Clinical Characteristics and Multi-Model Imaging Analysis of Moyamoya Disease: An Observational Study

Abstract The study was to analyze the clinical features and imaging characteristics of moyamoya disease (MMD) and to explore the significance of multi-model imaging in the diagnosis of MMD. A retrospective analysis of the clinical features, imaging characteristics, and treatment of 78 adult MMD patients enrolled from March 2010 to March 2013 was performed. The MMD patients in our series were between 23 and 53 years old, and the male to female ratio was 4:1. The main clinical manifestations were sensory abnormalities, headache, and motor dysfunction, depending on the type of MMD. Intracerebral hemorrhage (ICH) was detected in 54 patients (69.2％), cerebral infarction in 20 (25.6％), and ICH together with cerebral infarction in 4 (5.1%). Using computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA), stenotic or occlusive lesions were observed in the internal carotid artery, anterior cerebral artery, and middle cerebral artery. Aneurysms accompanying MMD were found in 17 of the patients (21.8％). Ultimately, 21 patients underwent multiple burr-hole surgery and 57 underwent bypass surgery with or without temporalis muscle sticking. Fourteen patients underwent aneurysm embolization. The clinical manifestations of MMD vary, though the most common is ICH. DSA is the gold standard method for the diagnosis of MMD, and should be performed as early as possible in clinically suspected cases. CTA and MRA are non-invasive techniques used for MMD patient screening and follow-up.