title: Clinical features of familial juvenile cases of moyamoya disease: analysis of patients treated in a single institute over a 28-year period.
abstract: OBJECTIVE
  The authors compared the clinical features between familial and sporadic cases of moyamoya disease (MMD) by retrospectively analyzing data on patients with MMD registered in the database of Tokyo Medical and Dental University over a period of 28 years.
  
  
  METHODS
  In total, 383 patients with hospital records at Tokyo Medical and Dental University from 1980 to 2007 were registered into the database. The data on all of these patients were retrospectively reviewed to clarify the occurrence of familial cases. Clinical features of child or adolescent patients (< 20 years of age) with MMD were compared between familial and sporadic cases in a subgroup of patients who were registered after 1995, initially diagnosed using MR angiography, and assessed using an intelligence scale.
  
  
  RESULTS
  Familial occurrence was observed in 59 patients (15.4%) in 40 pedigrees. The clinical features of juvenile patients were analyzed in 124 patients, 22 (17.7%) of whom had familial histories. In comparison with the sporadic cases, patients with familial histories were significantly younger at onset (4.7 vs 6.6 years old), had significantly more cortical infarction (59.1% vs 25.5%), and had significantly more stenoocclusive lesions in the posterior cerebral artery (45.4% vs 24.5%). The rate of patients with intellectual disturbance (intelligence quotient < 75) was significantly larger in the familial cases (47.4%) than in the sporadic cases (17.8%).
  
  
  CONCLUSIONS
  This survey of the clinical features of familial MMD suggests that patients with familial MMD had a more serious clinical course in childhood than the sporadic MMD cases.
authors.affiliation: Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Mukawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nariai
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Matsushima
authors.forename: Kikuo
authors.initials: K
authors.lastname: Ohno
mesh_terms: D000293:Adolescent; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D014041:Tokyo / Q000453:epidemiology