| Clinical Observation on Moyamoya Disease in Childhood. |
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Se Hee Hwang, Jae Il Sohn, Yong Seung Hwang |
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Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea |
| Moyamoya병에 관한 소아연령에서의 임상적 고찰 |
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황세희, 손재일, 황용승 |
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서울대학교 의과대학 소아과학교실 |
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Received: 26 September 1989 • Accepted: 9 November 1989 |
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| Abstract |
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Although the etiology and treatment of moyamoya disease are unknown, the surgical correction is
expected as a good treatment method. But its effectiveness is not confirmed until now. A clinical
study was performed on 21 patients of moyamoya disease in childhood who admitted to the
Pediatric and Neurosurgical department of SNUCH from Jan. 1980 till July 1989.
The results were as follows:
1) The ratio of male to female was 1.6:1. Thirteen patients were male, 8 patients female. The mean
age on admission was 5 years old.
2) We classified the past medical hisotry into two groups, previosuly healthy group (57%) and
abnormal past history group (43%)-such as seizure, etc.
3) Chief complaints on admission were cerebral ischemic symptoms, which revealed motor weak-
ness in 20 paitents (95%), bulbar symptoms in 10 patients (48%), hemiplegia in 2 patients (95%), loss
of consciousness in 2 patients (95%) and seizure in 1 patient (4.8%).
4) The frequency of iscemic attack was recurrent in 15 patients (75%), the other 6 patients (25%)
had one or two ischemic attacks on admission.
5) Provoking factors of the ischemic attacks were identified in 12 patients (75%). The characteris-
tic provoking factors are eating hot food, being excited, crying and psychological stress such as
quarrel.
6) All cases showed the characteristic angiographic findings of moyamoya disease. Seventeen cases
(18%) were of bilateral carotid artery involvement, and 4 cases (19%) were of unilateral involvement.
And there were 5 cases (24%) of posterior cerebral artery involvement.
7) All cases of CT scan showed cerebral infarction and 2 cases were combined with brain atr-
ophy and 1 case combined with hydrocephalus.
8) EEG was checked in 14 patients and 13 patients had abnormal findings, which were focal
slowing (47%, 8 cases), asymmetry (21%, 3 cases), focal epileptiform (21%, 3 cases), diffuse slowing
(9.5%, 2 cases).
9) MRI was checked in 8 patients, and all of them showed major vessel obstruction and collateral
vessels. Besides, there were 6(75%) cases of cerebral infarction and 2(27%) cases of brain atrophy.
10) SPECT was perfromed in 6 patients, and all of them showed perfusion defect in the area of
infarction.
11) Cerebral blood flow was measured in 4 patients, which showed decreased cerebral blood flow in
the infarcted area.
12) The newly developed surgical therapy of EDAS(encephalo-duro-arterio-synangfiosis) has been
performed in 4 patients. The result of the surgical treatment should be evaluated after the further
follow-up period. |
| Key Words:
Moyamoya disease |
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