Analysis of Clinical Characteristic and Risk Factors for Short-Term Prognosis of Moyamoya Disease with Intraventricular Hemorrhage in Adults

Intraventricular hemorrhage (IVH) is the most common type of hemorrhage in moyamoya disease (MMD) with intracerebral hemorrhage (ICH), but the risk factors affecting the short-term prognosis of MMD with IVH in adults are still unclear. We retrospectively analyzed patients of MMD with IVH between January 1, 2018 and January 31, 2020 in the First Affiliated Hospital of Zhengzhou University. According to the modified Rankin Scale (mRS) score at 3 months after discharge, the patients were divided into mRS score ≤2 (good prognosis) group and mRS score >2 (poor prognosis) groups. Univariate and multivariate logistics regression analysis was used to analyze the risk factors affecting the short-term prognosis of adult MMD with IVH. Univariable analyses showed that patients in the poor prognosis group had a significantly older age of onset (48.48 ± 8.34 vs. 43.74 ± 5.44 years; P = 0.002), a higher percentage of hypertension (57.97% vs. 33.33%; P = 0.014), a higher percentage of tracheotomy (23.19% vs. 2.56%; P = 0.005), a lower Glasgow Coma Scale (GCS) score (7.90 ± 3.58 vs. 11.19 ± 2.56; P = 0.000), a higher Graeb score (7.46 ± 4.04 vs. 5.23 ± 1.93; P = 0.002), and treatment methods (P = 0.000). Multiple logistic regression analysis showed that the lower GCS score (odds ratio [OR], 1.761; P = 0.001) and higher Graeb score (OR, 1.767; P = 0.002) were independently associated with the poor prognosis of MMD with IVH, and surgery treatment (OR, 0.032; P = 0.000) was independently related to the good prognosis of MMD with IVH. Among patients with MMD with IVH, the lower GCS score and higher Graeb score are independent risk factors for poor prognosis, whereas in patients with MMD with IVH, surgery treatment acts as a protective factor.