Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease

Objective To investigate the related influencing factors of "de novo ivy sign" in patients with cerebral hyperperfusion syndrome (CHS) after moyamoya disease (MMD) surgery. Methods A total of 45 patients with MMD admitted to Aviation General Hospital from January to December 2019 were enro...

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Main Authors: FENG Zeng⁃wei, DING Ping, LIAO Xian⁃wen, JIAO Yong⁃hui, ZUO Yun⁃long, HAN Hong⁃yan
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2023-05-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
Subjects:
Online Access:http://cjcnn.org/index.php/cjcnn/article/view/2694
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author FENG Zeng⁃wei
DING Ping
LIAO Xian⁃wen
JIAO Yong⁃hui
ZUO Yun⁃long
HAN Hong⁃yan
author_facet FENG Zeng⁃wei
DING Ping
LIAO Xian⁃wen
JIAO Yong⁃hui
ZUO Yun⁃long
HAN Hong⁃yan
author_sort FENG Zeng⁃wei
collection DOAJ
description Objective To investigate the related influencing factors of "de novo ivy sign" in patients with cerebral hyperperfusion syndrome (CHS) after moyamoya disease (MMD) surgery. Methods A total of 45 patients with MMD admitted to Aviation General Hospital from January to December 2019 were enrolled, all of whom underwent superficial temporal artery (STA)⁃middle cerebral artery (MCA) bypass and encephalo⁃duro⁃myo⁃arterio⁃pericranio⁃synangiosis (EDMAPS) and suffered from CHS after surgery. The occurrence rate of "de novo ivy sign" after surgery was recorded. Univariate and multivariate Logistic regression analyses were used to screen the influcencing factors for postoperative "de novo ivy sign". Results In a total of 45 patients, the main manifestations of CHS after left surgery were language disorders in 27 cases (96.43%, 27/28), right limb sensory and motor disorders in 6 cases (21.43%, 6/28), and left limb sensory and motor disorders after right surgery in 9 cases (9/17), salivation and swallowing difficulties in 3 cases (3/17). A total of 26 patients (57.78%) developed "de novo ivy sign" after surgery, which were located in the anterior cerebral artery (ACA) blood supply area (2 cases), the anterior MCA blood supply area (9 cases), the posterior MCA blood supply area (6 cases), the ACA blood supply area and the anterior MCA blood supply area (4 cases), and the anterior and posterior MCA blood supply area (5 cases). The probability of the occurrence of "de novo ivy sign" in the patients without "ivy sign" before surgery, the occurrence time of postoperative CHS ≤ 3 d and the recovery time ≤ 7 d after surgery was higher than that of the patients with "ivy sign" before surgery (χ2 = 5.830, P = 0.016), the occurrence time of postoperative CHS > 3 d (χ2 = 30.162, P = 0.000), and recovery time > 7 d (χ2 = 6.764, P = 0.009). Logistic regression analysis showed only the occurrence time of postoperative CHS ≤ 3 d was a risk factor for postoperative "de novo ivy sign" (OR = 261.155, 95%CI: 7.635-8932.982; P = 0.002). Conclusions The manifestations of CHS after MMD were different in the surgical side. "De novo ivy sign" is a transient hemodynamic change after cerebrovascular reconstruction of MMD, and it is easy to form "de novo ivy sign" in patients who develop CHS within 3 d after surgery.
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spelling doaj.art-ef35148e9bf54d718ee8595b6e260fe12023-08-28T01:02:28ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312023-05-0123546046610.3969/j.issn.1672-6731.2023.05.0142648Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya diseaseFENG Zeng⁃wei0DING Ping1LIAO Xian⁃wen2JIAO Yong⁃hui3ZUO Yun⁃long4HAN Hong⁃yan5Department of Neurosurgery, Aviation General Hospital, Beijing 100012, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing 100012, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing 100012, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing 100012, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing 100012, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing 100012, ChinaObjective To investigate the related influencing factors of "de novo ivy sign" in patients with cerebral hyperperfusion syndrome (CHS) after moyamoya disease (MMD) surgery. Methods A total of 45 patients with MMD admitted to Aviation General Hospital from January to December 2019 were enrolled, all of whom underwent superficial temporal artery (STA)⁃middle cerebral artery (MCA) bypass and encephalo⁃duro⁃myo⁃arterio⁃pericranio⁃synangiosis (EDMAPS) and suffered from CHS after surgery. The occurrence rate of "de novo ivy sign" after surgery was recorded. Univariate and multivariate Logistic regression analyses were used to screen the influcencing factors for postoperative "de novo ivy sign". Results In a total of 45 patients, the main manifestations of CHS after left surgery were language disorders in 27 cases (96.43%, 27/28), right limb sensory and motor disorders in 6 cases (21.43%, 6/28), and left limb sensory and motor disorders after right surgery in 9 cases (9/17), salivation and swallowing difficulties in 3 cases (3/17). A total of 26 patients (57.78%) developed "de novo ivy sign" after surgery, which were located in the anterior cerebral artery (ACA) blood supply area (2 cases), the anterior MCA blood supply area (9 cases), the posterior MCA blood supply area (6 cases), the ACA blood supply area and the anterior MCA blood supply area (4 cases), and the anterior and posterior MCA blood supply area (5 cases). The probability of the occurrence of "de novo ivy sign" in the patients without "ivy sign" before surgery, the occurrence time of postoperative CHS ≤ 3 d and the recovery time ≤ 7 d after surgery was higher than that of the patients with "ivy sign" before surgery (χ2 = 5.830, P = 0.016), the occurrence time of postoperative CHS > 3 d (χ2 = 30.162, P = 0.000), and recovery time > 7 d (χ2 = 6.764, P = 0.009). Logistic regression analysis showed only the occurrence time of postoperative CHS ≤ 3 d was a risk factor for postoperative "de novo ivy sign" (OR = 261.155, 95%CI: 7.635-8932.982; P = 0.002). Conclusions The manifestations of CHS after MMD were different in the surgical side. "De novo ivy sign" is a transient hemodynamic change after cerebrovascular reconstruction of MMD, and it is easy to form "de novo ivy sign" in patients who develop CHS within 3 d after surgery.http://cjcnn.org/index.php/cjcnn/article/view/2694moyamoya diseasecerebral revascularizationhemodynamicspostoperative complicationsrisk factorslogistic models
spellingShingle FENG Zeng⁃wei
DING Ping
LIAO Xian⁃wen
JIAO Yong⁃hui
ZUO Yun⁃long
HAN Hong⁃yan
Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
Chinese Journal of Contemporary Neurology and Neurosurgery
moyamoya disease
cerebral revascularization
hemodynamics
postoperative complications
risk factors
logistic models
title Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
title_full Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
title_fullStr Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
title_full_unstemmed Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
title_short Clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
title_sort clinical analysis of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease
topic moyamoya disease
cerebral revascularization
hemodynamics
postoperative complications
risk factors
logistic models
url http://cjcnn.org/index.php/cjcnn/article/view/2694
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AT dingping clinicalanalysisofcerebralhyperperfusionsyndromeaftercerebrovascularreconstructioninmoyamoyadisease
AT liaoxianwen clinicalanalysisofcerebralhyperperfusionsyndromeaftercerebrovascularreconstructioninmoyamoyadisease
AT jiaoyonghui clinicalanalysisofcerebralhyperperfusionsyndromeaftercerebrovascularreconstructioninmoyamoyadisease
AT zuoyunlong clinicalanalysisofcerebralhyperperfusionsyndromeaftercerebrovascularreconstructioninmoyamoyadisease
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