Objectives

The anterior choroidal artery (AchA) is one of the collateral vessels in moyamoya disease (MMD). The incidence of cerebral ischemia in MMD was analyzed through the association between development of the AchA and advancement of MMD stage.

Materials and Methods

Twelve patients of MMD with cerebral ischemia (infarction; 9 patients, transient ischemic attack; 3 patients) were enrolled. Advancement of MMD was evaluated using Suzuki's stage. The grades in Suzuki's stage were subclassified into a non-progressive stage for grades 1 and 2, and a progressive stage for grades 4 and 5. Dilatation of the AchA was judged as the presence of development of this artery. Development of the AchA was grouped into proximal type and proximal and distal type.

Results

Most frequent locations of infarcts were the anterior and parietal lobes in 6 patients each. Development of the AchA was confirmed on the ischemic side in all patients and on the non-ischemic side in 9 patients. Development of the AchA in the progressive stage was limited in the proximal and distal type on both sides. Development of the AchA in the non-progressive stage was the proximal type on the ischemic side.

Conclusions

The cause of cerebral ischemia was possibly associated with inadequate blood supply of the AchA in the non-progressive stage, and the lower blood flow from the internal carotid artery (ICA) in the progressive stage. Disparity between collateral blood flow from the AchA and the blood flow from the ICA was considered to relate to incidence of cerebral ischemia in MMD.

中文翻译：

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从脉络膜前动脉发育看烟雾病脑缺血的临床研究

目标

脉络膜前动脉 (AchA) 是烟雾病 (MMD) 的侧支血管之一。通过AchA发展与MMD分期进展之间的关系分析MMD脑缺血的发生率。

材料和方法

12 名患有脑缺血的 MMD 患者（梗塞；9 名患者，短暂性脑缺血发作；3 名患者）入组。使用 Suzuki 的阶段评估 MMD 的进展。Suzuki 阶段的等级被细分为 1 级和 2 级的非进行性阶段，以及 4 和 5 级的进行性阶段。AchA 的扩张被判断为该动脉发育的存在。AchA的发展分为近端型和近端和远端型。

结果

最常见的梗塞部位是前叶和顶叶，各有 6 名患者。在所有患者的缺血侧和 9 名患者的非缺血侧证实了 AchA 的发展。进展期 AchA 的发展受限于两侧近端和远端型。非进展期 AchA 的发展是缺血侧的近端型。

结论

脑缺血的原因可能与非进展期AchA供血不足，进展期颈内动脉（ICA）血流减少有关。来自 AchA 的侧支血流和来自 ICA 的血流之间的差异被认为与 MMD 中脑缺血的发生率有关。