Relationship between Champagne bottle neck sign and internal carotid artery flow in moyamoya disease

Abstract

Purpose: The aim of this study is to investigate the relationship between Champagne bottle neck sign (CBNS) and the internal carotid artery (ICA) flow. Methods: We investigated 108 patients with moyamoya and akin-moyamoya disease (216 vessels) from January 2001 to December 2013 who received cerebral angiography and carotid ultrasonography. We retrospectively assessed the relationship between CBNS and stage of moyamoya disease, and the presence of the posterior communicating artery (Pcom) by cerebral angiography, pulsatility index (PI) and mean velocity (MV) of the ICA were measured by carotid ultrasonography. Results: Prevalence of the CBNS was well correlated with stage of moyamoya disease and CBNS was detected more often in patients with stage 3–6 than in those with stage 1–2. PI was higher (1.30 ± 0.34 vs. 1.02 ± 0.12, p=0.027) and MV was lower (33.8 ± 3.6 cm/sec vs. 45.6 ± 3.2 cm/sec p<0.001) in the patients with CBNS positive group than in those without. Conclusions: It seems that CBNS is related to progression of stage of moyamoya disease and to low ICA flow due to increased peripheral resistance by defect of Pcom.