title: Thirteen-year Experience of 44 Patients with Adult Hemorrhagic Moyamoya Disease from a Single Institution: Clinical Analysis by Management Modality.
abstract: Our objective was a retrospective assessment of the management modalities that provided the most beneficial treatment in hemorrhagic moyamoya disease during the last 13 years at our institution. The clinical results of 44 patients with hemorrhagic moyamoya disease were investigated, comparing revascularization surgery (direct, indirect, and combined bypass) or conservative treatment. Angiographic features, rebleeding, and clinical outcome were investigated. Six of the 35 patients (17.1%) with revascularization surgery experienced rebleeding, as did 4 of 9 patients (44.4%) with conservative treatment. However, patients who underwent bypass surgery had a lower chance of rebleeding. No significant difference in chance of rebleeding was observed between bypass surgery and non surgery groups (p > 0.05). Cerebral angiography performed after bypass surgery showed that for achieving good postoperative revascularization, direct and combined bypass methods were much more effective (p < 0.05). While the risk of rebleeding in the revascularization group was generally lower than in the conservative treatment group, there was no statistically significant difference between treatment modalities and conservative treatment. Although statistical significance was not attained, direct and combined bypass may reduce the risk of hemorrhage more effectively than indirect bypass.
authors.affiliation: Department of Neurosurgery, Uijeongbu St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Uijongbu, Korea.
authors.forename: Won-Seo
authors.initials: WS
authors.lastname: Choi
authors.forename: Sang-Bok
authors.initials: SB
authors.lastname: Lee
authors.forename: Dal-Soo
authors.initials: DS
authors.lastname: Kim
authors.forename: Pil-Woo
authors.initials: PW
authors.lastname: Huh
authors.forename: Do-Sung
authors.initials: DS
authors.lastname: Yoo
authors.forename: Tae-Gyu
authors.initials: TG
authors.lastname: Lee
authors.forename: Kyoung-Suok
authors.initials: KS
authors.lastname: Cho
keywords: Hemorrhagic moyamoya disease; Intracranial hemorrhage; Revascularization surgery; Surgical results