Background and Purpose: Cerebral microbleeds (CMB) are reported to be frequent in moyamoya disease (MMD) and moyamoya syndrome (MMS) in the Asian population. It is associated with an increased risk of intracerebral hemorrhage. The significance of CMB in MMD/MMS in non-Asian populations has not been well established. Our study aimed to investigate the prevalence of CMB in MMD/MMS in a moymoya cohort with a majority of non-Asians and to identify risk factors for developing a CMB and its predictive value for subsequent vascular events. Methods: The moyamoya database was compiled by screening for MMD/MMS among patients admitted to the Zale-Lipshy University Hospital at the University of Texas Southwestern Medical Center. We identified and analyzed data of 67 patients with MMD or MMS. Patients were characterized as CMB+ or CMB– based on MRI findings. In CMB+ patients, the total number and location of CMB were identified. Univariate and multivariate logistic regression were used to identify risk factors for developing CMB and whether CMB are associated with the development of subsequent vascular events. Results: Out of a total of 67 patients, 11 (16%) had CMB. Males had significantly higher odds of having CMB as compared to females (OR 1.76; 95% CI 1.40–24.3, p = 0.021). The incidence of CMB was also associated with age at diagnosis (mean age of CMB+ patients vs. CMB– patients: 44 vs. 34 years, respectively, p = 0.024), smoking (p = 0.006), and hemorrhagic stroke at presentation (p = 0.034). Logistic regression with multivariate analysis found that gender and age at diagnosis remained statistically significant. New ischemic events occurred in 2 (20%) out of 10 CMB+ patients and 13 (23%) out of 55 CMB– patients, respectively (p = 0.79). While 2 (3%) CMB– patients had a new cerebral hemorrhage during follow-up, none of the CMB+ patients did. Conclusions: CMB are less prevalent in MMD/MMS in the USA than in Asia. An older age at diagnosis and male gender were associated with CMB. The presence of CMB was not associated with an increased risk of a subsequent ischemic or hemorrhagic stroke.
Cerebrovasc Dis Extra 2019;9:139–147

中文翻译：

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美国人群Moyamoya病和综合征中脑微出血的患病率和危险因素

背景与目的：据报道在亚洲人群的烟雾病（MMD）和烟雾病综合征（MMS）中脑微出血（CMB）频繁发生。它与脑出血的风险增加有关。在非亚洲人群中，CMB在MMD / MMS中的重要性尚未得到很好的确定。我们的研究旨在调查与大多数非亚洲人同居的Momomoya人群中CMB在MMD / MMS中的患病率，并确定发展CMB的危险因素及其对随后血管事件的预测价值。方法：通过筛选德克萨斯州西南医学中心Zale-Lipphy大学医院住院患者的MMD / MMS来收集moyamoya数据库。我们确定并分析了67名MMD或MMS患者的数据。根据MRI表现将患者定性为CMB +或CMB-。在CMB +患者中，确定了CMB的总数和位置。单因素和多因素logistic回归用于确定发生CMB的危险因素以及CMB是否与后续血管事件的发展相关。结果：在总共67位患者中，有11位（16％）患有CMB。与女性相比，男性患CMB的几率明显更高（OR 1.76； 95％CI 1.40–24.3，p= 0.021）。CMB的发生率还与诊断时的年龄相关（CMB +患者与CMB–患者的平均年龄：分别为44岁与34岁，p = 0.024），吸烟（p = 0.006）和就诊时出血性中风（p = 0.034）。采用多因素分析的逻辑回归分析发现，诊断时的性别和年龄仍具有统计学意义。10例CMB +患者中有2例（20％）发生了新的缺血事件，55例CMB–患者中13例（23％）发生了新事件（p = 0.79）。尽管有2名（3％）CMB–患者在随访期间出现了新的脑出血，但CMB +患者均没有。结论：CMB在美国的MMD / MMS中的流行程度低于亚洲。诊断时年龄较大和男性与CMB有关。CMB的存在与随后的缺血性或出血性中风的风险增加无关。
Cerebrovasc Dis Extra 2019; 9：139–147