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Stanishevskiy A, Babichev K, Svistov D, Savello A, Abramyan A, Zelenskiy B. Coexistence of moyamoya syndrome with arteriovenous malformation. Systematic review and illustrative case report. J Clin Neurosci 2024; 121:34-41. [PMID: 38354649 DOI: 10.1016/j.jocn.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
The coexistence of Moyamoya Syndrome with Arteriovenous Malformation is exceedingly rare. Here, we present the case of a 37-year-old female patient diagnosed with AVM in the right parietal lobe, accompanied by severe stenosis of the right middle cerebral artery and right anterior cerebral artery, along with moyamoya collateral induction. Our objective was to investigate the frequency and mutual influence of these conditions, and to determine a preferable treatment strategy by conducting a comprehensive review of previous case reports. We conducted a thorough search of PubMed, Scopus, and Web of Science databases, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our review encompassed 36 publications, reporting a total of 64 cases of AVM coexisting with Moyamoya Syndrome. Notably, bilateral stenosis was observed in half of the cases. Among patients with unilateral stenosis, AVM was localized in the opposite hemisphere only in 2 cases. Treatment approaches varied, with 18 cases undergoing active treatment for both stenosis and AVM, 11 cases treating stenosis prior to AVM, 5 cases addressing AVM first, and 3 cases treating both AVM and stenosis simultaneously. Embolization, either standalone or supplemented by stereotactic radiosurgery, was employed in six cases. Stereotactic radiosurgery alone was utilized in 12 cases, while 15 patients underwent surgical removal of the AVM. Our findings provide valuable insights for neurosurgeons managing patients with concurrent AVM and Moyamoya Syndrome. The variety of treatment approaches observed in the literature underscores the complexity of these cases, emphasizing the need for individualized strategies. This information may guide future systematic reviews and meta-analyses, contributing to a better understanding of the optimal management of these rare coexisting vascular pathologies.
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Affiliation(s)
- Artem Stanishevskiy
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
| | - Konstantin Babichev
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
| | - Dmitriy Svistov
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
| | - Alexander Savello
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia
| | | | - Bogdan Zelenskiy
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
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Sun T, Huang L, Sun J, Wu Z, Chen C, Wang H. Persistent trigeminal artery in a patient with moyamoya disease:a case report and literature review. BMC Neurol 2024; 24:54. [PMID: 38308221 PMCID: PMC10835905 DOI: 10.1186/s12883-024-03545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUNDS Persistent trigeminal artery (PTA) is a rare anastomosis between internal carotid artery (ICA) and basilar artery. In rare conditions, the PTA could be combined with others cerebrovascular anomalies, moyamoya disease (MMD) is one of them. CASE PRESENTATION Here, we reported one rare case of MMD associated with PTA, the patient admitted to our department for severe dizziness and headache, imaging examination suggested MMD combined with right PTA, which arising from the ipsilateral cavernous portion of ICA. The patient received phased bilaterral revascularization with no any complication. In the subsequent follow-up, the patient's symptoms and intracranial vascular condition gradually improved. Moreover, we conducted a literature review of coexistence of PTA and MMD, the results of a web of science regarding such condition, and a deep discussion providing brief insight into the status of co-occurrence of PTA and MMD, including its manifestation, treatment and outcome. CONCLUSIONS The coexistence of PTA and MMD was rarely reported, the pathogenesis of such condition remains unknown. We found that the features of the coexistence of PTA and MMD were diverse, revascularization might be a feasible for such patient.
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Affiliation(s)
- Tao Sun
- Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, No. 600th Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Lixin Huang
- Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, No. 600th Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Jun Sun
- Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, No. 600th Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Zhimin Wu
- Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, No. 600th Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Chuan Chen
- Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, No. 600th Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Hui Wang
- Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, No. 600th Tianhe Road, Guangzhou, 510630, Guangdong, China.
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Park H, Lee EJ, Cheon JE, Kim JE, Kang HS, Kim SK. Clinical Features and Treatment Outcomes of Cerebral Arteriovenous Malformation Associated With Moyamoya Disease. World Neurosurg 2021; 154:e633-e640. [PMID: 34329751 DOI: 10.1016/j.wneu.2021.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cerebral arteriovenous malformation (AVM) can rarely occur in conjunction with moyamoya disease (MMD). There is still no consensus on how to treat AVM when accompanied by MMD. In this study, we assessed the clinical features and suggested appropriate management when AVM was combined with MMD. METHODS From August 1994 to December 2020, 7 out of 4004 patients with MMD were found to have AVM. The Karnofsky Performance Scale (KPS) was used to evaluate the clinical outcomes of AVM and MMD. KPS greater than 80 was classified as a good outcome. In addition, the radiologic outcomes of the patients were evaluated. RESULTS The incidence of AVM with MMD was 1.7 per 1000 persons. Five patients underwent bypass surgery for MMD, and 5 patients underwent Gamma Knife surgery (GKS) for concurrent AVM. Postoperative perfusion magnetic resonance imaging and brain single photon emission computerized tomography showed improved cerebral hemodynamics in 4 out of 7 territories. Postoperative cerebral angiography showed good revascularization in 4 out of 8 territories. After GKS, 4 patients showed complete obliteration, and 1 patient showed a significantly decreased AVM size. Six patients showed favorable clinical outcomes (KPS 80-100), and 1 patient with delayed GKS for AVM had a poor outcome (KPS 20) due to AVM rupture. CONCLUSIONS In this study, AVM tended to occur where the angiographic stage of MMD was higher. When AVM is combined with MMD, MMD bypass surgery is recommended based on symptoms and cerebral perfusion status. For AVM, less invasive but effective treatments, such as GKS, should be implemented as soon as possible.
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Affiliation(s)
- Hangeul Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun Jung Lee
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung-Eun Cheon
- Division of Pediatric Radiology, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Jeong Eun Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun-Seung Kang
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
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De Novo Development of Moyamoya Disease after Stereotactic Radiosurgery for Brain Arteriovenous Malformation in a Patient With RNF213 p.Arg4810Lys (rs112735431). World Neurosurg 2020; 140:276-282. [DOI: 10.1016/j.wneu.2020.05.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 12/12/2022]
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Yu J, Yuan Y, Zhang D, Xu K. Moyamoya disease associated with arteriovenous malformation and anterior communicating artery aneurysm: A case report and literature review. Exp Ther Med 2016; 12:267-271. [PMID: 27347048 PMCID: PMC4906688 DOI: 10.3892/etm.2016.3289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/05/2016] [Indexed: 11/09/2022] Open
Abstract
Moyamoya disease (MMD) can be associated with an aneurysm or arteriovenous malformation (AVM). However, no case of MMD simultaneously associated with both intracranial aneurysm and AVM has been previously reported. The present study reports the case of a patient with MMD simultaneously associated with both aneurysm and AVM. The patient was a 46-year-old woman presenting with a subarachnoid hemorrhage whose imaging diagnosis of MMD was associated with an aneurysm and AVM. The aneurysm was located in the anterior communicating artery, which was similar to a berry aneurysm caused by hemodynamics. The AVM was located in the posterior circulation. Beyond the presentation of the posterior cerebral artery, the appearance of an artery supplying blood from the middle cerebral artery supported the view that the AVM was congenital and unruptured. Conservative treatment was provided and examination of the patient at follow-up showed good recovery. In addition to the case report, the present study also reviewed the relevant literature in order to compile information on MMD associated with both an aneurysm and AVM.
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Affiliation(s)
- Jinlu Yu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yongjie Yuan
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Duoduo Zhang
- Department of Radiotherapy, Third Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Kan Xu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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Noh JH, Yeon JY, Park JH, Shin HJ. Cerebral arteriovenous malformation associated with moyamoya disease. J Korean Neurosurg Soc 2014; 56:356-60. [PMID: 25371789 PMCID: PMC4219197 DOI: 10.3340/jkns.2014.56.4.356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/06/2014] [Accepted: 09/29/2014] [Indexed: 01/20/2023] Open
Abstract
The coexistence of moyamoya disease (MMD) with an arteriovenous malformation (AVM) is exceedingly rare. We report two cases of AVM associated with MMD. The first case was an incidental AVM diagnosed simultaneously with MMD. This AVM was managed expectantly after encephalo-duro-arterio-synangiosis (EDAS) as the main feeders stemmed from the internal carotid artery, which we believed would be obliterated with the progression of MMD. However, the AVM persisted with replacement of the internal carotid artery feeders by new external carotid artery feeders from the EDAS site. The AVM was eventually treated with gamma knife radiosurgery considering an increasing steal effect. The second case was a de novo AVM case. The patient was initially diagnosed with MMD, and acquired an AVM eight years later that was slowly fed by the reconstituted anterior cerebral artery. Because the patient remained asymptomatic, the AVM is currently being closely followed for more than 2 years without further surgical intervention. Possible differences in the pathogenesis and the radiologic presentation of these AVMs are discussed with a literature review. No solid consensus exists on the optimal treatment of MMD-associated AVMs. Gamma knife radiosurgery appears to be an effective treatment option for an incidental AVM. However, a de novo AVM may be managed expectantly considering the possible risks of damaging established collaterals, low flow characteristics, and probably low risks of rupture.
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Affiliation(s)
- Jung-Hoon Noh
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Je Young Yeon
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Han Park
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Jin Shin
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Ahn SH, Choo IS, Kim JH, Kim HW. Arteriovenous Malformation with an Occlusive Feeding Artery Coexisting with Unilateral Moyamoya Disease. J Clin Neurol 2010; 6:216-20. [PMID: 21264203 PMCID: PMC3024527 DOI: 10.3988/jcn.2010.6.4.216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 09/23/2009] [Accepted: 09/23/2009] [Indexed: 11/21/2022] Open
Abstract
Background Arteriovenous malformations (AVMs) with vascular abnormalities, including aneurysms, have been reported frequently. However, the coexistence of AVM and unilateral moyamoya disease is rare. We report herein an AVM patient who presented with acute ischemic stroke with unilateral moyamoya disease and occlusion of the feeding artery. Case Report A-41-year old man was admitted with sudden dysarthria and facial palsy. Brain computed tomography and magnetic resonance imaging revealed an acute infarction adjacent to a large AVM in the right frontal lobe. Cerebral angiography revealed occlusions of the proximal right middle cerebral and proximal anterior cerebral arteries, which were the main feeders of the AVM. Innumerable telangiectatic moyamoya-type vessels between branches of the anterior cerebral artery and dilated lenticulostriate arteries on the occluded middle cerebral artery were detected. However, a nidus of the AVM was still opacified through the distal right callosomarginal artery, which was supplied by the remaining anterior cerebral artery and leptomeningeal collaterals from the posterior cerebral artery. Conclusions While AVM accompanied by unilateral moyamoya disease is rare, our case suggests an association between these two dissimilar vascular diseases.
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Affiliation(s)
- Seong Hwan Ahn
- Department of Neurology, Chosun University School of Medicine, Gwangju, Korea
| | - In Seong Choo
- Department of Neurology, Chosun University School of Medicine, Gwangju, Korea
| | - Jin Ho Kim
- Department of Neurology, Chosun University School of Medicine, Gwangju, Korea
| | - Hoo Won Kim
- Department of Neurology, Chosun University School of Medicine, Gwangju, Korea
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Killory BD, Gonzalez LF, Wait SD, Ponce FA, Albuquerque FC, Spetzler RF. SIMULTANEOUS UNILATERAL MOYAMOYA DISEASE AND IPSILATERAL DURAL ARTERIOVENOUS FISTULA. Neurosurgery 2008. [DOI: 10.1227/01.neu.0000317274.57687.0e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Killory BD, Gonzalez LF, Wait SD, Ponce FA, Albuquerque FC, Spetzler RF. SIMULTANEOUS UNILATERAL MOYAMOYA DISEASE AND IPSILATERAL DURAL ARTERIOVENOUS FISTULA. Neurosurgery 2008; 62:E1375-6; discussion E1376. [DOI: 10.1227/01.neu.0000333311.87554.9c] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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