Clinical features of familial juvenile cases of moyamoya disease: analysis of patients treated in a single institute over a 28-year period

Clinical article

Maki Mukawa M.D., Tadashi Nariai M.D., Ph.D., Yoshiharu Matsushima M.D., Ph.D., and Kikuo Ohno M.D., Ph.D.
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  • Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
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Object

The authors compared the clinical features between familial and sporadic cases of moyamoya disease (MMD) by retrospectively analyzing data on patients with MMD registered in the database of Tokyo Medical and Dental University over a period of 28 years.

Methods

In total, 383 patients with hospital records at Tokyo Medical and Dental University from 1980 to 2007 were registered into the database. The data on all of these patients were retrospectively reviewed to clarify the occurrence of familial cases. Clinical features of child or adolescent patients (< 20 years of age) with MMD were compared between familial and sporadic cases in a subgroup of patients who were registered after 1995, initially diagnosed using MR angiography, and assessed using an intelligence scale.

Results

Familial occurrence was observed in 59 patients (15.4%) in 40 pedigrees. The clinical features of juvenile patients were analyzed in 124 patients, 22 (17.7%) of whom had familial histories. In comparison with the sporadic cases, patients with familial histories were significantly younger at onset (4.7 vs 6.6 years old), had significantly more cortical infarction (59.1% vs 25.5%), and had significantly more stenoocclusive lesions in the posterior cerebral artery (45.4% vs 24.5%). The rate of patients with intellectual disturbance (intelligence quotient < 75) was significantly larger in the familial cases (47.4%) than in the sporadic cases (17.8%).

Conclusions

This survey of the clinical features of familial MMD suggests that patients with familial MMD had a more serious clinical course in childhood than the sporadic MMD cases.

Abbreviations used in this paper:IQ = intelligence quotient; MMD = moyamoya disease; PCA = posterior cerebral artery.

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Contributor Notes

Address correspondence to: Tadashi Nariai, M.D., Ph.D., Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. email: nariai.nsrg@tmd.ac.jp.

Please include this information when citing this paper: published online May 31, 2013; DOI: 10.3171/2013.4.PEDS12420.

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