This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mugikura, S. Articles by Yamada, S. Search for Related Content PubMed PubMed Citation Articles by Mugikura, S. Articles by Yamada, S. Related Collections Imaging Brain Circulation and Metabolism Angiography Stroke in Children and the Young Other Stroke

(Stroke. 2002;33:1497.)
© 2002 American Heart Association, Inc.

Original Contributions

Predominant Involvement of Ipsilateral Anterior and Posterior Circulations in Moyamoya Disease

Shunji Mugikura, MD, PhD; Shoki Takahashi, MD, PhD; Shuichi Higano, MD, PhD; Reizo Shirane, MD, PhD; Yoshiharu Sakurai, MD, PhD Shogo Yamada, MD, PhD

From the Departments of Diagnostic Radiology (S.M., S.T., S.H.), Neurosurgery (R.S.), and Radiation Oncology (S.Y.), Tohoku University School of Medicine, and Department of Neurosurgery (Y.S.), Stroke Center, Sendai National Hospital, Sendai, Japan.

Correspondence to Shunji Mugikura, MD, Department of Diagnostic Radiology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. E-mail mugi777{at}ma.mni.ne.jp

Background and Purpose— We encountered several patients with childhood onset of moyamoya disease in whom the ipsilateral anterior and posterior circulations were predominantly involved. This study investigated whether this is an angiographic characteristic of this disease.

Methods— We evaluated steno-occlusive lesions on angiograms of 85 patients with pediatric onset of moyamoya disease, using two 4-stage angiographic classification scales for the internal carotid artery and posterior cerebral artery systems (ICA and PCA staging, respectively) and determined whether lesions with more advanced ICA and PCA stages were on ipsilateral sides.

Results— When positive laterality was defined as the presence of a difference by 1 stage between the stages on both sides, lateralities in the ICA stages and in the PCA stages were present in 40 (47%) and 27 patients (32%), respectively. Lesions with more advanced ICA and PCA stages were on the same side, with significant probability (P=0.024, Fisher’s exact test). Lateralities in both ICA and PCA lesions were found in 17 patients. In 14 (82%) of the 17 patients, the more advanced side of ICA lesions was the same as that of PCA lesions, while it was contralateral in 3 patients (18%).

Conclusions— In pediatric-onset moyamoya disease, asymmetrical involvement of bilateral ICAs and PCAs was common, and the ipsilateral ICA and PCA tended to be predominantly involved.

Key Words: angiography • cerebrovascular disorders • child • moyamoya disease

This article has been cited by other articles:

				N. Mori, S. Mugikura, S. Higano, T. Kaneta, M. Fujimura, A. Umetsu, T. Murata, and S. Takahashi The Leptomeningeal "Ivy Sign" on Fluid-Attenuated Inversion Recovery MR Imaging in Moyamoya Disease: A Sign of Decreased Cerebral Vascular Reserve? AJNR Am. J. Neuroradiol., May 1, 2009; 30(5): 930 - 935. [Abstract] [Full Text] [PDF]