Moyamoya: Indiana University Medical Center experience

Engin Y. Yilmaz, Michael B. Pritz, Askiel Bruno, Alfredo Lopez-Yunez, José Biller

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background: Moyamoya usually presents with cerebral ischemia in children and intracranial hemorrhage in adults. Treatment remains controversial. Design and Objective: We reviewed our experience from June 1995 to August 1999 of 20 adult and pediatric angiographically diagnosed patients with moyamoya to report their clinical presentation, radiological findings, management, and clinical outcomes. Results: The mean age of patients at symptom onset was 17 years (range, 2-54 years). Patients were divided into 2 age groups (group 1, <18 years; group 2, ≥18 years). There were 13 patients in group 1 and 7 patients in group 2. Ischemic strokes or transient ischemic attacks were the predominant initial presentations in both groups. One patient in group 2 had an intraparenchymal brain hemorrhage. Five patients received medical treatment, and 15 had surgical revascularization. The mean time from symptom onset to surgical procedure was significantly longer for patients in group 1 than for those in group 2 (P=.03). The mean follow-up time was 36 months. One patient in group 1 had an ischemic stroke. There was no difference in stroke recurrence, mortality, or modified Rankin scale score among medically or surgically treated patients. Conclusions: Moyamoya disease may have a different presentation and more benign natural history in our population than in Asian populations. Our findings emphasize the need to better understand the natural history of patients with moyamoya as well as the clinical benefit of different treatment modalities. Structured multicenter randomized clinical trials are needed to further assess the best treatment modalities for patients with moyamoya in the United States.

Original languageEnglish (US)
Pages (from-to)1274-1278
Number of pages5
JournalArchives of Neurology
Volume58
Issue number8
StatePublished - Aug 27 2001
Externally publishedYes

Fingerprint

Intracranial Hemorrhages
Stroke
Natural History
Moyamoya Disease
Transient Ischemic Attack
Therapeutics
Brain Ischemia
Population
Randomized Controlled Trials
Age Groups
Pediatrics
Recurrence
Mortality
Modality
Onset
Attack
Clinical Trials
Medical Treatment
Asia

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Yilmaz, E. Y., Pritz, M. B., Bruno, A., Lopez-Yunez, A., & Biller, J. (2001). Moyamoya: Indiana University Medical Center experience. Archives of Neurology, 58(8), 1274-1278.

Moyamoya : Indiana University Medical Center experience. / Yilmaz, Engin Y.; Pritz, Michael B.; Bruno, Askiel; Lopez-Yunez, Alfredo; Biller, José.

In: Archives of Neurology, Vol. 58, No. 8, 27.08.2001, p. 1274-1278.

Research output: Contribution to journalArticle

Yilmaz, EY, Pritz, MB, Bruno, A, Lopez-Yunez, A & Biller, J 2001, 'Moyamoya: Indiana University Medical Center experience', Archives of Neurology, vol. 58, no. 8, pp. 1274-1278.
Yilmaz EY, Pritz MB, Bruno A, Lopez-Yunez A, Biller J. Moyamoya: Indiana University Medical Center experience. Archives of Neurology. 2001 Aug 27;58(8):1274-1278.
Yilmaz, Engin Y. ; Pritz, Michael B. ; Bruno, Askiel ; Lopez-Yunez, Alfredo ; Biller, José. / Moyamoya : Indiana University Medical Center experience. In: Archives of Neurology. 2001 ; Vol. 58, No. 8. pp. 1274-1278.
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