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Surgical Outcomes and Predictors of Stroke in a North American White and African American Moyamoya Population

التفاصيل البيبلوغرافية
العنوان: Surgical Outcomes and Predictors of Stroke in a North American White and African American Moyamoya Population
المؤلفون: Grant W. Mallory, Nicholas M. Wetjen, Ricardo A. Hanel, Fredric B. Meyer, Macaulay Nwojo, Philipp Taussky, Regina S. Bower, Thais C. Varzoni
المصدر: Neurosurgery. 73:984-992
بيانات النشر: Ovid Technologies (Wolters Kluwer Health), 2013.
سنة النشر: 2013
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Population, Revascularization, White People, Brain Ischemia, Young Adult, Postoperative Complications, Risk Factors, Internal medicine, Humans, Medicine, Moyamoya disease, Young adult, education, Stroke, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, Cerebral Revascularization, business.industry, Thyroid disease, Retrospective cohort study, Middle Aged, Prognosis, medicine.disease, Surgery, Black or African American, Cohort, Female, Neurology (clinical), Moyamoya Disease, business
الوصف: BACKGROUND: The majority of moyamoya surgical series have been confined to Asian and pediatric populations. Few have studied demographics, risk factors, and outcomes in adult North American populations. OBJECTIVE: To examine outcomes after revascularization for moyamoya in white and African American adults and to assess for predictors of recurrent stroke. METHODS: A retrospective review of 75 non-Asian patients undergoing 110 procedures at the Mayo Clinic was performed. Demographics, known moyamoya associations, cerebrovascular risk factors, and autoimmune diseases were recorded. Primary outcomes for vascular events were assessed with Kaplan-Meier analysis. Fisher exact methods were used to evaluate for associations with recurrent events. RESULTS: Mean age was 42 years, and mean follow-up was 47 months. Seventy-one of the 75 patients were white. The majority had bilateral disease (n = 49). Perioperative ischemic events occurred in 5 patients (4.5%). The 5- and 10-year event rates were 5.8% and 9.9%. Significant associations were found with a history of thyroid disease (P = .05) and recurrent stroke. A trend was also found between hypertension and autoimmune disease with recurrent stroke. CONCLUSION: Outcomes were favorable with revascularization in this subset with moyamoya. A significant association between a history of thyroid disease and recurrent stroke was found. Additionally, high prevalences of autoimmune disease, hypertension, and thyroid disease were found in our cohort, suggesting that they may play a role in the pathophysiology and progression of moyamoya disease in this population. A new classification for moyamoya is proposed based on these data.
تدمد: 0148-396X
DOI: 10.1227/neu.0000000000000162
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e0dca119ebc1fb5d27ed87473c2a720b
https://doi.org/10.1227/neu.0000000000000162
رقم الانضمام: edsair.doi.dedup.....e0dca119ebc1fb5d27ed87473c2a720b
قاعدة البيانات: OpenAIRE
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