临床神经外科杂志2025，Vol.22Issue(2)：121-125,5.DOI:10.3969/j.issn.1672-7770.2025.02.001
儿童单侧出血型烟雾病脑血运重建术的中长期疗效及预后分析
Analysis of the medium-and long-term curative effects and prognosis of cerebrovascular revascularization for children with unilateral hemorrhagic moyamoya disease
摘要
Abstract
Objective To explore the medium-and long-term curative effects after cerebrovascular revascularization for children with unilateral hemorrhagic moyamoya disease(MMD).Methods The clinical data of 13 pediatric patients with unilateral hemorrhagic MMD who underwent treatment at Beijing Tiantan Hospital from October 2010 to February 2025 were analyzed retrospectively.Among them,11 received combined superficial temporal artery-middle cerebral artery(STA-MCA)bypass with encephalo-duro-arterio-synangiosis(EDAS),1 underwent EDAS alone,and 1 was treated conservatively.Follow-up endpoints included rebleeding,cerebral infarction,and death.Results Among 13 children,intraventricular hemorrhage predominated in 4 cases(38.5％).During a median follow-up of 93 months(IQR 51-133),rebleeding occurred in 1 patient(7.7％)at 29 months post-EDAS surgery.Additionally,1 patient(7.7％)experienced a transient ischemic attack(TIA)2 months after combined revascularization,followed by a new cerebral infarction at 7 months postoperatively.No mortality or contralateral progression was observed on follow-up computed tomography angiography(CTA).Favorable neurological outcomes(modified Rankin Scale score ≤2)were achieved in 84.6％(11/13)of cases.Conclusions Unilateral hemorrhagic MMD in pediatric patients shows a low risk of contralateral progression during medium-and long-term follow-up.Combined cerebral revascularization effectively mitigates rebleeding risk and ensures favorable neurological outcomes,highlighting its safety and efficacy in pediatric populations.关键词
烟雾病/脑血运重建术/儿童/神经功能预后/随访研究Key words
moyamoya disease/cerebrovascular revascularization/child/neurological prognosis/follow-up study分类
临床医学引用本文复制引用
朱宸宇,李文杰,朱桓,张启航,刘通,杨桐宇,张岩,刘兴炬..儿童单侧出血型烟雾病脑血运重建术的中长期疗效及预后分析[J].临床神经外科杂志,2025,22(2):121-125,5.基金项目
国家自然科学基金面上项目(82371915) （82371915）
