Moyamoya Disease: Evaluation of Collateral Pathway on DSA and Its Clinical Significance

Objective To analyze the collateral pathways in Moyamoya disease with DSA, and to study the correlation of the collateral circulation with the clinical presentation and CT findings.Materials and Methods Angiographic features, CT findings and clinical data of 30 patients with Moyamoya disease were retrospectively analyzed.Results All patients showed stenosis or occlusion of the internal carotid arteries or their branches, and extensive abnormal vascular anastomotic network, so called moyamoya, was developed at the basal area of the brain. The collateral blood supply was obtained from the circle of Willis in 20 patients. The ophthalmic arteries were dilated in 14 patients. The leptomeningeal collateral vessels were markedly dilated in 17 patients. Posterior basal moyamoya was found in 7 patients. Dilated anterior choroidal artery was seen in one patient. On CT scan, cerebral infarction and hemorrhage was present in 4 and 23 patients, respectively, while normal CT scan was seen in 3 patients. Conclusion Being the gold standard for the diagnosis of Moyamoya disease, DSA provides a reliable technique for the study of collateral pathways. The close relationship between the collateral circulation and clinical manifestation in Moyamoya disease is very helpful for the clinician to decide the therapy plan and to make precise prognosis.