found in other demographics. During autopsy, intracerebral hematoma is found and most commonly serves as the major cause of death in patients with MMD. Moyamoya vessels at the base of the brain are composed of medium-sized or small muscular arteries emanating from the circle of Willis, mainly the intracranial portions of ICAs, anterior choroidal arteries, and posterior cerebral arteries, forming complex channels that connect with distal positions of the MCAs. Off of these channels are small tortuous and dilated vessels that penetrate into the base of the brain at the site of the thalamoperforate and lenticulostriate arteries. On angiography, there is the characteristic stenosis or occlusion bilaterally at the terminal portion of the ICAs as well as the moyamoya vessels at the base of the brain. Six angiographic stages have been described, from Stage 1, which reveals a narrowing of the carotid forks, to Stage 6, in which the moyamoya vessels disappear and collateral circulation is produced solely from the external carotid arteries. Cases with milder symptoms are usually treated conservatively; however, more severe symptomatic cases are treated using revascularization procedures. Surgical treatments are divided into 3 types: direct, indirect, and combined/other methods. Direct bypass includes superficial temporal artery-MCA bypass or use of other graft types. Indirect procedures bring in circulation to the intracranial regions by introducing newly developed vasculature from newly approximated tissues. These procedures may not be enough to prevent further ischemia; therefore, a combination of direct and indirect procedures is more suitable. This article will give a review of the epidemiology, natural history, pathology, pathophysiology, and diagnostic criteria, including imaging, and briefly describe the surgical treatment of MMD.

show abstract