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Abstract Details

Unraveling Moyamoya- a clinico-radio-etiological study from India
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (8:00 AM-9:00 AM)
4-006
To assess Clinico-Radio-Etiological profile of MMA in eastern India.
Moyamoya is a chronic progressive occlusive intracranial vasculopathy of unknown cause with characteristic angiographic findings, known to differ among populations with different ethnicity. This is the largest Indian study on MMA to our knowledge.
It is a single centre descriptive type of observational study from tertiary care center in India that included consecutive seventy-six patients having angiographic findings suggestive of MMA. Their epidemiological, clinical and radiological parameters were documented and statistically analyzed. ABBREVIATION MMA-Moyamoya Angiopathy M:F-Male:Female
Among seventy-six patients with MMA, forty(52.6%) were adult(M:F1:2.3) and thirty-six(47.4%) were pediatric(M:F-1:1). No familial associations were seen. MMS constituted 18.4% of cases, common associations were atherosclerosis(42.9%), thalassemia(28.6%). 38.2% patients were diagnosed as MMA only on recurrence of neurological symptoms, mean age at diagnosis and age at onset of first neurological symptom were 33.5years and 32.1years in adults, 7.4years and 4.2years in pediatrics respectively. The common symptoms leading to diagnosis were fixed motor paresis(55.3%), headache(13.2%), seizure and cognitive-behavioral changes(9.2%) each. Patients with seizure or headache as the first neurological symptom had maximum delay in diagnosis. Brain imaging revealed infarct in 81.6%; hemorrhage constituted 13.2%, all in adult; no acute insult could be seen in 5.3%. Brain atrophy was seen in 63.2%. Posterior circulation stroke occurred in only 1.3% though it was involved in 56.6%.
Indian Moyamoya is a distinct entity with some features similar to Caucasians and some to Japanese. It is a frequently overlooked cause of stroke in young, often with wide array of nonmotor paretic presentation, failure to recognize which usually leads to a more progressive disease at the time of diagnosis. A huge radiological burden disproportionate to number of acute vascular events, with subtle neurological manifestations like headache or seizure, often with cognitive decline, should raise suspicion of Moyamoya.
Authors/Disclosures
Shambaditya Das, Jr., MD, MBBS (Bangur Institute of Neuroscience)
PRESENTER
Dr. Das has nothing to disclose.
Souvik Dubey Souvik Dubey has nothing to disclose.
Mrinal K. Acharya, MBBS (Bangur Institute of Neurosciences) No disclosure on file
Goutam Gangopadhyay No disclosure on file
No disclosure on file
Biman K. Ray, MD Dr. Ray has nothing to disclose.