title: Coexistence of moyamoya and Graves' diseases: the clinical characteristics and treatment effects of 21 Chinese patients.
abstract: OBJECTIVE
  To investigate the clinical features, pathogenesis and treatment effect of patients who had moyamoya disease (MMD) concurrent with Graves' disease (GD).
  
  
  METHODS
  Retrospective analysis of the examination and treatment results of the MMD patients with GD from January 2003 to April 2012 treated by our teamwork.
  
  
  RESULTS
  There were 1493 MMD patients included in this retrospective study. Among them, there were 16 female and 5 male MMD patients coexisted with Graves' diseases, and 15 of them were adult patients. Bilateral and unilateral lesions were observed in 18 and 3 cases, respectively. 19 patients show cerebral infarction. 18 patients manifested MMD symptoms when they were in a hyperthyroid state. 17 patients received encephaloduroarteriosynangiosis (EDAS) surgery after antithyroid treatment. There were 20 patients completed 2 and 77 months follow-up. 17 patients had good recovery and the other 3 patients had mild or moderate disability. Post-operative DSA achieved in 8 patients examinations showed good collateral circulation to the brain from superficial temporal artery (STA).
  
  
  CONCLUSIONS
  Moyamoya disease complicating GD is mostly occurred in adult female patients. Their clinical symptoms are mainly ischemic lesions and usually occur during the state of hyperthyroidism. The pathogenesis of moyamoya disease complicating GD may be associated with a variety of genetic and immune factors. Surgical treatment can establish effective collateral circulation and reduce the risk of recurrence of stroke.
authors.affiliation: Department of Neurosurgery, Affiliated Hospital of Academy of Military Medical Sciences, No 8 Dongdajie, Beijing 100071, China.
authors.forename: Desheng
authors.initials: D
authors.lastname: Li
authors.forename: Weizhong
authors.initials: W
authors.lastname: Yang
authors.forename: Peng
authors.initials: P
authors.lastname: Xian
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Bao
authors.forename: Rui
authors.initials: R
authors.lastname: Zong
authors.forename: Lian
authors.initials: L
authors.lastname: Duan
mesh_terms: D000293:Adolescent; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D044466:Asian People; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013956:Antithyroid Agents
keywords: Brain infarction; Encephaloduroarteriosynangiosis (EDAS); Graves’ disease; Hyperthyroidism; Moyamoya disease