title: Assessment of cognitive function in adult patients with hemorrhagic moyamoya disease who received no surgical revascularization.
abstract: OBJECTIVE
  Due to controversial surgical treatment for hemorrhagic moyamoya disease (MMD), a large proportion of these patients chose conservative treatment. The aim of this study was to assess cognitive function in adult patients with hemorrhagic MMD who received no surgical revascularization.
  
  
  METHODS
  Twenty-six adult hemorrhagic MMD patients with only intraventricular hemorrhage (IVH) confirmed by positive computed tomography and magnetic resonance imaging scan, 20 patients with spontaneous IVH whose digital subtraction angiography results were negative, and 30 healthy controls were identified and matched for age, gender, education background and living area. Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA). The non-parametric test was used for comparisons among the three groups.
  
  
  RESULTS
  No patient was confirmed cognitive dysfunction at the initial screening. Twenty-four (92%) cases presented mild cognitive impairment (MCI) after 1 year. All the cases demonstrated MCI after 2 years. The difference between cases and healthy controls was statistically significant at the second screening (P = 0.000) and the third screening (P = 0.000), as was that between cases and patients with spontaneous IVH at the second screening (P = 0.000) and the third screening (P = 0.000). In addition, there were significant decreases in all MoCA subscores (P = 0.000) with special regards to delayed recall, visual space and executive function in cases compared with the other two groups. Moreover, significant differences were found in the subgroups of smoking (P = 0.021) and Suzuki angiographic classification of MMD (P = 0.030).
  
  
  CONCLUSIONS
  Cognitive impairment is a long-term complication for adult hemorrhagic MMD patients who underwent conservative treatment.
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji University, Shanghai, China.
authors.forename: S-H
authors.initials: SH
authors.lastname: Su
authors.forename: J
authors.initials: J
authors.lastname: Hai
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: F
authors.initials: F
authors.lastname: Yu
authors.forename: Y-F
authors.initials: YF
authors.lastname: Wu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology* / Q000601:surgery; D002548:Cerebral Revascularization; D003072:Cognition Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology* / Q000601:surgery; D009483:Neuropsychological Tests; D011859:Radiography