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The different infarct patterns between adulthood-onset and childhood-onset moyamoya disease

 H J Cho  ;  Y H Jung  ;  Y D Kim  ;  H S Nam  ;  D S Kim  ;  J H Heo 
 Journal of Neurology, Neurosurgery and Psychiatry, Vol.82(1) : 38-40, 2011 
Journal Title
 Journal of Neurology, Neurosurgery and Psychiatry 
Issue Date
Adult ; Age of Onset ; Brain/pathology ; Brain Ischemia/pathology ; Cerebral Angiography ; Cerebral Infarction/diagnostic imaging ; Cerebral Infarction/etiology ; Cerebral Infarction/pathology* ; Child ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Angiography ; Male ; Moyamoya Disease/complications ; Moyamoya Disease/diagnostic imaging ; Moyamoya Disease/pathology* ; Tomography, Emission-Computed, Single-Photon
BACKGROUND AND PURPOSE: The pattern of infarctions based on the findings of diffusion-weighted image was assessed, and it was also investigated whether there are any age-specific differences in patients with moyamoya disease (MMD). METHODS: The subjects were 66 consecutive patients with MMD who had an acute cerebral infarction. Each ischaemic lesion was categorised into one of seven patterns (gyral, atypical territorial, honeycomb, classic territorial, multiple-dot, borderzone, deep lacunar) based on diffusion-weighted image findings. The patterns were compared between adulthood-onset MMD (A-MMD, ≥20 years old, 34 patients) and childhood/adolescent-onset MMD (C-MMD, <20 years old, 32 patients) according to their ages of infarct presentation. RESULTS: A total of 91 infarct patterns were observed from 66 patients. The gyral, atypical territorial, and honeycomb patterns, which are not usually seen in conventional stroke patients, were common in MMD (68.1%). Among all patterns, a gyral pattern was most common (40/91, 44.0%). Borderzone and deep lacunar patterns were infrequent. Gyral and borderzone patterns were more frequently seen in the C-MMD group, whereas a honeycomb pattern was not seen in young patients. Honeycomb pattern was more common at advanced vascular stages. Infarctions confined to the cortex were more common in the C-MMD group (26/32, 75.0%) than in A-MMD patients (14/34, 41.2%). CONCLUSIONS: Moyamoya disease showed various characteristic and age-specific infarct patterns. Different infarct patterns between the A-MMD and C-MMD groups may be associated with age-specific vulnerability of the brain to ischaemia, stage of arteriopathy or changes of abnormal collateral pathways.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Jung, Yo Han(정요한)
Cho, Hyun Ji(조현지)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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