Assessment of cognitive function in adult patients with hemorrhagic moyamoya disease who received no surgical revascularization

Background and purpose Due to controversial surgical treatment for hemorrhagic moyamoya disease (MMD), a large proportion of these patients chose conservative treatment. The aim of this study was to assess cognitive function in adult patients with hemorrhagic MMD who received no surgical revasculari...

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Bibliographic Details
Published in:European journal of neurology 2013-07, Vol.20 (7), p.1081-1087
Main Authors: Su, S.-H., Hai, J., Zhang, L., Yu, F., Wu, Y.-F.
Format: Article
Language:English
Subjects:
Adult
assessment
Case-Control Studies
Cerebral Hemorrhage - complications
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - psychology
Cerebral Hemorrhage - surgery
Cerebral Revascularization
Cognition Disorders - complications
Cognition Disorders - diagnostic imaging
Cognition Disorders - psychology
Cognitive ability
Cognitive Dysfunction - complications
Cognitive Dysfunction - diagnostic imaging
Cognitive Dysfunction - psychology
cognitive function
Female
Humans
intraventricular hemorrhage
Male
Medical research
Middle Aged
moyamoya disease
Moyamoya Disease - complications
Moyamoya Disease - diagnostic imaging
Moyamoya Disease - psychology
Moyamoya Disease - surgery
Neuropsychological Tests
Radiography
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Summary:Background and purpose Due to controversial surgical treatment for hemorrhagic moyamoya disease (MMD), a large proportion of these patients chose conservative treatment. The aim of this study was to assess cognitive function in adult patients with hemorrhagic MMD who received no surgical revascularization. Methods Twenty‐six adult hemorrhagic MMD patients with only intraventricular hemorrhage (IVH) confirmed by positive computed tomography and magnetic resonance imaging scan, 20 patients with spontaneous IVH whose digital subtraction angiography results were negative, and 30 healthy controls were identified and matched for age, gender, education background and living area. Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA). The non‐parametric test was used for comparisons among the three groups. Results No patient was confirmed cognitive dysfunction at the initial screening. Twenty‐four (92%) cases presented mild cognitive impairment (MCI) after 1 year. All the cases demonstrated MCI after 2 years. The difference between cases and healthy controls was statistically significant at the second screening (P = 0.000) and the third screening (P = 0.000), as was that between cases and patients with spontaneous IVH at the second screening (P = 0.000) and the third screening (P = 0.000). In addition, there were significant decreases in all MoCA subscores (P = 0.000) with special regards to delayed recall, visual space and executive function in cases compared with the other two groups. Moreover, significant differences were found in the subgroups of smoking (P = 0.021) and Suzuki angiographic classification of MMD (P = 0.030). Conclusions Cognitive impairment is a long‐term complication for adult hemorrhagic MMD patients who underwent conservative treatment.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.12138