Stroke and neurological outcomes in the early phase following revascularization for moyamoya disease (MMD) may depend on the patient’s age. In this study, an age-stratified comparative analysis was performed to clarify this issue. We reviewed 105 MMD patients who underwent 179 revascularization surgeries. The demographic characteristics were collected in four age groups (≤ 5 and 6–17 years for pediatric patients and 18–49 and ≥ 50 years for adults). Additionally, we assessed the incidence of subsequent stroke and deterioration of modified Rankin Scale (mRS) score. Then, we evaluated predictors of postoperative stroke and mRS deterioration using logistic regression. The mean patient age was 26.2 ± 18.5 years. No significant difference in the incidence of postoperative stroke was observed between age groups; however, the incidence tended to be increased among patients aged ≤ 5 years (17.9%) and patients aged ≥ 50 years (16.7%). Deterioration of mRS scores was significantly associated with ages ≤ 5 years (17.9%) and ≥ 50 years (11.1%). Logistic regression showed that posterior cerebral artery involvement (odds ratio [OR], 4.6) and postoperative transient neurological events (TNEs) (OR, 5.93) were risk factors for postoperative stroke. Age ≤ 5 years (OR, 9.73), postoperative TNEs (OR, 7.38), and postoperative stroke (OR, 49) were identified as predictors of unfavorable neurological outcomes. The novel feature of this comparative analysis by age group is that membership in the early-childhood MMD patient group (under 5 years old) was an independent risk factor for unfavorable short-term neurological outcomes and was mainly associated with the incidence of postoperative severe cerebral infarction.

烟雾病 (MMD) 血运重建后早期的中风和神经系统结果可能取决于患者的年龄。在这项研究中，进行了年龄分层比较分析以澄清这个问题。我们回顾了 105 名接受了 179 次血运重建手术的 MMD 患者。在四个年龄组（儿童患者≤ 5 和6-17 岁，成人18-49 和≥ 50 岁）收集人口统计学特征。此外，我们评估了后续卒中的发生率和改良 Rankin 量表 (mRS) 评分的恶化。然后，我们使用逻辑回归评估了术后卒中和 mRS 恶化的预测因素。平均患者年龄为 26.2 ± 18.5 岁。不同年龄组的术后卒中发生率无显着差异；然而，≤5岁（17.9%）和≥50岁（16.7%）患者的发病率有升高趋势。mRS 评分的恶化与年龄≤ 5 岁（17.9%）和≥ 50 岁（11.1%）显着相关。Logistic 回归显示大脑后动脉受累（比值比 [OR]，4.6）和术后短暂性神经系统事件（TNEs）（OR，5.93）是术后卒中的危险因素。年龄 ≤ 5 岁 (OR, 9.73)、术后 TNEs (OR, 7.38) 和术后卒中 (OR, 49) 被确定为不利神经学结果的预测因子。