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Research Progress of Moyamoya Disease in Children
#MMPMID26180513
Piao J
; Wu W
; Yang Z
; Yu J
Int J Med Sci
2015[]; 12
(7
): 566-75
PMID26180513
show ga
During the onset of Moyamoya disease (MMD), progressive occlusion occurs at the
end of the intracranial internal carotid artery, and compensatory net-like
abnormal vessels develop in the skull base, generating the corresponding clinical
symptoms. MMD can affect both children and adults, but MMD in pediatric patients
exhibits distinct clinical features, and the treatment prognoses are different
from adult patients. Children are the group at highest risk for MMD. In children,
the disease mainly manifests as ischemia, while bleeding is the primary symptom
in adults. The pathogenesis of MMD in children is still unknown, and some factors
are distinct from those in adults. MMD in children could result in progressive,
irreversible nerve functional impairment, and an earlier the onset corresponds to
a worse prognosis. Therefore, active treatment at an early stage is highly
recommended. The treatment methods for MMD in children mainly include indirect
and direct surgeries. Indirect surgeries mainly include multiple burr-hole
surgery (MBHS), encephalomyosynangiosis (EMS), and
encephaloduroarteriosynangiosis (EDAS); direct surgeries mainly include intra-
and extracranial vascular reconstructions that primarily consist of superficial
temporal artery-middle cerebral artery (STA-MCA) anastomosis. Indirect surgery,
as a treatment for MMD in children, has shown a certain level of efficacy.
However, a standard treatment approach should combine both indirect and direct
procedures. Compared to MMD in adults, the treatment and prognosis of MMD in
children has higher clinical significance. If the treatment is adequate, a
satisfactory outcome is often achieved.
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