title: Histopathological Characteristics of Distal Middle Cerebral Artery in Adult and Pediatric Patients with Moyamoya Disease.
abstract: Moyamoya disease (MMD) is a unique progressive steno-occlusive disease of the distal ends of bilateral internal arteries and their proximal branches. The difference in clinical symptoms between adult and children MMD patients has been well recognized. In this study, we sought to investigate the phenomenon through histopathological study. Fifty-one patients underwent surgical procedures for treatment of standard indications of MMD at Kyoto University Hospital. Fifty-nine specimens of MCA were obtained from MMD patients during the surgical procedures. Five MCA samples were also obtained in the same way from control patients. The samples were analyzed by histopathological methods. In this study, MCA specimens from MMD patients had significantly thinner media and thicker intima than control specimens. In subsequent analysis, adult (≥ 20 years) patients had thicker intima of MCA compared to pediatric (< 20 years) patients. There is no difference in internal elastic lamina pathology between adult and pediatric patients. Our results indicated that the pathological feature of MMD in tunica media occurs in both adult and pediatric patients. However, the MMD feature in tunica intima of MCA is more prominent in adult patients. Further analysis from MCA specimens and other researches are necessary to elucidate the pathophysiology of MMD.
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Yulius
authors.initials: Y
authors.lastname: Hermanto
authors.forename: Jun C
authors.initials: JC
authors.lastname: Takahashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Funaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mineharu
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D009072:Moyamoya Disease / Q000473:pathology* / Q000601:surgery; D017539:Tunica Intima / Q000473:pathology; D055815:Young Adult