关键词: 烟雾病; 儿童; 缺血型; 脑血管造影; 脑梗死

Abstract:

【Abstract】 Objective To analyze the clinical and radiological findings of ischemic moyamoya disease(MMD) in children and the risk factors of cerebral infarction in these patients. Methods The clinical and imaging data of 27 patients(54 cerebral hemispheres) with pediatric and ischemic MMD from June 2011 to June 2012 were analyzed retrospectively. Fifty-four cerebral hemispheres were divided into hemisphere without infarction(32) and with infarction(22). The relationship between cerebral infarction and patient's gender, age, as well as characteristics of angiography(including Suzuki stage, posterior cerebral artery[PCA] stage, collateral circulation from ophthalmic artery or superficial temporal artery or meningeal artery or occipital artery, or internal maxillary artery or extracranial artery or posterior circulation) were analyzed with χ 2 test and Mann-Whitney U test. Results Patient's gender and age were not associated with the risk of cerebral infarction(χ 2=2.095, P =0.148; χ 2=4.286, P =0.453). Among all the cerebral hemispheres, there are 17 cortical infarction(17/22), 14 frontal lobe infarction(14/22), and 9 subcortical infarction(9/22). The disparity between Suzuki stage of hemispheres without infarction and with infarction is of statistical significance(Mann-Whitney U test Z =-3.054, P =0.002). The similar result was also observed by PCA stage(Mann-Whitney U test Z =-4.557, P <0.001). There were no statistically significant differences between cerebral infarction and every collateral circulation from ophthalmic artery or superficial temporal artery or meningeal artery or occipital artery, or internal maxillary artery or posterior circulation. Conclusion Cortical infarction is more common than the subcortical one in children with ischemic MMD. And frontal lobe infarction has the highest prevalence. The occurrence of cerebral infarction is associated with steno-occlusive lesions of advanced Suzuki stage and PCA stage.

Key words: Moyamoya disease; Children; Ischemic; Cerebral angiography; Cerebral infarction