Objectives

To explore clinical features and compare of the difference between conservative treatment and surgical treatmentin prognosis of intracranial aneurysms associated with moyamoya disease (MMD).

Methods

104 patients with MMD a ssociated with intracranial aneurysms diagnosed by digital subtraction angiography (DSA) or computed tomography angiography (CTA) were retrospectively analyzed.

Results

All patients of MMD with intracranial aneurysms had 129 aneurysms distributed at different sites. The distribution of the aneurysms was as follows: 28(21.71%) anterior communicating artery aneurysms, 21(16.28%) basilar artery aneurysms, 19(14.73%) middle cerebral artery aneurysms, 17(13.18%) posterior cerebral artery aneurysms, 12(9.30%)internal carotid artery aneurysms, 11(8.53%) posterior communicating artery aneurysms, 10(7.75%) anterior cerebral artery aneurysms, 5(3.88%) anterior choroidal artery aneurysms, 2(1.55%) moyamoya vessel aneurysms, and 4(3.1%) other location aneurysms. 82 cases (78.85%) had one aneurysm, and 21 cases (20.19%) had 2 or more aneurysms. 64 cases were treated surgically, and 40 cases were treated conservatively. 57 of 81 cases (70.37%) had a good outcome, 2 cases (2.47%) were in paralyzed, and 22 cases were died. The mortality rate was (27.16%). Death occurred in 16 (47.06%) of 34 patients with conservative treatment, and 6(12.77%) of 47 patients with surgical treatment. 7 cases (8.64%) had twice cerebral hemorrhage, and one case (1.23%) had third cerebral hemorrhage in the follow-up period. There were 5 deaths, two good outcomes, and one coma among 8 cases experienced re-hemorrhage.

Conclusion

Compared with conservative treatment, positive surgical treatment showed clinical significance for preventing cerebral hemorrhage and reducing mortality of MMD with intracranial aneurysms.

Abbreviations

MMD: moyamoya disease; DSA: digital subtraction angiography; CTA: computed tomography angiography

中文翻译：

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烟雾病与颅内动脉瘤相关的临床特征和预后分析。

目标

探讨伴有烟雾病（MMD）的颅内动脉瘤的临床特点，并比较保守治疗与手术治疗之间的差异。

方法

回顾性分析了104例MMD患者并发数字减影血管造影（DSA）或计算机断层摄影血管造影（CTA）诊断的颅内动脉瘤。

结果

所有MMD颅内动脉瘤患者的129个动脉瘤分布在不同部位。动脉瘤分布如下：前交通动脉瘤28（21.71％），基底动脉瘤21（16.28％），大脑中动脉瘤19（14.73％），大脑后动脉瘤17（13.18％），12（ 9.30％）颈内动脉瘤，11（8.53％）后交通动脉瘤，10（7.75％）前脑动脉瘤，5（3.88％）前脉络膜动脉瘤，2（1.55％）烟雾弥漫性血管瘤和4（ 3.1％）其他位置的动脉瘤。82例（78.85％）有一个动脉瘤，21例（20.19％）有2个或更多动脉瘤。手术治疗64例，保守治疗40例。81例中的57例（70.37％）有良好的预后，2例（2.47％）瘫痪，22例死亡。死亡率为（27.16％）。保守治疗的34例患者中有16例（47.06％）死亡，手术治疗的47例中6例（12.77％）死亡。随访期间有两次脑出血的病例为7例（8.64％），第三次脑出血的病例为一例（1.23％）。再次出血的8例中有5例死亡，2例好转和1例昏迷。

结论

与保守治疗相比，积极的手术治疗对预防脑出血和降低颅内动脉瘤MMD的死亡率具有临床意义。

缩略语

MMD：烟雾病；DSA：数字减影血管造影；CTA：计算机断层扫描血管造影