Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial
OBJECTIVE Following hemorrhagic stroke in moyamoya disease, de novo intracranial hemorrhage can occur in the previously unaffected nonhemorrhagic hemisphere. In the present analysis the authors intended to determine whether the presence in the nonhemorrhagic hemisphere of choroidal collateral vessel...
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| Veröffentlicht in: | Journal of neurosurgery 2020-02, Vol.132 (2), p.408-414 |
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| creator | Funaki, Takeshi Takahashi, Jun C. Houkin, Kiyohiro Kuroda, Satoshi Fujimura, Miki Tomata, Yasutake Miyamoto, Susumu |
| description | OBJECTIVE Following hemorrhagic stroke in moyamoya disease, de novo intracranial hemorrhage can occur in the previously unaffected nonhemorrhagic hemisphere. In the present analysis the authors intended to determine whether the presence in the nonhemorrhagic hemisphere of choroidal collateral vessels, which have been the focus of attention as a source of bleeding, affects the risk of de novo hemorrhage.
METHODS The subject of focus of the present cohort study was the nonhemorrhagic hemispheres of adult patients with hemorrhagic moyamoya disease enrolled in the Japan Adult Moyamoya Trial and allocated to the nonsurgical arm. The variable of interest was the presence of choroidal collaterals (also termed choroidal anastomoses), identified with baseline angiography and represented by a connection (anastomosis) between the anterior or posterior choroidal arteries and the medullary arteries. The outcome measure was de novo hemorrhage during the 5-year follow-up period, assessed in all nonhemorrhagic hemispheres. The incidence of de novo hemorrhage in the collateral-positive and -negative groups was compared.
RESULTS Choroidal collaterals were present in 15 of 36 (41.7%) nonhemorrhagic hemispheres analyzed. The overall annual risk of de novo hemorrhage was 2.0%. Three de novo hemorrhages occurred in the collateral-positive group, whereas no hemorrhage occurred in the collateral-negative group. The annual risk of de novo hemorrhage was significantly higher in the collateral-positive group than in the collateral-negative group (5.8% per year vs 0% per year; p = 0.017). All hemorrhage sites corresponded to the distribution of choroidal collaterals.
CONCLUSIONS The present preliminary results suggest that the presence of choroidal collaterals affects the risk of de novo hemorrhage in the nonhemorrhagic hemisphere, subject to verification in larger studies. Further studies are needed to determine the optimal treatment strategy for nonhemorrhagic hemispheres and asymptomatic patients. |
| doi_str_mv | 10.3171/2018.10.JNS181139 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2229082651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2229082651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c367t-3d056f19449406d43d8b1750b71a946b0262e703cda913adfa7a38d4b70e136a3</originalsourceid><addsrcrecordid>eNqNkc1u1DAURi0EokPhAdggL5GqlGs7sRN21aj8VAUWlHV0Y98Qo4w92EnRvApPS6JpZ83C8r3S-Y4sf4y9FnCphBHvJIj6clluvn4XtRCqecI2olGqAN2op2wDIGWhoK7O2IucfwEIXWr5nJ0pMKpWtdmwv9d9T3bised2iCl6hyO3cRxxorSM95QzjZnHwB3xEO8jH2gXUxrwJ3Ef-C4ecD3c-UyY6T3HgOMh-7w6Qwwn3Ns16vN-oER5zU4D8RvcY-BXbh4n_uXRdZc8ji_Zsx7HTK8e7nP248P13fZTcfvt4-ft1W1hlTZToRxUuhdNWTYlaFcqV3fCVNAZgU2pO5BakgFlHTZCoevRoKpd2RkgoTSqc_b26N2n-HumPLXLIy0tXxAozrmVUjZQS12JBRVH1KaYc6K-3Se_w3RoBbRrJe1aybqcKlkybx70c7cjd0o8drAAF0fgD3Wxz9ZTsHTCAKASC1fKZYJVV_8_vfUTTj6GbZzDpP4Bwoyp6w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2229082651</pqid></control><display><type>article</type><title>Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Funaki, Takeshi ; Takahashi, Jun C. ; Houkin, Kiyohiro ; Kuroda, Satoshi ; Fujimura, Miki ; Tomata, Yasutake ; Miyamoto, Susumu</creator><creatorcontrib>Funaki, Takeshi ; Takahashi, Jun C. ; Houkin, Kiyohiro ; Kuroda, Satoshi ; Fujimura, Miki ; Tomata, Yasutake ; Miyamoto, Susumu ; JAM Trial Investigators</creatorcontrib><description>OBJECTIVE Following hemorrhagic stroke in moyamoya disease, de novo intracranial hemorrhage can occur in the previously unaffected nonhemorrhagic hemisphere. In the present analysis the authors intended to determine whether the presence in the nonhemorrhagic hemisphere of choroidal collateral vessels, which have been the focus of attention as a source of bleeding, affects the risk of de novo hemorrhage.
METHODS The subject of focus of the present cohort study was the nonhemorrhagic hemispheres of adult patients with hemorrhagic moyamoya disease enrolled in the Japan Adult Moyamoya Trial and allocated to the nonsurgical arm. The variable of interest was the presence of choroidal collaterals (also termed choroidal anastomoses), identified with baseline angiography and represented by a connection (anastomosis) between the anterior or posterior choroidal arteries and the medullary arteries. The outcome measure was de novo hemorrhage during the 5-year follow-up period, assessed in all nonhemorrhagic hemispheres. The incidence of de novo hemorrhage in the collateral-positive and -negative groups was compared.
RESULTS Choroidal collaterals were present in 15 of 36 (41.7%) nonhemorrhagic hemispheres analyzed. The overall annual risk of de novo hemorrhage was 2.0%. Three de novo hemorrhages occurred in the collateral-positive group, whereas no hemorrhage occurred in the collateral-negative group. The annual risk of de novo hemorrhage was significantly higher in the collateral-positive group than in the collateral-negative group (5.8% per year vs 0% per year; p = 0.017). All hemorrhage sites corresponded to the distribution of choroidal collaterals.
CONCLUSIONS The present preliminary results suggest that the presence of choroidal collaterals affects the risk of de novo hemorrhage in the nonhemorrhagic hemisphere, subject to verification in larger studies. Further studies are needed to determine the optimal treatment strategy for nonhemorrhagic hemispheres and asymptomatic patients.</description><identifier>ISSN: 0022-3085</identifier><identifier>ISSN: 1933-0693</identifier><identifier>EISSN: 1933-0693</identifier><identifier>DOI: 10.3171/2018.10.JNS181139</identifier><identifier>PMID: 30738387</identifier><language>eng</language><publisher>ROLLING MEADOWS: Amer Assoc Neurological Surgeons</publisher><subject>Adult ; Cerebral Hemorrhage - diagnostic imaging ; Cerebral Hemorrhage - epidemiology ; Choroid Plexus - blood supply ; Choroid Plexus - diagnostic imaging ; Clinical Neurology ; Cohort Studies ; Collateral Circulation - physiology ; Female ; Follow-Up Studies ; Humans ; Japan - epidemiology ; Life Sciences & Biomedicine ; Longitudinal Studies ; Male ; Middle Aged ; Moyamoya Disease - diagnostic imaging ; Moyamoya Disease - epidemiology ; Neurosciences & Neurology ; Science & Technology ; Surgery</subject><ispartof>Journal of neurosurgery, 2020-02, Vol.132 (2), p.408-414</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>37</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000518384200009</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c367t-3d056f19449406d43d8b1750b71a946b0262e703cda913adfa7a38d4b70e136a3</citedby><cites>FETCH-LOGICAL-c367t-3d056f19449406d43d8b1750b71a946b0262e703cda913adfa7a38d4b70e136a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932,28255</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30738387$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Funaki, Takeshi</creatorcontrib><creatorcontrib>Takahashi, Jun C.</creatorcontrib><creatorcontrib>Houkin, Kiyohiro</creatorcontrib><creatorcontrib>Kuroda, Satoshi</creatorcontrib><creatorcontrib>Fujimura, Miki</creatorcontrib><creatorcontrib>Tomata, Yasutake</creatorcontrib><creatorcontrib>Miyamoto, Susumu</creatorcontrib><creatorcontrib>JAM Trial Investigators</creatorcontrib><title>Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial</title><title>Journal of neurosurgery</title><addtitle>J NEUROSURG</addtitle><addtitle>J Neurosurg</addtitle><description>OBJECTIVE Following hemorrhagic stroke in moyamoya disease, de novo intracranial hemorrhage can occur in the previously unaffected nonhemorrhagic hemisphere. In the present analysis the authors intended to determine whether the presence in the nonhemorrhagic hemisphere of choroidal collateral vessels, which have been the focus of attention as a source of bleeding, affects the risk of de novo hemorrhage.
METHODS The subject of focus of the present cohort study was the nonhemorrhagic hemispheres of adult patients with hemorrhagic moyamoya disease enrolled in the Japan Adult Moyamoya Trial and allocated to the nonsurgical arm. The variable of interest was the presence of choroidal collaterals (also termed choroidal anastomoses), identified with baseline angiography and represented by a connection (anastomosis) between the anterior or posterior choroidal arteries and the medullary arteries. The outcome measure was de novo hemorrhage during the 5-year follow-up period, assessed in all nonhemorrhagic hemispheres. The incidence of de novo hemorrhage in the collateral-positive and -negative groups was compared.
RESULTS Choroidal collaterals were present in 15 of 36 (41.7%) nonhemorrhagic hemispheres analyzed. The overall annual risk of de novo hemorrhage was 2.0%. Three de novo hemorrhages occurred in the collateral-positive group, whereas no hemorrhage occurred in the collateral-negative group. The annual risk of de novo hemorrhage was significantly higher in the collateral-positive group than in the collateral-negative group (5.8% per year vs 0% per year; p = 0.017). All hemorrhage sites corresponded to the distribution of choroidal collaterals.
CONCLUSIONS The present preliminary results suggest that the presence of choroidal collaterals affects the risk of de novo hemorrhage in the nonhemorrhagic hemisphere, subject to verification in larger studies. Further studies are needed to determine the optimal treatment strategy for nonhemorrhagic hemispheres and asymptomatic patients.</description><subject>Adult</subject><subject>Cerebral Hemorrhage - diagnostic imaging</subject><subject>Cerebral Hemorrhage - epidemiology</subject><subject>Choroid Plexus - blood supply</subject><subject>Choroid Plexus - diagnostic imaging</subject><subject>Clinical Neurology</subject><subject>Cohort Studies</subject><subject>Collateral Circulation - physiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Life Sciences & Biomedicine</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Moyamoya Disease - diagnostic imaging</subject><subject>Moyamoya Disease - epidemiology</subject><subject>Neurosciences & Neurology</subject><subject>Science & Technology</subject><subject>Surgery</subject><issn>0022-3085</issn><issn>1933-0693</issn><issn>1933-0693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAURi0EokPhAdggL5GqlGs7sRN21aj8VAUWlHV0Y98Qo4w92EnRvApPS6JpZ83C8r3S-Y4sf4y9FnCphBHvJIj6clluvn4XtRCqecI2olGqAN2op2wDIGWhoK7O2IucfwEIXWr5nJ0pMKpWtdmwv9d9T3bised2iCl6hyO3cRxxorSM95QzjZnHwB3xEO8jH2gXUxrwJ3Ef-C4ecD3c-UyY6T3HgOMh-7w6Qwwn3Ns16vN-oER5zU4D8RvcY-BXbh4n_uXRdZc8ji_Zsx7HTK8e7nP248P13fZTcfvt4-ft1W1hlTZToRxUuhdNWTYlaFcqV3fCVNAZgU2pO5BakgFlHTZCoevRoKpd2RkgoTSqc_b26N2n-HumPLXLIy0tXxAozrmVUjZQS12JBRVH1KaYc6K-3Se_w3RoBbRrJe1aybqcKlkybx70c7cjd0o8drAAF0fgD3Wxz9ZTsHTCAKASC1fKZYJVV_8_vfUTTj6GbZzDpP4Bwoyp6w</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Funaki, Takeshi</creator><creator>Takahashi, Jun C.</creator><creator>Houkin, Kiyohiro</creator><creator>Kuroda, Satoshi</creator><creator>Fujimura, Miki</creator><creator>Tomata, Yasutake</creator><creator>Miyamoto, Susumu</creator><general>Amer Assoc Neurological Surgeons</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200201</creationdate><title>Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial</title><author>Funaki, Takeshi ; Takahashi, Jun C. ; Houkin, Kiyohiro ; Kuroda, Satoshi ; Fujimura, Miki ; Tomata, Yasutake ; Miyamoto, Susumu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-3d056f19449406d43d8b1750b71a946b0262e703cda913adfa7a38d4b70e136a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Cerebral Hemorrhage - diagnostic imaging</topic><topic>Cerebral Hemorrhage - epidemiology</topic><topic>Choroid Plexus - blood supply</topic><topic>Choroid Plexus - diagnostic imaging</topic><topic>Clinical Neurology</topic><topic>Cohort Studies</topic><topic>Collateral Circulation - physiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Life Sciences & Biomedicine</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Moyamoya Disease - diagnostic imaging</topic><topic>Moyamoya Disease - epidemiology</topic><topic>Neurosciences & Neurology</topic><topic>Science & Technology</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Funaki, Takeshi</creatorcontrib><creatorcontrib>Takahashi, Jun C.</creatorcontrib><creatorcontrib>Houkin, Kiyohiro</creatorcontrib><creatorcontrib>Kuroda, Satoshi</creatorcontrib><creatorcontrib>Fujimura, Miki</creatorcontrib><creatorcontrib>Tomata, Yasutake</creatorcontrib><creatorcontrib>Miyamoto, Susumu</creatorcontrib><creatorcontrib>JAM Trial Investigators</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Funaki, Takeshi</au><au>Takahashi, Jun C.</au><au>Houkin, Kiyohiro</au><au>Kuroda, Satoshi</au><au>Fujimura, Miki</au><au>Tomata, Yasutake</au><au>Miyamoto, Susumu</au><aucorp>JAM Trial Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial</atitle><jtitle>Journal of neurosurgery</jtitle><stitle>J NEUROSURG</stitle><addtitle>J Neurosurg</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>132</volume><issue>2</issue><spage>408</spage><epage>414</epage><pages>408-414</pages><issn>0022-3085</issn><issn>1933-0693</issn><eissn>1933-0693</eissn><abstract>OBJECTIVE Following hemorrhagic stroke in moyamoya disease, de novo intracranial hemorrhage can occur in the previously unaffected nonhemorrhagic hemisphere. In the present analysis the authors intended to determine whether the presence in the nonhemorrhagic hemisphere of choroidal collateral vessels, which have been the focus of attention as a source of bleeding, affects the risk of de novo hemorrhage.
METHODS The subject of focus of the present cohort study was the nonhemorrhagic hemispheres of adult patients with hemorrhagic moyamoya disease enrolled in the Japan Adult Moyamoya Trial and allocated to the nonsurgical arm. The variable of interest was the presence of choroidal collaterals (also termed choroidal anastomoses), identified with baseline angiography and represented by a connection (anastomosis) between the anterior or posterior choroidal arteries and the medullary arteries. The outcome measure was de novo hemorrhage during the 5-year follow-up period, assessed in all nonhemorrhagic hemispheres. The incidence of de novo hemorrhage in the collateral-positive and -negative groups was compared.
RESULTS Choroidal collaterals were present in 15 of 36 (41.7%) nonhemorrhagic hemispheres analyzed. The overall annual risk of de novo hemorrhage was 2.0%. Three de novo hemorrhages occurred in the collateral-positive group, whereas no hemorrhage occurred in the collateral-negative group. The annual risk of de novo hemorrhage was significantly higher in the collateral-positive group than in the collateral-negative group (5.8% per year vs 0% per year; p = 0.017). All hemorrhage sites corresponded to the distribution of choroidal collaterals.
CONCLUSIONS The present preliminary results suggest that the presence of choroidal collaterals affects the risk of de novo hemorrhage in the nonhemorrhagic hemisphere, subject to verification in larger studies. Further studies are needed to determine the optimal treatment strategy for nonhemorrhagic hemispheres and asymptomatic patients.</abstract><cop>ROLLING MEADOWS</cop><pub>Amer Assoc Neurological Surgeons</pub><pmid>30738387</pmid><doi>10.3171/2018.10.JNS181139</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Cerebral Hemorrhage - diagnostic imaging Cerebral Hemorrhage - epidemiology Choroid Plexus - blood supply Choroid Plexus - diagnostic imaging Clinical Neurology Cohort Studies Collateral Circulation - physiology Female Follow-Up Studies Humans Japan - epidemiology Life Sciences & Biomedicine Longitudinal Studies Male Middle Aged Moyamoya Disease - diagnostic imaging Moyamoya Disease - epidemiology Neurosciences & Neurology Science & Technology Surgery |
| title | Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial |
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