Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management?
Whereas several studies have been so far presented about the surgical outcomes in terms of mortality and perioperative complications for elderly patients submitted to neurosurgical treatments, the management of elderly moyamoya patients is unclear. This review aims to explore the available data abou...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/11/2287 |
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| author | Ignazio G. Vetrano Anna Bersano Isabella Canavero Francesco Restelli Gabriella Raccuia Elisa F. Ciceri Giuseppe Faragò Andrea Gioppo Morgan Broggi Marco Schiariti Laura Gatti Paolo Ferroli Francesco Acerbi |
| author_facet | Ignazio G. Vetrano Anna Bersano Isabella Canavero Francesco Restelli Gabriella Raccuia Elisa F. Ciceri Giuseppe Faragò Andrea Gioppo Morgan Broggi Marco Schiariti Laura Gatti Paolo Ferroli Francesco Acerbi |
| author_sort | Ignazio G. Vetrano |
| collection | DOAJ |
| description | Whereas several studies have been so far presented about the surgical outcomes in terms of mortality and perioperative complications for elderly patients submitted to neurosurgical treatments, the management of elderly moyamoya patients is unclear. This review aims to explore the available data about the clinical manifestation, characteristics, and outcome after surgery of older patients with moyamoya arteriopathy (MA). We found only two articles strictly concerning elderly patients with MA. We have also evaluated other reported adult series of moyamoya patients, including elderly cases in their analysis. Patients with MA above 50 years old may be considered a peculiar subset in which patients are often presenting with ischemic symptoms and a higher Suzuki grade. Conservative treatment may be proposed in asymptomatic or stable cases due to their fragility and possible increase of post-operative complications, while the best surgical options in symptomatic cases are still under investigation, although we believe that a minimal invasive superficial temporal artery—middle cerebral artery bypass could be considered the treatment of choice for the immediate effect on brain perfusion with a limited rate of post-operative complications. |
| first_indexed | 2024-03-10T11:04:53Z |
| format | Article |
| id | doaj.art-e4291fa3cc8544caab26371b133c689c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T11:04:53Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-e4291fa3cc8544caab26371b133c689c2023-11-21T21:14:46ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011011228710.3390/jcm10112287Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management?Ignazio G. Vetrano0Anna Bersano1Isabella Canavero2Francesco Restelli3Gabriella Raccuia4Elisa F. Ciceri5Giuseppe Faragò6Andrea Gioppo7Morgan Broggi8Marco Schiariti9Laura Gatti10Paolo Ferroli11Francesco Acerbi12Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyCerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyCerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyInterventional Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyInterventional Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyInterventional Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyCellular Neurobiology Laboratory, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyWhereas several studies have been so far presented about the surgical outcomes in terms of mortality and perioperative complications for elderly patients submitted to neurosurgical treatments, the management of elderly moyamoya patients is unclear. This review aims to explore the available data about the clinical manifestation, characteristics, and outcome after surgery of older patients with moyamoya arteriopathy (MA). We found only two articles strictly concerning elderly patients with MA. We have also evaluated other reported adult series of moyamoya patients, including elderly cases in their analysis. Patients with MA above 50 years old may be considered a peculiar subset in which patients are often presenting with ischemic symptoms and a higher Suzuki grade. Conservative treatment may be proposed in asymptomatic or stable cases due to their fragility and possible increase of post-operative complications, while the best surgical options in symptomatic cases are still under investigation, although we believe that a minimal invasive superficial temporal artery—middle cerebral artery bypass could be considered the treatment of choice for the immediate effect on brain perfusion with a limited rate of post-operative complications.https://www.mdpi.com/2077-0383/10/11/2287cerebral angiopathyelderlyextracranial-intracranial bypassinternal carotid arterymoyamoyamiddle cerebral artery |
| spellingShingle | Ignazio G. Vetrano Anna Bersano Isabella Canavero Francesco Restelli Gabriella Raccuia Elisa F. Ciceri Giuseppe Faragò Andrea Gioppo Morgan Broggi Marco Schiariti Laura Gatti Paolo Ferroli Francesco Acerbi Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? Journal of Clinical Medicine cerebral angiopathy elderly extracranial-intracranial bypass internal carotid artery moyamoya middle cerebral artery |
| title | Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? |
| title_full | Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? |
| title_fullStr | Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? |
| title_full_unstemmed | Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? |
| title_short | Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? |
| title_sort | characteristics of moyamoya disease in the older population is it possible to define a typical presentation and optimal therapeutical management |
| topic | cerebral angiopathy elderly extracranial-intracranial bypass internal carotid artery moyamoya middle cerebral artery |
| url | https://www.mdpi.com/2077-0383/10/11/2287 |
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