Ischemic Stroke in Young Adults with Moyamoya Disease: Prognostic Factors for Stroke Recurrence and Functional Outcome after Revascularization.

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Ischemic Stroke in Young Adults with Moyamoya Disease: Prognostic Factors for Stroke Recurrence and Functional Outcome after Revascularization.

World Neurosurg. 2017 Apr 10;:

Authors: Zhao M, Deng X, Gao F, Zhang D, Wang S, Zhang Y, Wang R, Zhao J

Abstract
OBJECTIVE: Stroke in young adults is uncommon and have rarely been described. Moyamoya disease is one of the leading causes of stroke in young adults. We aimed to study the prognostic factors for stroke recurrences and functional outcomes in young stroke patients with moyamoya disease after revascularization.
METHODS: We reviewed 696 consecutive patients with moyamoya disease admitted to our hospital from 2009 to 2015 and identified patients aged 18-45 years with first-ever stroke. Follow-up was conducted via face-to-face or structured telephone interviews. Outcome measures were recurrent stroke events and unfavorable functional outcomes (modified Rankin Scale > 2).
RESULTS: We included 121 young patients with moyamoya disease suffering from stroke (initial presentation age, 35.4 ± 7.5 years). All patients underwent revascularization after the acute phase of initial stroke events as the secondary prevention for recurrences. During follow-up (median, 40 months), nine patients (7.4%) experienced recurrent strokes and eight (6.6%) suffered unfavorable functional outcomes. In the multivariate analysis, diabetes was an independent predictor for stroke recurrences (Hazard Ratio 6.76; 95% CI 1.30-35.11; P = 0.02) and was significantly associated with unfavorable functional outcomes (Odd Ratio 7.87; 95%CI 1.42-38.74; P = 0.01).
CONCLUSIONS: We identified diabetes as an independent risk factor for recurrent strokes and unfavorable functional outcomes after revascularization in young stroke patients with moyamoya disease.

PMID: 28408257 [PubMed - as supplied by publisher]

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