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Abstract：
Background Moyamoya disease (MMD) can be a major cause of hemorrhagic stroke. Though extensive angiographic studies have been undertaken, the understanding of the association between aneurysms and MMD remains unanswered. In this study, we explore the association of the aneurysm with MMD and its management. We have also reviewed such associations described in the literature and how the present cases differ from those previously described. Materials and methods The clinical and radiologic data of moyamoya disease cases were accessed from medical and radiological records between January 2010 and July 2017. Two neuroradiologists independently analyzed the data and imaging details. Results Out of 103 patients with MMD, eight patients (7.77%) had associated intracranial aneurysms with eleven aneurysms. Out of the 11 aneurysms, five were the tip of the basilar artery aneurysms and were the most common location for aneurysm (45.5%), followed by lenticulostriate artery, PCA perforator, and distal ACA (DACA) in the P1 PCA, P2 PCA, and P3 PCA artery aneurysms. Out of eight patients, five (62.5%) had a hemorrhage on a non-contrast computed tomography (NCCT) scan of the brain, whereas three (37.5%) had an ischemic presentation. Out of 11 aneurysms, seven aneurysms, including three basilar tip aneurysms (unruptured) and one PCA perforator (ruptured), and three saccular PCA (P1, P2, and P3) (ruptured) were treated by endovascular coiling. Follow-up angiography showed stable aneurysmal occlusion except in one basilar tip, where recurrence was observed. Conclusions MMD-intracranial aneurysm is commonly observed in patients with intracranial hemorrhage and carries a higher risk of rupture. Therefore, identification of the aneurysm is essential for management. Endovascular treatment, either with coil or glue embolization, can be a safe and effective treatment method for such aneurysms with long-term good results.
摘要：
背景烟雾病（MMD）可能是出血性中风的主要原因。尽管已经进行了广泛的血管造影研究，对动脉瘤和MMD之间的关联的理解仍然没有答案.在这项研究中,我们探讨动脉瘤与MMD的关系及其治疗方法.我们还回顾了文献中描述的这种关联，以及目前的情况与以前描述的情况有何不同。材料和方法2010年1月至2017年7月，从医学和放射学记录中获取烟雾病病例的临床和放射学数据。两名神经放射科医生独立分析了数据和成像细节。结果103例MMD患者中,8例(7.77%)患者的颅内动脉瘤与11例动脉瘤相关。在11个动脉瘤中，五个是基底动脉动脉瘤的尖端，是动脉瘤最常见的位置（45.5％），接着是豆状纹状动脉,PCA穿孔器,和P1PCA中的远端ACA(DACA)，P2PCA，和P3PCA动脉瘤。八个病人中,5人（62.5%）在脑部非对比计算机断层扫描（NCCT）扫描中出血，而3人(37.5%)出现缺血表现.在11个动脉瘤中,七个动脉瘤,包括三个基底动脉尖端动脉瘤（未破裂）和一个PCA穿支（破裂），并通过血管内卷绕治疗了三个囊状PCA（P1，P2和P3）（破裂）。随访血管造影显示稳定的动脉瘤闭塞，除了一个基底动脉尖端，观察到复发。结论MMD-颅内动脉瘤常见于颅内出血患者，破裂风险较高。因此,动脉瘤的识别对治疗至关重要。血管内治疗,用线圈或胶水栓塞，是一种安全有效的治疗方法,具有长期良好的效果。
