Clinical and imaging analysis of hemorrhagic moyamoya disease

Objective To analyze the clinical and radiological findings of hemorrhagic moyamoya disease(MMD),as well as the causes of cerebral hemorrhage in these patients.Methods The clinical and imaging data of 30 patients with hemorrhagic moyamoya disease from August 2011 to May 2012 were analyzed retrospectively.Results MMD patients with hemorrhage accounted for 19.6%(30/153) of MMD patients admitted to our hospital over the same period.The male to female ratio was 1:3.3(7:23).The age of onset ranged from 12 to 55 years old(mean 35.0±11.4 years old).The rate of hemorrhage among adults with MMD was higher than that among children(22.6% vs.10.5%).Intra-ventricular hemorrhage(IVH) and intra-cerebral hemorrhage(ICH) combined IVH were the two most common types of hemorrhage in MMD(73%).Eight patients had aneurysms(26.7%,8/30).There was no statistical difference in Suzuki classification between the two groups(Z =-0.109,P = 0.913).Thrity-two of the 60 hemispheres had dilation of anterior choroidal artery and posterior communicating artery.Among them,the hemorrhagic hemispheres accounted for 62.5%(20/32),and the non-hemorrhagic hemispheres accounted for 37.5%(12/32)(X2=4.286,P = 0.038).Conclusion Hemorrhagic moyamoya disease is prevalence in adult and female patients.IVH and ICH combined IVH are the two most common types of hemorrhage in MMD.Rupture of aneurysm and the dilated anterior choroidal artery are considered to be two mechanisms that may lead to hemorrhage in MMD.