Moyamoya - Revision history

Rossdonaldson1: /* Evaluation */

2023-01-25T22:03:54Z

Evaluation

← Older revision		Revision as of 22:03, 25 January 2023
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	==Evaluation==		==Evaluation==
	[[File:Moyamoya disease-MRI T1.png\|thumb\|T1-weighted MR image of moyamoya disease. Flow void in the basal ganglia is indicated by the arrow..]]		[[File:Moyamoya disease-MRI T1.png\|thumb\|T1-weighted MR image of moyamoya disease. Flow void in the basal ganglia is indicated by the arrow.]]
			[[File:MRA Moya-moya-disease.jpg\|thumb\|Left: MIP reconstructed MR angiography of a 11-year-old girl with moyamoya disease.
			Right: healthy patient, for comparison.]]
	*[[Head CT]] and/or [[brain MRI]] are important studies to visualize infarctions and brain hemorrhages.		*[[Head CT]] and/or [[brain MRI]] are important studies to visualize infarctions and brain hemorrhages.
	*CT can show dilation of the sulci accompanies by focal ventricular enlargement.		*CT can show dilation of the sulci accompanies by focal ventricular enlargement.

Rossdonaldson1: /* Evaluation */

2023-01-25T21:54:32Z

Evaluation

← Older revision		Revision as of 21:54, 25 January 2023
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	==Evaluation==		==Evaluation==
			[[File:Moyamoya disease-MRI T1.png\|thumb\|T1-weighted MR image of moyamoya disease. Flow void in the basal ganglia is indicated by the arrow..]]
	*[[Head CT]] and/or [[brain MRI]] are important studies to visualize infarctions and brain hemorrhages.		*[[Head CT]] and/or [[brain MRI]] are important studies to visualize infarctions and brain hemorrhages.
	*CT can show dilation of the sulci accompanies by focal ventricular enlargement.		*CT can show dilation of the sulci accompanies by focal ventricular enlargement.

Rossdonaldson1: /* Background */

2023-01-25T21:52:55Z

Background

← Older revision		Revision as of 21:52, 25 January 2023
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	==Background==		==Background==
	[[File:Circle of Willis en.png\|thumb\|]]		[[File:Circle of Willis en.png\|thumb\|Circle of Willis]]
	*A cerebrovascular disease characterized by progressive stenosis/occlusion of the arteries around the Circle of Willis.		*A cerebrovascular disease characterized by progressive stenosis/occlusion of the arteries around the Circle of Willis.
	*The narrowing or blockage stimulates angiogenesis to provide collateral circulation to the brain.		*The narrowing or blockage stimulates angiogenesis to provide collateral circulation to the brain.

Rossdonaldson1: /* Background */

2023-01-25T21:46:06Z

Background

← Older revision		Revision as of 21:46, 25 January 2023
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	==Background==		==Background==
			[[File:Circle of Willis en.png\|thumb\|]]
	*A cerebrovascular disease characterized by progressive stenosis/occlusion of the arteries around the Circle of Willis.		*A cerebrovascular disease characterized by progressive stenosis/occlusion of the arteries around the Circle of Willis.
	*The narrowing or blockage stimulates angiogenesis to provide collateral circulation to the brain.		*The narrowing or blockage stimulates angiogenesis to provide collateral circulation to the brain.

SeanDenny: /* Clinical Features */

2020-12-14T23:12:49Z

Clinical Features

← Older revision		Revision as of 23:12, 14 December 2020
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	==Clinical Features==		==Clinical Features==
	*The developed collateral circulation is prone to bleeding, aneurysm, thrombosis exhibiting: [[focal neurological deficits]], [[TIA]], [[epilepsy]], and bowel/bladder incontinence.		*The developed collateral circulation is prone to bleeding, aneurysm, thrombosis exhibiting: [[focal neurological deficits]], [[TIA]], [[epilepsy]], and bowel/bladder incontinence.
	*Children predominately exhibit [[ischemic ~~strokes~~]].		*Children predominately exhibit [[ischemic stroke]].
	*Approximately 2/3rd of children exhibit Electroencephalography (EEG) abnormalities: high voltage slow waves that occur during hyperventilation.		*Approximately 2/3rd of children exhibit Electroencephalography (EEG) abnormalities: high voltage slow waves that occur during hyperventilation.
	*Can be associated with atherosclerosis, [[meningitis]], [[vasculitis]], autoimmune diseases, hematological conditions, [[brain tumor]]s, and chromosomal abnormalities		*Can be associated with atherosclerosis, [[meningitis]], [[vasculitis]], autoimmune diseases, hematological conditions, [[brain tumor]]s, and chromosomal abnormalities

ClaireLewis at 22:49, 2 October 2019

2019-10-02T22:49:32Z

← Older revision		Revision as of 22:49, 2 October 2019
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	==Clinical Features==		==Clinical Features==
	*The developed collateral circulation is prone to bleeding, aneurysm, thrombosis exhibiting: [[focal neurological deficits]], [[TIA]], [[epilepsy]], and ~~bowl~~/bladder incontinence.		*The developed collateral circulation is prone to bleeding, aneurysm, thrombosis exhibiting: [[focal neurological deficits]], [[TIA]], [[epilepsy]], and bowel/bladder incontinence.
	*Children predominately exhibit ischemic strokes.		*Children predominately exhibit [[ischemic strokes]].
	*Approximately 2/3rd of children exhibit Electroencephalography (EEG) abnormalities: high voltage slow waves that occur during hyperventilation.		*Approximately 2/3rd of children exhibit Electroencephalography (EEG) abnormalities: high voltage slow waves that occur during hyperventilation.
	*Can be associated with atherosclerosis, meningitis, vasculitis, autoimmune diseases, hematological conditions, brain ~~tumors~~, and chromosomal abnormalities		*Can be associated with atherosclerosis, [[meningitis]], [[vasculitis]], autoimmune diseases, hematological conditions, [[brain tumor]]s, and chromosomal abnormalities

	==Differential Diagnosis==		==Differential Diagnosis==
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	*[[Giant cell arteritis]], [[vasculitis]]		*[[Giant cell arteritis]], [[vasculitis]]
	*[[Head trauma]]		*[[Head trauma]]
	*Basilar ~~Artery Thrombosis~~		*Basilar artery thrombosis
	*Blood ~~Dyscrasias~~		*Blood dyscrasias
	*[[Cavernous sinus thrombosis]]		*[[Cavernous sinus thrombosis]]
	*Cerebral ~~Aneurysms~~		*Cerebral aneurysms
	*Dissection ~~Syndromes~~		*Dissection syndromes (e.g. intracranial [[vertebral and carotid artery dissection]])
	*Carotid atherosclerosis		*Carotid atherosclerosis
	*~~Fibromusclar Dysplasia~~		*Fibromuscular dysplasia
	*Craniopharyngioma		*Craniopharyngioma

	==Evaluation==		==Evaluation==
	*[[Head CT]] and/or brain MRI are important studies to visualize infarctions and brain hemorrhages.		*[[Head CT]] and/or [[brain MRI]] are important studies to visualize infarctions and brain hemorrhages.
	*CT can show dilation of the sulci accompanies by focal ventricular enlargement.		*CT can show dilation of the sulci accompanies by focal ventricular enlargement.
	*MRI has higher sensitivity for detecting ischemic regions.		*MRI has higher sensitivity for detecting ischemic regions.
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	==Management==		==Management==
	*Symptomatic treatment: decrease [[elevated ICP]], improve cerebral blood flow, control active seizures, pain control , supplemental O2		*Symptomatic treatment: decrease [[elevated ICP]], improve cerebral blood flow, control active seizures, pain control , supplemental [[O2]]
	*Avoid hypotension, hypervolemia, hypernatremia, hypocarbia		*Avoid hypotension, hypervolemia, hypernatremia, hypocarbia
	*Ventricular drainage if there is hemorrhage		*Ventricular drainage if there is hemorrhage

ClaireLewis at 18:30, 27 September 2017

2017-09-27T18:30:37Z

← Older revision		Revision as of 18:30, 27 September 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Hemorrhagic stroke/Ischemic stroke		*[[Hemorrhagic stroke]]/[[Ischemic stroke]]
	*Giant cell arteritis~~/Vasculitis~~		*[[Giant cell arteritis]], [[vasculitis]]
	*~~Cranial~~ trauma		*[[Head trauma]]
	*Basilar Artery Thrombosis		*Basilar Artery Thrombosis
	*Blood Dyscrasias		*Blood Dyscrasias
	*Cavernous ~~Sinus Syndrome~~		*[[Cavernous sinus thrombosis]]
	*Cerebral Aneurysms		*Cerebral Aneurysms
	*Dissection Syndromes		*Dissection Syndromes
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	==Management==		==Management==
	*Symptomatic treatment: decrease elevated ~~intracranial pressure~~, improve cerebral blood flow, control active seizures, pain control , supplemental O2		*Symptomatic treatment: decrease [[elevated ICP]], improve cerebral blood flow, control active seizures, pain control , supplemental O2
	*Avoid hypotension, hypervolemia, hypernatremia, hypocarbia		*Avoid hypotension, hypervolemia, hypernatremia, hypocarbia
	*Ventricular drainage if there is hemorrhage		*Ventricular drainage if there is hemorrhage

Rossdonaldson1: /* Evaluation */

2017-09-19T11:10:56Z

Evaluation

← Older revision		Revision as of 11:10, 19 September 2017
Line 26:		Line 26:

	==Evaluation==		==Evaluation==
	*Head CT and/or brain MRI are important studies to visualize infarctions and brain hemorrhages.		*[[Head CT]] and/or brain MRI are important studies to visualize infarctions and brain hemorrhages.
	*CT can show dilation of the sulci accompanies by focal ventricular enlargement.		*CT can show dilation of the sulci accompanies by focal ventricular enlargement.
	*MRI has higher sensitivity for detecting ischemic regions.		*MRI has higher sensitivity for detecting ischemic regions.
	*Magnetic Resonance Angiographic studies can demonstrate occlusions within the circle of Willis and better visualize the collateral vasculature. It is preferred over CTA in most institutions.		*Magnetic Resonance Angiographic studies can demonstrate occlusions within the circle of Willis and better visualize the collateral vasculature. It is preferred over CTA in most institutions.

	==Management==		==Management==

Rossdonaldson1: /* Clinical Features */

2017-09-19T11:10:38Z

Clinical Features

← Older revision		Revision as of 11:10, 19 September 2017
Line 7:		Line 7:

	==Clinical Features==		==Clinical Features==
	*The developed collateral circulation is prone to bleeding, aneurysm, thrombosis exhibiting: focal neurological deficits, TIA, epilepsy, and bowl/bladder incontinence.		*The developed collateral circulation is prone to bleeding, aneurysm, thrombosis exhibiting: [[focal neurological deficits]], [[TIA]], [[epilepsy]], and bowl/bladder incontinence.
	*Children predominately exhibit ischemic strokes.		*Children predominately exhibit ischemic strokes.
	*Approximately 2/3rd of children exhibit Electroencephalography (EEG) abnormalities: high voltage slow waves that occur during hyperventilation.		*Approximately 2/3rd of children exhibit Electroencephalography (EEG) abnormalities: high voltage slow waves that occur during hyperventilation.
	*Can be associated with atherosclerosis, meningitis, vasculitis, autoimmune diseases, hematological conditions, brain tumors, and chromosomal abnormalities		*Can be associated with atherosclerosis, meningitis, vasculitis, autoimmune diseases, hematological conditions, brain tumors, and chromosomal abnormalities

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Background */

2017-09-19T11:07:58Z

Background

← Older revision		Revision as of 11:07, 19 September 2017
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	==Background==		==Background==
	*~~MoyaMoya is a~~ cerebrovascular disease characterized by progressive stenosis/occlusion of the arteries around the Circle of Willis.		*A cerebrovascular disease characterized by progressive stenosis/occlusion of the arteries around the Circle of Willis.
	*The narrowing or blockage stimulates angiogenesis to provide collateral circulation to the brain.		*The narrowing or blockage stimulates angiogenesis to provide collateral circulation to the brain.
	*On ~~X-ray Angiography~~ these small blood vessels give off a puff of smoke appearance also known as MoyaMoya in Japanese.		*On angiography, these small blood vessels give off a "puff of smoke" appearance (also known as "MoyaMoya" in Japanese).
	*The disease is found more commonly in Asian countries and was first descried in Japanese literature in 1957.		*The disease is found more commonly in Asian countries and was first descried in Japanese literature in 1957.
	*There is mounting evidence there is a genetic cause of the disease.		*There is mounting evidence there is a genetic cause of the disease.