[Clinical manifestations of infantile moyamoya disease].
OBJECTIVE
The present study aimed to clarify clinical manifestations of infantile moyamoya disease by comparing them with those of schoolchild moyamoya disease.


METHODS
This study included a total of 55 patients who were diagnosed as moyamoya disease on cerebral angiography. Their medical records were precisely evaluated. CT or MRI was performed to examine the location of cerebral infarction in all subjects. Cerebral blood flow was measured in 33 patients before surgery, using the 133-xenon inhalation method and single photon emission computed tomography (SPECT). Postoperative full-scale IQ (FSIQ) was also examined.


RESULTS
Of 55 patients, onset age was < 6 yr in 32 (infantile group) and > or = 6 yr in 23 (schoolchild group). Completed stroke was significantly more frequent in the infantile group than in schoolchild group (p = 0.0014). Incidence of cerebral infarct was also higher in the infantile group than in the schoolchild group (p = 0.0023). PCA stenosis/occlusion was observed in 14 of 32 infantile patients, but only in 4 of 23 schoolchild patients (p = 0.0474). Mean cerebral blood flow value was significantly lower than control value in the infantile group, but not in the schoolchild group. The effect of bypass surgery on cerebral ischemic attack was satisfactory in both groups. However, the postoperative FSIQ value was significantly lower in the infantile group than in the schoolchild group (p = 0.0452).


CONCLUSIONS
The present study showed that infantile moyamoya disease involves a higher risk for cerebral infarct and completed stroke due to its more advanced stage, and that earlier diagnosis and treatment should be performed to improve the mental prognosis of patients.
Kuroda
Satoshi
S
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
Nanba
Rina
R
Ishikawa
Tatsuya
T
Houkin
Kiyohiro
K
Kamiyama
Hiroyasu
H
Iwasaki
Yoshinobu
Y
D000293:Adolescent; D002544:Cerebral Infarction / Q000150:complications*; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007360:Intelligence; D008279:Magnetic Resonance Imaging; D008297:Male; D009072:Moyamoya Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D014888:Wechsler Scales