To demonstrate the prevalence of cerebral hypoperfusion without focal cerebral lesions in patients with Moyamoya disease (MMD), and the relationship between areas of hypoperfusion and cognitive impairment.
Twenty-six MMD patients were included. Patients were categorized according to the presence/absence of hypoperfusion in the frontal, parietal, temporal, and occipital lobes on brain single-photon-emission computed tomography (SPECT) after acetazolamide challenge. Computerized neuropsychological test (CNT) results were compared between groups.
Only 3 patients showed normal cerebral perfusion. Baseline characteristics were similar between groups. Patients with frontal lobe hypoperfusion showed lower scores in visual continuous performance test (CPT), auditory CPT, forward digit span test, backward digit span test, verbal learning test, and trail-making test. Patients with parietal lobe hypoperfusion showed lower backward digit span test, visual learning test, and trail-making test scores. Related to temporal and occipital lobes, there were no significant differences in CNT results between the hypoperfusion and normal groups.
MMD patients without focal cerebral lesion frequently exhibit cerebral hypoperfusion. MMD patients with frontal and parietal hypoperfusion had abnormal CNT profiles, similar to those with frontal and parietal lesions. It is suggested that the hypoperfusion territory on brain SPECT without focal lesion may affect the characteristics of neurocognitive dysfunction in MMD patients.
Citations
Objective: We documented childhood strokes in this hospital to ascertain the causes of childhood strokes and the proportion of stroke types.
Method: We reviewed the medical records and brain imaging studies of all children with possible strokes who were admitted to Asan Medical Center from 1990 to 1999. Our review of charts identified 131 acute childhood stroke patients aged from one to eighteen years old. Results: Seventy boys (53.4%) and 61 girls (46.6%) were involved in this study. The predominant diagnoses responsible for the stroke were arteriovenous malformation (42.0%) and moyamoya disease (24.4%). The diagnoses of 30 stroke patients (22.9%) were undetermined, 16 of them were ischemic and 14 hemorrhagic. The total number of hemorrhagic stroke was almost twice as that of ischemic stroke. As patients aged, the incidence of ischemic stroke decreased while the opposite trend was observed in hemorrhagic stroke. There were 14 death (10.7%) consisting of 13 hemorrhagic stroke patients and 1 ischemic during the admission period. Relapse of stroke were noted in 19 of 131 patients (14.5%) with the main cause being arteriovenous malformation.
Conclusion: Although the main diagnoses of childhood strokes were arteriovenous malformation and moyamoya disease, the cause of strokes in 23% could not be confirmed. The incidence of ischemia decreased while that of hemorrhage increased with the increase in age. Death, relapse, and complication occurred more frequently in hemorrhagic than ischemic stroke.
First
Prev
