Journal article
Cerebral hemodynamics as a predictor of stroke in adult patients with moyamoya disease: a prospective observational study
Neurosurgical focus, Vol.26(4), pp.E6-E6
04/2009
DOI: 10.3171/2009.01.FOCUS08305
PMCID: PMC2747517
PMID: 19335132
Abstract
Moyamoya disease is an obliterative vasculopathy of the large arteries at the base of the brain. In the US, it most commonly affects women in their 3rd and 4th decades of life, frequently causing ischemic stroke. The natural history of this disorder is not well described. It is very likely that hemodynamic factors play an important role in the risk of future stroke, as has been established in atherosclerotic carotid occlusive disease.
The authors describe an ongoing, prospective observational study designed to test the hypothesis that increased oxygen extraction in the cerebral hemisphere beyond the occlusive lesion is a predictor of subsequent risk of ipsilateral stroke in medically treated patients with moyamoya phenomenon. On enrollment, all patients undergo regional measurements of cerebral oxygen extraction fraction (OEF) with PET. Information on baseline clinical, laboratory, epidemiological, and angiographic risk factors are obtained at the time of the PET study. Decisions regarding surgery are made by the treating physicians based on clinical information while being blinded to PET data. Patients undergo follow-up at 6-month intervals to determine the subsequent risk of ipsilateral stroke. All patients will return at 1 and 3 years for repeat PET studies. Secondary, exploratory, aims of this longitudinal and blinded study are to determine other predictive factors for stroke in this population; to determine preliminary estimates of the effects of different medical treatment regimens in this population; to determine the temporal changes in hemodynamic impairment in medically treated patients; to determine the effects of surgery on hemodynamic impairment in the subset of patients who undergo surgical revascularization; and to obtain estimates of surgical complication rates for patients with and without hemodynamic impairment.
Details
- Title: Subtitle
- Cerebral hemodynamics as a predictor of stroke in adult patients with moyamoya disease: a prospective observational study
- Creators
- Gregory J Zipfel - Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MissouriJames Sagar - Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MissouriJ Phillip Miller - Division of Biostatistics, Washington University School of Medicine, St. Louis, MissouriTom O Videen - Department of Neurology, Washington University School of Medicine, St. Louis, MissouriRobert L Grubb - Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MissouriRalph G Dacey - Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MissouriColin P Derdeyn - Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri
- Resource Type
- Journal article
- Publication Details
- Neurosurgical focus, Vol.26(4), pp.E6-E6
- DOI
- 10.3171/2009.01.FOCUS08305
- PMID
- 19335132
- PMCID
- PMC2747517
- ISSN
- 1092-0684
- eISSN
- 1092-0684
- Language
- English
- Date published
- 04/2009
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984018210202771
Metrics
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