本邦におけるモヤモヤ病の実態について
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概要
- 論文の詳細を見る
In this presentation, some clinical characteristics were reported based on the statistical analysis derived from 907 patients of moyamoya disease in Japan. <BR>Among 907 patients, 518 were of those we reported in 1973, and other 389 were collected from all of the neurosurgical institutes throughout Japan for the 3 year-period from 1976 to 1978. <BR>The incidence was higher for female than male (_??_: 360, _??_: 547) including 391 children under 15 years old and 512 adult patients over 16 years. There were seen two high peaks at the first (0-9 years) and fourth (30-39 years) decades as age destribution. <BR>Mortality rates were 7.6%(child 2.7%, adult 11.1%). Patients were divided by clinical symptoms into four types: hemorrhage, TIA, completed stroke and seizure. Children had higher incidence for TIA and stroke types (39% in each), while adult patients had for hemorrhage type (65%). <BR>In CT examinations of 222 patients, low density areas were found mainly in the cortical and subcortical regions, on the contrary, high density areas were found mainly in the basal ganglia regions. These findings correspond with the higher occurrence of hemorrhage from the abnormally developed basal moyamoya vascular network and with that of ischemia in the cortical region. <BR>Follow-up study in 271 cases out of later 389 patients revealed high mortality rates of 22% in hemorrhage type patients among four clinical types, and favourable outcome (active and self-sustained) in 58% of them. <BR>Recently vascular reconstructive surgery has become more popular and shows good results for TIA and stroke patients. <BR>Some authors have an idea that the vascular reconstruction will prevent the recurrence of hemorrhage in hemorrhage type patients, because the load to the basal moyamoya vessels will be decreased by an increase of blood flow to the cortical vessels through the anastomotic channels formed by surgery. <BR>However, this is still controversial and a careful long-term study of the natural history of the patients with hemorrhage will be necessary to prove the effectiveness of the reconstructive surgery.
- The Japanese Society on Surgery for Cerebral Strokeの論文
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