2000 Volume 9 Issue 2 Pages 75-80
Interval changes in the diameter of cerebral arteries were studied in 9 cases of Moyamoya disease(4 children, 5 adults)by means of retrospective quantitative measurement of cerebral angiographical films. The initial clinical symptoms were hemorrhage in 3 cases and ischemia in 6 cases. The index of angiographic changes was obtained as follows. The diameters of the anterior cerebral artery(A1), middle cerebral artery(M1), maxillary artery(Max), and superficial temporal artery(STA)were divided by that of the ipsilateral internal carotid artery(ICA). The indices were compared between child-onset cases(COC)and adult-onset cases(AOC), and between ischemic-onset cases(IOC)and hemorrhagic-onset cases(HOC). In the non-operated sides, the diameter indices of the A1 and M1 decreased progressively in IOC, but did not decrease remarkably in HOC. There was no significant difference between COC and AOC. The diameter indices of the STA and Max were decreased in ischemic AOC, but not in ischemic COC. Thus, quantitative analysis using angiography distinctly reveals the natural progression of Moyamoya disease. In the operated sides, the diameter index of the M1 decreased progressively in both COC and AOC, while those of the STA and Max increased remarkably only in COC regardless of ischemic and hemorrhagic onset. This finding demonstrated that indirect revascularization is more effective in COC than in AOC. Consequently, it is useful to take advantage of past angiographical films by quantitavely estimating them during the follow-up of Moyamoya disease and by comparing findings with those of follow-up MRI and MRA.
