Moyamoya Disease-Related Versus Primary Intracerebral Hemorrhage Location and Outcomes Are Different

• Published in: Stroke (1970) Vol. 43; no. 7; pp. 1947 - 1950
• Main Authors: NAH, Hyun-Wook, KWON, Sun U, KANG, Dong-Wha, AHN, Jae-Sung, KWUN, Byung-Duk, KIM, Jong S
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.07.2012
• Subjects: Adult; Aged; Biological and medical sciences; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - epidemiology; Cerebral Ventricles - pathology; Cerebral Ventriculography - methods; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Moyamoya Disease - diagnostic imaging; Moyamoya Disease - epidemiology; Neurology; Neuropharmacology; Neurotransmitters. Neurotransmission. Receptors; Pharmacology. Drug treatments; Putamen - diagnostic imaging; Serotoninergic system; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Stroke; Nishimoto Kudo disease; Nervous system diseases; Prognosis; Moya Moya disease; Cardiovascular disease; Intracranial hemorrhage; Cerebral disorder; Vascular disease; Vasculitis; Cerebral hemorrhage; Systemic disease; Central nervous system disease; Comparative study; Cerebrovascular disease; Takayashu arteritis; moyamoya disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.112.654004

The purpose of our study was to compare lesion location between moyamoya disease-related intracerebral hemorrhage (MMD-ICH) and primary intracerebral hemorrhage (P-ICH). Ninety-three patients each with MMD-ICH and P-ICH were compared. In patients with MMD-ICH, angiographic findings were assessed with special attention to the prominent anterior choroidal artery. Follow-up data were obtained through clinical visit and telephone interview. The location of hemorrhage was different between MMD-ICH and P-ICH, the most frequent one being intraventricular region (37.6%) in the former and putaminal region (46.2%) in the latter (P<0.001). Intraventricular hemorrhage was more frequent in MMD-ICH than P-ICH (80.6% versus 20.4%, P<0.001). In MMD-ICH, primary intraventricular hemorrhage was more closely associated with prominent ipsilateral anterior choroidal artery than ICHs without intraventricular hemorrhage (75.0% versus 16.7%, P<0.001). Higher rates of rebleeding and infarction were observed in MMD-ICH than in age- and sex-matched patients with P-ICH. MMD-ICH may differ from P-ICH in hemorrhage location, generally presenting with intraventricular hemorrhage with or without ICH, which may be due to a prominent anterior choroidal artery. Patients with MMD may be more likely to experience recurrent bleeding and infarction.