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Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia

BACKGROUND: Adult moyamoya disease is rare in the United States, and patients mostly present with cerebral ischemia. However, clinical and neurodiagnostic correlates of ischemia are not well known in this population. We sought to characterize the clinical and radiographic features of moyamoya diseas...

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Autores principales: Zafar, Sahar F., Bershad, Eric M., Gildersleeve, Kasey L., Newmark, Michael E., Calvillo, Eusebia, Suarez, Jose I., Venkatasubba Rao, Chethan P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310411/
https://www.ncbi.nlm.nih.gov/pubmed/25037198
http://dx.doi.org/10.1161/JAHA.114.001123
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author Zafar, Sahar F.
Bershad, Eric M.
Gildersleeve, Kasey L.
Newmark, Michael E.
Calvillo, Eusebia
Suarez, Jose I.
Venkatasubba Rao, Chethan P.
author_facet Zafar, Sahar F.
Bershad, Eric M.
Gildersleeve, Kasey L.
Newmark, Michael E.
Calvillo, Eusebia
Suarez, Jose I.
Venkatasubba Rao, Chethan P.
author_sort Zafar, Sahar F.
collection PubMed
description BACKGROUND: Adult moyamoya disease is rare in the United States, and patients mostly present with cerebral ischemia. However, clinical and neurodiagnostic correlates of ischemia are not well known in this population. We sought to characterize the clinical and radiographic features of moyamoya disease in a large urban center in the United States, with a focus on angiographic and neuroimaging patterns of ischemia. METHODS AND RESULTS: We retrospectively reviewed charts of consecutive adult moyamoya disease patients evaluated at 2 centers in Houston, Texas from January 2002 to December 2011. We reviewed all available cerebral angiograms and neuroimaging studies to evaluate the Suzuki grades, presence of intracranial hemorrhage or ischemia, infarct patterns, and vascular territory distribution. Our analysis was mainly descriptive. We identified 31 adults with moyamoya disease who met our inclusion criteria. The female‐to‐male ratio was 2.4:1. The majority of patients were white, followed by Hispanic, black, and Asian. Most presented with ischemia (61%), followed by headaches, and intracranial hemorrhage. Of the 22 patients with available neuroimaging, 72.7% had ischemic findings, with the vast majority having a watershed pattern (81.3%). CONCLUSIONS: We observed a high burden of ischemia, mostly watershed pattern on neuroimaging in our adult moyamoya disease patients. Long‐term monitoring of adult moyamoya disease patients in the United States would be useful to better understand the natural history of this condition.
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spelling pubmed-43104112015-02-10 Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia Zafar, Sahar F. Bershad, Eric M. Gildersleeve, Kasey L. Newmark, Michael E. Calvillo, Eusebia Suarez, Jose I. Venkatasubba Rao, Chethan P. J Am Heart Assoc Original Research BACKGROUND: Adult moyamoya disease is rare in the United States, and patients mostly present with cerebral ischemia. However, clinical and neurodiagnostic correlates of ischemia are not well known in this population. We sought to characterize the clinical and radiographic features of moyamoya disease in a large urban center in the United States, with a focus on angiographic and neuroimaging patterns of ischemia. METHODS AND RESULTS: We retrospectively reviewed charts of consecutive adult moyamoya disease patients evaluated at 2 centers in Houston, Texas from January 2002 to December 2011. We reviewed all available cerebral angiograms and neuroimaging studies to evaluate the Suzuki grades, presence of intracranial hemorrhage or ischemia, infarct patterns, and vascular territory distribution. Our analysis was mainly descriptive. We identified 31 adults with moyamoya disease who met our inclusion criteria. The female‐to‐male ratio was 2.4:1. The majority of patients were white, followed by Hispanic, black, and Asian. Most presented with ischemia (61%), followed by headaches, and intracranial hemorrhage. Of the 22 patients with available neuroimaging, 72.7% had ischemic findings, with the vast majority having a watershed pattern (81.3%). CONCLUSIONS: We observed a high burden of ischemia, mostly watershed pattern on neuroimaging in our adult moyamoya disease patients. Long‐term monitoring of adult moyamoya disease patients in the United States would be useful to better understand the natural history of this condition. Blackwell Publishing Ltd 2014-07-18 /pmc/articles/PMC4310411/ /pubmed/25037198 http://dx.doi.org/10.1161/JAHA.114.001123 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Zafar, Sahar F.
Bershad, Eric M.
Gildersleeve, Kasey L.
Newmark, Michael E.
Calvillo, Eusebia
Suarez, Jose I.
Venkatasubba Rao, Chethan P.
Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia
title Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia
title_full Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia
title_fullStr Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia
title_full_unstemmed Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia
title_short Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia
title_sort adult moyamoya disease in an urban center in the united states is associated with a high burden of watershed ischemia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310411/
https://www.ncbi.nlm.nih.gov/pubmed/25037198
http://dx.doi.org/10.1161/JAHA.114.001123
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