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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is an unusual vascular network at the base of the brain in patients with moyamoya disease. We detected various histologic lesions in the perforating arteries of 22 patients. Vessels showing rupture ranged from 50 to 530 microns in diameter; they were dilated, some had fibrin deposits in the wall, fragmented elastic laminae and attenuated media. Non-ruptured perforating arteries (diameter 200 to 550 microns) revealed microaneurysm formation, focal fibrin deposits and marked attenuation of the wall thickness with diminution of the elastic lamina. These changes seem to predispose to rupture of perforating arteries. Stenotic changes such as fibrous intimal thickening, collapse of the lumen and thrombosis were detected in 14 out of 22 cases. Morphometric analysis of perforating arteries indicated that arteries showing extreme degrees of stenosis or dilatation were more frequent in the patients with moyamoya disease than in the control cases. Dilative arteries were more frequent in the young patients and stenotic vessels were, in contrast, less frequent in the young patients.
Stroke
PMID:Histopathology of the brain vascular network in moyamoya disease. 682 86

A 17-year-old boy with type I glycogen storage disease (GSD-I) and a stroke associated with moyamoya disease is described. This is the first report of this association, and only the second reported case of cerebrovascular disease in patients with GSD-I. The relationship of the primary metabolic error and the vascular injury is explored. This represents yet another disorder associated with moyamoya disease, which is considered to be a secondary phenomenon of vascular occlusion that occurs under a specific set of circumstances in a susceptible age group.
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PMID:Moyamoya disease in a patient with type I glycogenosis. 693 75

Cerebrovascular disease (CBVD) is very common in the People's Republic of China (PRC). In 8 of 12 large cities in the PRC, CBVD ranked first in frequency as a cause of death. The ratio fo aneurysms to arteriovenous malformations (AVMs) was 0.84-2:1, much lower than in the United States (6.5:1). Hypertensive intracerebral hemorrhage (HIH) is the commonest cause of mortality in patients with CBVD; patients with ischemic stroke have been submitted to the extracranial-intracranial (EC-IC) arterial anastomosis since 1976. Moyamoya syndrome is not uncommon in the PRC; leptospiral arteritis was one of the major causes in the series that have been reported.
Stroke
PMID:A review of cerebrovascular surgery in the People's Republic of China. 706 97

Sickle cell (drepanocytic) anemia is a hereditary blood disease occurring very rarely in Mexico. A 13-year-old Mexican boy with sickle cell anemia eventually died of a cerebrovascular accident of the brain stem, as shown by computerized tomography (CT). A characteristic moyamoya-like angiographic pattern was demonstrated on bilateral carotid and left vertebral arteriograms. Moyamoya disease has no known etiology, but the characteristic angiographic features of moyamoya have been observed in conjunction with some other disease of known origin (including sickle cell anemia). It is therefore my belief that these latter cases should be referred to as pseudomoyamoya and not true moyamoya.
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PMID:Pseudomoyamoya in sickle cell anemia. 716 62

Progressive vascular changes are described in an adult with moyamoya syndrome and similar cases are reviewed. Angiographic findings support the concept of a progressive acquired stenosis of the internal carotid artery as the primary abnormality in this syndrome.
Stroke
PMID:Progressive vascular changes in Moyamoya syndrome. 721 74

A 41-year-old Libyan woman with Moyamoya disease and persisting post-stroke neurological deficits was treated by a superficial temporal-middle cerebral artery (STA-MCA) anastomosis. The postoperative angiograms revealed that the STA was rapidly irrigating the territory of the middle cerebral artery including those regions that had been filled preoperatively via different networks of collaterals. Furthermore prompt venous drainage was seen to occur postoperatively. Following surgery EEG analyses revealed considerable increase in the electrical brain activity, and neurological examinations showed reversal of neurological deficits. The dependence of the postoperative neurological improvement on the increased cerebral blood supply through the new collateral channel could be demonstrated by the effect of temporary occlusion of the STA on the electrical brain activity.
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PMID:Superficial temporal-middle cerebral artery anastomosis in Moyamoya disease. 737 42

The surgical management of adult moyamoya disease was evaluated retrospectively. Eight of 10 patients with hemorrhagic stroke had no bleeding episodes and eight of 11 patients with ischemic stroke were asymptomatic postoperatively. Angiography demonstrated neovascularization via the external carotid artery (ECA) in 22 sites (88%) and reduced basal moyamoya vessels in 11 sites (44%) postoperatively. These symptomatic improvements and angiographic findings suggest that reconstructive surgery for adult moyamoya disease patients with hemorrhagic or ischemic stroke is effective in decreasing hemodynamic stress in the basal moyamoya vessels and increasing the cortical blood supply via the ECA.
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PMID:Management of adult moyamoya disease. 768 36

From January 1978 to December 1993, 73 patients with moyamoya disease were collected from seven neurological centers in Taiwan. The annual incidence of this disease in Taiwan is 0.024 per 100,000 population. There were 33 males and 40 females. The ages ranged from 2 to 62 years with a peak incidence in the 31 to 40 year age group (18 cases). Cerebral infarction occurred in 16 out of 19 juvenile patients (84.2%); by contrast, only 19 out of 54 adult patients (35.2%) presented with infarction. Hemorrhagic strokes were more frequent in adult patients. Computed tomographic scans following stroke showed cerebral infarction in 35 cases, ventricular hemorrhage in 21 cases, intracerebral hemorrhage in 11 cases and pure subarachnoidal hemorrhage in 6 cases. The most frequent initial symptom was motor disturbance (58.9%), followed by headaches (49.3%), and impaired consciousness (34.2%). Compared with reports from Japan, this survey showed a lower incidence of moyamoya disease in Taiwan.
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PMID:[Moyamoya disease in Taiwan]. 771 66

A 28-year-old woman presented with a clinical picture of hyperthyroidism, goiter, ophthalmopathy, and an ensuing ischemic stroke. Cerebral angiography demonstrated moyamoya vessels around the Willis's circle and tubular stenosis of the bilateral extracranial internal carotid arteries. The combination of the above angiographic abnormalities occurring in a patient with Graves' disease is extremely rare. A pathogenic link between Graves' disease and certain specific vascular disorders is suspected.
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PMID:A case of Graves' diseases associated with intracranial moyamoya vessels and tubular stenosis of extracranial internal carotid arteries. 773 12

Presented are the results of an extensive noninvasive assessment of supraclinoid internal carotid artery (ICA) stenosis with moyamoya-like vasculopathy in 3 patients with a history of stroke. Five noninvasive criteria for the diagnosis based on magnetic resonance imaging of the brain, and hemodynamic testing using ocular pneumoplethysmography, duplex carotid ultrasound, and transcranial Doppler sonography were established: (1) normal ocular pneumoplethysmography demonstrating no pressure significant stenosis to the level of the ophthalmic artery; (2) abnormal Doppler spectral waveforms showing either no flow or a high-resistance flow pattern for the ipsilateral cervical internal carotid artery; (3) paradoxically low flow velocities for the ipsilateral intracranial (ICA) and middle cerebral artery (MCA), and markedly abnormal high velocities for the contralateral ICA and MCA; (4) decreased ipsilateral MCA vasomotor reactivity; and (5) deep MCA territory ipsilateral subcortical watershed infarction evidenced by magnetic resonance imaging. This report demonstrates that a noninvasive battery of tests may be useful in the early diagnosis and treatment of these patients.
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PMID:Unilateral supraclinoid internal carotid artery stenosis with moyamoya-like vasculopathy. Noninvasive assessments. 813 74


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