Moyamoya Disease Associated with Renovascular Hypertension

Jansen, J.; Donker, A. J. M.; Luth, W. J.; Smit, L.

doi:10.1055/s-2008-1071457

Cited by 34 publications

(17 citation statements)

References 9 publications

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“…We believe that the PTA procedure is the first choice of treatment for renal artery stenosis in patients with moyamoya disease. In previous reports, 10,11,15 renal artery stenosis in moyamoya disease has been treated with renal autotransplantation or PTA.…”

Section: Discussionmentioning

confidence: 99%

“…The hypertension in patients with moyamoya disease manifesting renal artery stenosis was also reported in the previous case reports. [7][8][9][10][11][12][13][14][15] Thus, the presence of renovascular hypertension in young patients may suggest the possibility of moyamoya disease in the differential diagnosis of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Recently, renal artery lesions in moyamoya disease have been described sporadically in several case reports. [7][8][9][10][11][12][13][14][15] However, to our knowledge, no report has yet determined the prevalence of renal artery lesions in a large-scale study of patients with moyamoya disease. In this study we prospectively performed both cerebral angiography and abdominal aortography in 86 patients with moyamoya disease to evaluate the angiographic findings of renal artery lesions and to determine the prevalence of renal artery lesions in patients with moyamoya disease.…”

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confidence: 99%

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Renal Artery Lesions in Patients With Moyamoya Disease

Yamada

Himeno

Matsushima

et al. 2000

Stroke

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Background and Purpose-Renal artery lesions in moyamoya disease have been described sporadically in several case reports. The purpose of this study is to evaluate the angiographic findings of renal artery lesions in moyamoya disease and to determine the prevalence of renal artery lesions in patients with moyamoya disease. Methods-Eighty-six consecutive patients with idiopathic moyamoya disease were prospectively examined with both cerebral angiography and abdominal aortography. The findings of abdominal aortography were reviewed for the presence and appearance of renal artery lesions and compared with the clinical data and cerebral angiographic findings. Results-Of 86 patients with idiopathic moyamoya disease, 7 patients (8%) were found to have renal artery lesions. Six patients (7%) had stenosis in the renal artery, and 1 patient (1%) had a small saccular aneurysm in the renal artery. Two patients (2%) with a marked renal artery stenosis presented with renovascular hypertension, which resulted in an intraventricular hemorrhage in 1 patient. Furthermore, the renal artery stenosis in the 2 patients with renovascular hypertension was successfully treated with percutaneous transluminal angioplasty. There was no significant correlation between the presence of renal artery lesions and cerebral angiographic findings. Conclusions-Seven (8%) of 86 patients with moyamoya disease showed renal artery lesions, including 6 stenoses (7%) and 1 aneurysm (1%

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Renal Artery Lesions in Patients With Moyamoya Disease

Yamada

Himeno

Matsushima

et al. 2000

Stroke

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“…55 Other vascular abnormalities described in Down syndrome include abnormal nailbed capillary loops and renovascular hypertension. 56 Neuropathologic investigation of a child with Down syndrome who did not have moyamoya syndrome revealed significant structural abnormalities in vessels of the circle of Willis, ie, irregular internal elastic membrane surrounding regions of marked endothelial hyperplasia, which again suggests a possible underlying structural change in the cerebral arteries of children with moyamoya syndrome and Down syndrome. 30 One report suggests that protein C deficiency among children with Down syndrome leads to thromboembolism and recurrent strokes.…”

Section: Mechanisms Of Pathogenesismentioning

confidence: 99%

Moyamoya Syndrome Associated With Down Syndrome: Outcome After Surgical Revascularization

Jea¹,

Smith²,

Robertson

et al. 2005

Pediatrics

137

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ABSTRACT. Objectives. This study was undertaken to describe the clinical, radiologic, and angiographic features of moyamoya syndrome in a surgical series of children and adults with Down syndrome. We wished to define the features of moyamoya syndrome associated with Down syndrome and to determine the results of surgical revascularization among these patients at early and late follow-up times.Methods. We reviewed the clinical, radiologic, and angiographic records of all patients with moyamoya syndrome associated with Down syndrome, as a subset of a previously reported, consecutive series of patients who underwent cerebral revascularization surgery with a standardized surgical procedure, pial synangiosis, between January 1, 1985, and June 30, 2004.Results. Of 181 patients with moyamoya syndrome from the initial series who were treated surgically during the study period, 16 patients had Down syndrome (10 female patients and 6 male patients). The average age at onset was 9.3 years (range: 1-29 years); the average age at the time of surgery was 9.8 years (range: 2-29 years). Although the presenting symptoms were transient ischemic attacks for 10 patients and strokes for 6 patients, computed tomographic and/or MRI scans demonstrated bilateral infarctions for 9 patients and unilateral infarctions for 6, with only 1 patient having no imaging evidence of a previous stroke. No cases presented with intracerebral hemorrhage. Preoperative angiography showed the presence of bilateral moyamoya syndrome changes for all patients, including posterior circulation involvement for 8 patients. Surgical treatment included pial synangiosis for all patients, although 1 patient underwent a superficial temporal artery-middle cerebral artery bypass in the contralateral hemisphere. Surgical complications included symptomatic subdural hematomas requiring evacuation, at 48 days and 54 days postoperatively (2 cases), seizures (2 cases), and strokes within 30 days after surgery, at 1 day and 7 days postoperatively (2 cases). Late clinical and radiologic follow-up data (average: 67.6 months; range: 6 -146 months) demonstrated no worsening in neurologic status for any patient except for 1 patient who developed a seizure disorder with associated chronic hypocalcemia; she was totally dependent at the 10-year follow-up evaluation, despite no evidence of new infarction since her surgery. There was no clinical or radiologic evidence of new infarction for any patient in late follow-up evaluations. Postoperative angiography, conducted 1 year after surgery for 11 patients, revealed radiologic evidence of good to excellent cerebral revascularization in 85% of the surgically treated hemispheres. Patients were maintained on lifetime aspirin therapy.Conclusions. The clinical, radiologic, and angiographic features of moyamoya syndrome associated with Down syndrome seem comparable to those of primary moyamoya disease. Cerebral revascularization surgery with the pial synangiosis technique seems to confer long-lasting protection against additional strokes in thi...

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“…4 The coexistence of lesions in the cerebral and renal vascular territories was scarcely reported. [5][6][7][8][9][10][11][12][13] More recently, Yamada and colleagues 14 were reported in Caucasian patients. We present a case of Moyamoya disease with renal artery involvement in a young male adult, which may be the first to be described in a patient with an African origin.…”

Section: Introductionmentioning

confidence: 99%

Moyamoya disease associated with renovascular disease in a young African-Brazilian patient

Fuchs

et al. 2001

J Hum Hypertens

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Moyamoya is a rare disease characterized by fibrous dysplasia of the internal carotid and proximal cerebral arteries, which has been described mainly in young Japanese. We present a case of Moyamoya disease with renal artery involvement in a young male patient with an African origin. A 15-year-old boy was referred to our hospital due to uncontrolled blood pressure, headache, somnolence, cognitive deficit and multiple lacunar infarcts in the computed tomography. Cerebral arteriography showed the absence of the normal vascular anatomy at the level of the circle of Willis. The intracraneal vessels presented severe stenosis or were occluded and replaced by an extensive network of ectasic collateral vessels. Abdominal ultrasound examination identified asymmetric kidneys, and renal arteriog-

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Moyamoya Disease Associated with Renovascular Hypertension

Cited by 34 publications

References 9 publications

Renal Artery Lesions in Patients With Moyamoya Disease

Renal Artery Lesions in Patients With Moyamoya Disease

Moyamoya Syndrome Associated With Down Syndrome: Outcome After Surgical Revascularization

Moyamoya disease associated with renovascular disease in a young African-Brazilian patient

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